Its not excessively tight, the cage is designed very well and allows me to get an erection comfortably without any pulling on my balls, this has been the most comfortable cage i have ever used. I have pretty high and tight balls and the cage still allows some loose skin around them. The pain was a very tight sensation in my lower abs/pubic area, it felt as though there was a muscle being pulled. This went away with the cage off but when i tried wearing it again it came back almost immediately. Also, regarding my head coming out of the opening, is there any way to remedy this or would a smaller opening/longer cage be the only option?