Use of Anti-Inflammatory Prior to Climax

[yorkere]

My first flare had occurred a morning after ejaculation; this first episode signaled the onset of Prostatitis, several months ago (My first posting is in "other treatments"). A repeat of this a few days later resulted in a worsening of symptoms. This caused me to try a rather long period (driven by fear) of abstinence/avoidance, to the point where erotic thought during attempt to sleep actually induced a climax. This was followed a few seconds later by a strong, hard, dull blast of protest in my perineum. A couple of Advils allowed sleep; the following several weeks were the usual routine of discomfort with varying short periods of no pain or discomfort followed by relapses.

A faculty urologist at a nearby university medical school advised that regular ejaculation was usually beneficial in trying to persuade this thing to resolve for good, and that taking an ant-inflammatory prior to climax may head off any adverse effect. Three or 4 months prior to this I'd already tried a week long bout of 800mg tabs of Ibuprofen 3 times a day (this was prescribed by my regular doctor), which had moderated my symptoms a lot, so I decided to give this a try.

A couple of 200mg tabs of Advil just prior to ejaculation evidently did the job; no burst of any serious protest! Another result was moderation in the occurrence of episodes of right testicular pulses of dull pain, to the point of almost disappearance. As well, I tried to follow the advice I noted on this Forum to relax as much as possible during the event. I don't know, of course, whether this will continue....I haven't noted any other postings which specifically discuss this "technique" of regular use of an ant-inflammatory; does anyone have any experience with this?. My guess is that relieving the testicles of over storage and triggering the prostate into functioning may be of powerful benefit?

I'd appreciate any thoughts on this!

[webslave]

800mg tabs of Ibuprofen 3 times a day

2400mg is double the normal OTC dose; fine under medical supervision, but not recommended long term at all.

A couple of 200mg tabs of Advil just prior to ejaculation evidently did the job; no burst of any serious protest!

You're the first person to report this technique. Others can try it and follow up here.

[yorkere]

Webslave:

I'm well aware that these dose levels are very high; when my Dr. prescribed this I was REALLY concerned about it, but a week of it and then OFF didn't sound so bad. However I do agree that too frequent applications of such an approach is pretty damned risky. I was advised that a separation period of a couple of months might be appropriate....

My query was really focused on use of fairly moderate ammounts shortly prior to any sex...

[yorkere]

After waiting about a week; I decided to try a repeat; this time I took only one 200mg tab of ibuprofen. After climax, there was a perceived feeling of intermittently occurring slight pressured discomfort in the forward half of the perineum. I'm pretty sure this was dampened by the ibuprofen. This interfered a bit with attempt to sleep a bit, but not that much. The next morning there was a sensation of tenderness in the area, which seemed to fade quite a bit after rising. There remains a slight sensation of discomfort when standing and relaxing almost to the point of urination. This is mostly noticeable while resting most of body weight on one foot or the other, but is also noted while standing equally on both feet.

But at least there's been no hard yell out of the prostate...

This leads me to the question: Does a diminishing painful response of the prostate after ejaculation (either immediate, or delayed) an indication that the gland is beginning to recover (albeit very slowly)? Apparently my uro was correct in advising that some attempt at regular ejaculation was beneficial.

My diet still carefully avoids caffeine (coffee, chocolate) and spicy stuff. I'm convinced this has had a BIG positive effect...I also believe that Webslave's advice to attempt relaxation during ejaculation as much as possible is very helpful.

[webslave]

Pain after ejaculation is not necessarily originating in the prostate, but rather the nerves to the pelvis.

[yorkere]

Webslave:

Thanks for the correction; I was aware of this, thanks to this forum. Guess I was automatically referring to the prostate vice a more general term...due to the advice I've received as well as what I've learned from this forum regarding the need to try to function normally.

[strobers]

Ejaculation is what started me problem too. I won't go into it here, if you are interested you can read my case. It's pretty comprehensive.

I went from a four month flare, to a three week flare, to an eight hour flare to no flare over the course of 15 months. Abstinence, my personal protocol and taking a valium 1/2 before "blast off" seems to have helped a lot. I also attribute the work with my hypnotherapist to have helped immensely.

When you do get well, don't make the mistake of over doing it sex wise. I'm waiting a month this time around to see how things go. If I do fine, then I will go two weeks and if I'm fine then, I'll go one week and stay there. The force of an orgasm is extremely distressing to a hyper-sensitive pelvic area. It's probably best to not to let you little head rule your big head for a while.

[yorkere]

Strobers:

Thanks for your interesting response; valium is an anti-depressant, is it not? Regarding your stating that "Abstinence, my personal protocol and taking a valium 1/2 before "blast off" seems to have helped a lot."; I discovered, much to my dismay/chagrin that I actually suffered some really uncomfortable symptoms after ~3 or 4 weeks. Erections would be very quick in reponse to arousal, with an undercurrent of aching discomfort present. Arousal without release would result in a worsening of perineal discomfort the next day...this crap kept up 'till I made the decision to try for climax again (a period of about 6 or 7 weeks). As well, about 2 days prior to this attempt, my right testicle had begun bouts of sudden shooting pangs of aching discomfort. The morning after my successful attempt (Climax without a penalty) these testicular episodes occurred about 5 or 6 times that next day, but only for a few seconds at a time; then disappeared, with no recurrence since. It's been 4 days now, and for 3 mornings so far the whole affliction has been less and less each morning. I kinda hate to put this into words for fear I'll re-awaken a sleeping dragon, but I'll do it anyway: It's beginning to look as if this thing may be on it's way OUT!! I do realize I may be premature with this; based on what I think I've learned from this Forum I know that this thing can be quite treacherous. At any rate, it looks as if in my case, that persuading my prostate to function is beneficial...

