Perineal damage, blood congestion, pain and sexual orgasm

Reader: 8/2/2001>
Dr. Lin,

About one year ago, while on a large sailboat, I accidently sat down heavily on a large deck cleat. The perineal area and area around the sit bones (ischeal tuberosities) was bruised. Bruises and pain diminished after about two weeks. When sexual activity was resumed, some slight pain at time of ejaculation was noted. Two days after sex, perineal pain returned very strongly with pain across buttocks and pain up into low back. This pain was intense and persisted for several days and then diminished after two weeks. These cycles of intense pain and muscle spasm starting two days after sex continued to occur and did not get better. Perineal pain when sitting persisted. What I originally thought was prostatitis, was later identified as excessive pelvic floor muscle tension and levator ani. There may also be some Pudendal or other nerve involvement. For the past month I have been taking 400mg of Neurontin three times/day, receiving Japanese acupuncture (1hr/week), and Physical Therapy using biofeedback and massage to both relax pelvic floor muscles and also strengthen them (1hr/week). Also, I am doing groin stretches and Kegles with relaxation, daily. I am now feeling much better. Pain level has dimininshed from 4-7 to 1-3. Heat pack applied to perineal area for 5-10 minutes after sex, seems to help prevent muscle spasms. To much heat, (i.e. 15 minutes in hydrotherapy bath at 102 degree F.) causes muscle pain later and seems to not be good. Even though I am feeling better, I still feel pain and congestion in perineal area especially when sitting for moderate periods (1/2 hour to 45 minutes) and also after sex. I think blood congestion in perineal area persists. Visits to specialists (Urologist, Proctologist, Gastroeterologist, Orthopedic Surgeon, and Neurologist) revealed no pathology. Also for past month, I have been taking a chinese herbal formulation "Cinnamon and Poria" from Golden Flower Chinese Herbs. This was recommended by my acupuncturist to reduce inflammation (damp heat) and tension and improve improve blood flow. It seems to help. Do you have any advice or suggestions that might improve blood flow in the perineal area and help me get back to normal?

Sincerely,

Dr. Lin: 8/3/2001>
This is a simple problem - blood congestion in the mechanical damaged tissues which become scars that blocks your blood circulation down there. The local nerves have been damaged, compressed, starved without hormones, and signaled for healing.
You need Vacuum-Cupping Massage (0-003) to remove the blood congestion and dissolve the scar tissues, and ViaPal-hGH-D (3-012) to help repair the damaged nerves and re-establish the local blood circulation.
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It will require vacuum-cupping massage about 6 times to cleanse the blood congestion.
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