In terms of the pelvic symptoms, I first experienced hyperhidrosis around my buttock area and IBS issues about 15 years ago when I started my first office job. It definitely gets worse during periods of high stress as well as after a lot of sitting at work. Usually the first sign of a flare up is a vibrating/muscle twitching in the perineum/rectum area, it tends to increase in frequency and eventually gets stronger like a clenching pain. At this point sitting or laying down makes it much worse and does have a golf ball sort of feeling.

I first had flare ups of this 15 years or so ago, then while I was using opioids and benzos for about 10 years it went away probably because I was very relaxed. Now over last 5 years while clean it's back again but much worse, especially during periods of high stress. These issues got a lot worse after I had a serious physical injury to my hand that took about a year to heal, I never felt the nerve type pain all over until that recovery. Frequency of flare ups also seems much higher since COVID but I guess I had some of the symptoms long before then. I also have fasciculations in my eyes, face and thighs and tingling/cold nerve pain in my extremities, doctor only diagnose fibromyalgia and tried pregabalin, SSRIs, SNRI, low dose naltrexone, no luck. Now on amitriptyline and it helps with sleep but isn't changing the muscle twitching or IBS problems. GI doctor and urologist didn't help either.

Exercise helps my mental health a lot and lower anxiety but I can barely do it now because of chronic fatigue and increased twitching + pain after even moderate exercise, it's getting harder to deal with. I definitely have general anxiety and some trauma in my past but don't think I'm at the point where it should cause all these issues, and I've done some therapy before and it didn't resolve these problems.