an illustration comparing a normal penis versus a penis with hard flaccid syndrome

Hard Flaccid Syndrome

Hard Flaccid Syndrome (HFS), sometimes simply referred to as HF, is a sexual disorder that is only gradually being recognised as a sexual medical issue. Sufferers typically report that their penis is in a constant semi-rigid and semi-flaccid state and feels firm to the touch even without sexual stimulation.

For some sufferers the penis feels numb at rest, but the worst-case scenario is constant pain.




If you have developed Hard Flaccid Syndrome, don't be alarmed

We have a number of therapies that can help you overcome this.  




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What Causes Hard Flaccid Syndrome?

The precise cause of the condition is unknown, though there are a number of theories about what causes it including, injury to the pelvic floor or tailbone, penile trauma – sometimes during sexual intercourse, vigorous masturbation, and stress.

HFS doesn't only affect the way the penis looks and feels when at rest - it Affects a man's ability to get an erection, thus making it difficult to engage in penetrative intercourse. In many instances it also makes it difficult and painful to pass urine or have a bowel movement.

Penile sensory and changes in appearance, are the main features of HFS and serve to distinguish it from classic Chronic Pelvic Pain Syndrome (CPPS) or Benign Prostatic Hyperplasia (BPH).

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Common Complaints Among HFS Patients

The majority of the HFS patients are usually in their 20's and 30's and symptoms vary from patient to patient, but they usually seek medical advice due to the following common complaints:

  • Firmness or rigidity in the penis when it is flaccid.
  • No morning erections
  • Decreased libido.
  • Penile numbness
  • Painful ejaculation
  • Painful urination or a weak urine stream
  • Penile deformity (indentation), which is often variable with erections.
  • Pain and erection difficulties especially when standing.
  • Numbness and/or coldness and/or burning pain in the penis head or shaft.
  • Red and dry foreskin
  • Difficulty getting or maintaining erections (erectile dysfunction)
  • A need for more stimulation to achieve an erection.
  • Anxiety and depression often worse during times of stress





a diagram contrasting a flaccid penis versus an erect penis

Causes of Hard Flaccid Syndrome

As of yet medical science hasn't been able to fully explain why and how hard flaccid syndrome actually occurs. The research is still ongoing. However, we do have some understanding on the development of HFS.

  • Erections occur when there is relaxation of the muscle of the corpora cavernosa. When these muscles relax, blood is able to flow into the penile tissues and the penis gets erect.
  • In hard flaccid syndrome, these muscles become tense and lose their ability to relax, which restricts the free flow of the blood within the penile tissues. Due to insufficient blood supply, the penis won't get fully erect and thus men suffer from Erectile Dysfunction.  
  • Physical damage can also be a major cause of hard flaccid syndrome. Physical trauma in the penis and its surrounding region can damage the nerves. It can affect the functions of these nerves and restrict the free blood flow in the process.  As a result, aggressive intercourse or penile trauma can induce HFS.
  • Hard flaccid syndrome may also occur due to the imbalance in the nervous system. The “fight or flight” response of our bodies is generated by a reaction of the sympathetic nervous system. Due to this response, blood tends to flow out of the penis instead of in and out, which decreases the ability to have erections.
  • Severe mental stress and anxiety can also contribute to HFS. If someone with hard flaccid syndrome is constantly worried about his issue, then he is more likely to have erectile weakness.

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an illustration showing off shockwave therapy as a treatment for men's sexual health issues

Hard Flaccid Syndrome Treatment

Since it has been recognised as a sexual medical issue, Hard Flaccid Syndrome treatment has included medications for pain management and pelvic floor physical therapy. Men experiencing stress, anxiety or depression have found benefits from counselling.

More recently, our clinic has found that a combination of focussed shockwave therapy and Extracorporeal MagnetoTransduction Therapy (EMTT) can be a game changer for this chronic condition, allowing patients to resume normal sexual intercourse without pain.

