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Perineum and upper hamstring pain after ejaculation

In April of 2018 I had sex for the first time when I was 16 and instantly had perineum pain and went to the doctor where I was then prescribed rounds of antibiotics for about a 8 months. After having sex, every-time I ejaculated since I have had pain. It began becoming manageable for no sure reason for about 2 years. Now most recently it came back much stronger but my hamstrings are very tight as well.

Was hoping anyone had any ideas or solutions that I could try.

Thanks for the help in advance - this really put me down a dark path before and don’t want to repeat that.
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207091 tn?1337709493
What did they diagnose you with that they gave you antibiotics for?

What kind of doctors did you see?

I don't feel like we can give you suggestions without knowing what they diagnosed you with - I don't want to tell you to do something that might cause you harm. :(
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First 6 months I would have pain for about 3-7 days and a fever that would last a day. I did urinalysis tests and they would give me a range of different UTI medicines which at first helped a little but later on didn’t and this was only when I had sex (with a condom). Later on the fever aspect went away with sex but I continued to have extreme pain in perineum after ejculation and if I had sex without a condom it would be much worse. I tried prostatitis antibiotics as well that didn’t help at all. For about a year 1/2 I was managing it with topical pain reliever and would usually resolve by the next morning.

Now it had came back and I’m currently on day 4 and the pain is persisting without any fever. In addition to premium pain I have lower back pain and hamstring tightness. I live a healthy life style with weight lifting and daily exercise.

Thanks for any help!
So you were on antibiotics for 8 months with no diagnosis?

Did they ever do any imaging? Is there a physical issue causing the problem? A hernia? Something structural? Nerve issue?

I think you should see your doctor before trying anything on your own. I'd start with a urologist, and get some imaging done. Even if you've had it done before, you should get some updated imaging. You are no longer 16 - your body has changed.

Is there a reason you haven't gone back to the doc?
They found the white cells in urine then stopped finding it, I did a flow test, prostate check, and I did imaging- all normal. I stopped going to the doctor because I went on a constant loop of them not having answers and referring me to another doctor or prescribing me antibiotics that didn’t work and my parents didn’t want to keep spending money on it.
Sigh - yeah, that's super frustrating. The only plus might be is if you get some fresh eyes on it with fresh new technology, you might get some fresh new info.

It could also be chronic non-bacterial prostatitis, or chronic pelvic pain syndrome (CPPS).

You were 16 then, living at home. Are you now at college, maybe? In another city? Maybe close to a large research or teaching hospital?

Maybe they have a good urology dept?
I actually attend the University of Washington. I’m going to try to get a urinalysis to see if there’s any new infection causing the flare up. I have also been looking into pelvic floor issues or pundenal nerve damage, right now stuck on not knowing what type of doctor to go to
Ohhh well I found this -


Their urology dept is ranked #26 in the nation. I don't suppose that you get any benefit of using their services as a student, huh?

I think a urinalysis is a good start. Always smart to rule that out.

CPPS can involve pudendal nerve pain/ damage. I found this, which you may have already seen - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7707127

I think I'd start with a urologist. They can do a test to see if it's the pudendal nerve and imaging, and go from there. If it's not that, they can work to figure it out.

Start with the UA though. I hope you find answers. Keep us posted.
Urinalysis came back clear. For pelvic floor syndrome what type of doctor should I see? Haven’t had any improvement besides pain lasting slightly shorter time frame but the pain is still going to the perineum and hamstrings. It happens even if I am hard and but don’t finish, if I finish it is worse. Sounds like it has something to do with the muscles?
A urologist should be able to help. They can refer you for physical therapy, and that can really help.

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