You didn't post your personal protocol, but mine is only to STAY away from caffeine in any form, and try hard to avoid overly spiced foods.....

[webslave]

Yorkere, valium is a tranquilliser not an antidepressant.

From the sounds of it, you may have had ejaculatory duct obstruction (EDO), which can cause pain and is easily confused with CPPS. Just a thought. chronic prostatitis / chronic pelvic pain syndrome coming on for the forst time in a man of your age is very unusual. A TRUS can help to diagnose EDO.

BJU Int. 2007 Jun;99(6):1335-9. Epub 2007 Apr 6.

Painful ejaculation.
Ilie CP, Mischianu DL, Pemberton RJ.
Department of Urology, Central Clinical Emergency Military Hospital, Bucharest, Romania. [email protected]

We reviewed previous publications on post-orgasmic pain with reference to prevalence, epidemiology and treatment options, using the Ovid and PubMed (updated May 2006) databases to comprehensively search MEDLINE for reports on post-orgasmic pain that included peer-reviewed English-language articles. Official proceedings of internationally known scientific societies were also assessed. Because of the heterogeneity of the studies we did not apply meta- analytic techniques to the data. The incidence of post-orgasmic pain is 1-9.7%. The ejaculatory pain is associated with prostatitis, chronic pelvic pain syndrome, benign prostatic hyperplasia, and ejaculatory duct obstruction; it is also described in patients after procedures like radical prostatectomy. Aetiopathogenic theories include those referring to bladder neck closure and pudendal neuropathy. The treatment options vary from self-care, a 'perineal hyperprotection programme' to medication with the alpha-blocker, topiramate, and even surgical procedures like removing a section of the sacrotuberous ligament, neurolysis of the pudendal nerve or removing a section of the sacrospinous ligament. This is the first update of the subject, with reference to prevalence, epidemiology and treatment options. There is a need for adequately powered, prospective randomized trials on aetiology and treatment options.

[yorkere]

Webslave:

Thanks for the correction; I remember now, many years ago I was trying to prepare for my Master's oral exams; my eye began a nervous twitch that drove me nuts during that period. I went to a campus Dr. and he prescribed Valium. It worked, but in what I at the time thought was a peculiar way: the twitching kept right on; I just didn't give a damn!!

Anyway, your comment about my possibly having an ejaculatory duct obstruction sounds quite reasonable to me, but I'm STILL feeling mild perineal discomfort, and pressing on the perineum and then releasing still results in a sensation of returning congestion in the area....sitting at a PC for awhile seems to slightly enhance this, mostly noticeable when abruptly standing. This perineal "heaviness" is also evident while walking. However, the condition seems to be rather subdued these days, but not necessarily diminishing to zero. At least, not yet. This persistent symptom still kinda indicates CPPS....as well, the intermittent sensations of dull aching for awhile in the perineum after the event despite one tab of Advil.

I might add that I'm convinced this whole condition was brought on by the infection resulting from a botched catheter insertion for a bladder capacity test after PVP surgery.

And thank you for the journal abstract! I'm wondering what their term 'perineal hyperprotection programme' meant! To the unsophisticated reader, that might mean wearing a damned diaper! By the way, what is a "TRUS"?

[webslave]

A 'perineal hyperprotection programme' probably refers to sitting on donut cushions, avoiding bike riding etc.

A TRUS is a transrectal ultrasound.

[yorkere]

Webslave:

Thanks for the TRUS clarification; I don't think I would enjoy going through the procedure after viewing the "Needle Taking Sample" part of the illustration! Besides, since this li'l difficulty has seemed to clear up after my "prostate flush", I don't think I'd really need to find out about anything...and I hope it stays this way.

At any rate, the slight murmurs/mumbles of discomfort in my perineum seem to be occurring with a bit less frequency during the day. The cushions I've bought are indeed helpful, but apparently they can't cause a miracle...

[webslave]

The needle only takes a sample when the procedure involves a biopsy, which wouldn't be the case with you.

[yorkere]

Evening of 31 July, another prostate "flush" was induced after an Advil...during that day, there were no real symptoms noted and today (1 August), still no symptoms as yet....I am still adhering to a caffeine-free and spicy-food free diet. If I can just keep this up for ~a week, I'll begin to feel a bit confident that I'm on my way OUT of this....Webslave, thanks for being so powerfully helpful during this period; I know from other posts that you have much more than your share of difficulties. Is there a history of your own experiences somewhere on this Forum?

A short note: For several months I've been battling an occurrence of what I guess is a sub-set of sinusitis; ear Eustachian tube blockage problems. I've been to two ENT Doctors; each one had a different approach and it was a little obvious that they were kinda guessing. I then discovered there is an OPPOSITE condition called "patulous eustachian tube" which has many of the same symptoms, but is a condition where the tube(s) remain OPEN, vice closed. I know from reading what's on this site that there seems to be a statistical nexus between sinusitis and prostatitis....I wonder how many others on this forum are experiencing the same onsets?

[yorkere]

An update: for a couple of weeks now there's only been mumbles of discontent from the perineum. The onset of these seem to be triggered by my standing in a certain way on my right foot!! Sometimes during the course of a day I can feel a slight surge of this perineum discomfort while going down a flight of stairs. Is this weird or what? It's as if this damned thing is trying to hang on to me by the tips of it's fingers. There is still a very slight surge of vague discomfort when depressing the perineum by hand, then releasing, so I know the condition is still there, albeit relatively dormant.

I realize that my descriptions of what I've been going going through are quite trivial as compared with what so many others who contribute to this Board have to relate. I've been well aware that I've run a risk of running smack into the same extreme conditions as described elsewhere. By paying close attention and homage to what I needed to do I think I may be able to eventually really be rid of this....I hope that by actually putting these words in print that I'm not challenging/provoking fate...