Both of these therapies are non-invasive, have no major side-effects and require no incision into the penis. Our focused shockwave therapy utilises special sound waves to increase the flow of blood within the millions of blood vessels in the penile tissues. It will also effectively break down any sort of plaques that restrict blood flow in the penis and free up the blood pathway.

EMTT deals with erectile problems with the help of a strong magnetic field which is delivered to the endothelial cells present in the blood vessels of the penis. In this process, these cells heal faster and start to regenerate. Without proper functioning of endothelial cells, it's not possible to obtain strong erections. From our experience, we can say that the effectiveness of this therapy increases significantly when we use it in conjunction with our focused shockwave therapy.

Additionally, we can use the Tesla Chair to treat the problem as this works on exercising the pelvic floor. An article published in The Journal of Sexual Medicine showed that specialised pelvic floor physical therapy can relieve the overactive pelvic floor.

Treatment is usually undertaken during six or ten sessions over a number of weeks depending on the severity of the condition and the advice of our specialists.

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Hard Flaccid Syndrome FAQs

What Is Hard Flaccid Syndrome?

Hard flaccid syndrome or HFS is a sexual issue which is characterised by the semi hard and semi flaccid state of the penis. In this condition, the penis feels firm when touched even without any sort of stimulation.

Is Hard Flaccid Syndrome Common in Men?

It is not as common as Erectile Dysfunction or Peyronie’s Disease. It is a rare issue for men, but it can occur to anyone. If you believe you are suffering from it, you should seek medical advice.

What Are the Causes of Hard Flaccid Syndrome?

The exact cause of HFS is still not crystal clear, but some factors have been identified as possible causes. Penile trauma or damage due to aggressive intercourse and masturbation, imbalance in the nervous system and tensed muscles of corpora cavernosa are some of the possible causes of HFS. Stress can also be a major issue.

What Are the Symptoms of Hard Flaccid Syndrome?

Some of the common symptoms of HFS are that the penis will feel rigid even if it is in a flaccid state, lack of morning erections, painful urination, and ejaculation, reduced sexual desire, pain in the penis head, red and dry foreskin of the penis and Erectile Dysfunction.

Can I Suffer from ED Due to Hard Flaccid Syndrome?

Yes. Erectile Dysfunction is one of the symptoms and consequences of HFS. Your ability to obtain and sustain strong erections can decrease due to HFS.

How Does Hard Flaccid Syndrome Cause ED?

During an erection, muscles of the corpora cavernosa relax and therefore blood can flow within the penile tissues - This is how erections occur. But in hard flaccid syndrome, these muscles get tensed and therefore can’t be relaxed properly: blood cannot flow freely inside the penile tissues. The lack of blood supply in the penis leads to ED.

How Can I Decide Whether I Am Suffering from ED Only or From Both ED and Hard Flaccid Syndrome?

In hard flaccid syndrome, your penis will be semi hard even in a flaccid state. ED does not have such symptoms: If you fail to obtain and sustain strong erections, then you are suffering from ED. But if you feel your penis stays semi hard even when it’s flaccid and you are also suffering from erection problem then understand that you may be suffering from both ED and HFS.

Is Hard Flaccid Syndrome Treatable?

Yes, Hard flaccid syndrome can be treated. Up until recently there were limited treatments for this issue, with standard treatments involving medications to reduce pain and pelvic floor physical therapy. Thanks to technological advancements, procedures like focused shockwave therapy and EMTT have been shown to be effective.

Can Shockwave Therapy be Used to Treat Hard Flaccid Syndrome?

Shockwave therapy can be used to treat hard flaccid syndrome we use focused shockwave therapy as it is more effective than other types of shockwaves and also use it in combination with Extracorporeal MagnetoTransduction Therapy (EMTT) to increase the blood flow within the penile tissues and to promote the growth and regeneration of endothelial cells. These mechanisms effectively treat HFS and increase the ability of our patients to obtain strong and spontaneous erections.

How Many Shockwave Sessions Are Required to Treat Hard Flaccid Syndrome?

It really depends on the individual patients. Our standard shockwave protocol for HFS is either six or ten sessions




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