Uncomfortable feeling in Anus/Sphincter

Hello all,

New member. 47 Y/O Male. Started TRT with a local clinic about 1 month ago after very low T results (180 range) and symptoms of low energy, brain fog, weight gain, etc.

Now on my 4th week (200mg/test & 100mg/deca per week, 500IU HCG 2x week, .5MG Tablet Anastrozole 2x week plus a multivitamin, DHEA, and Vitamin D) I started to see positive side effects... more energy, more focus, higher sex drive, better mood, etc.

But the last few days I started getting a sort of slight burning/pressure feeling around my anus or sphincter. Sorry for the visual but I gotta put it out there.

At first I thought maybe I just ate something spicy... it's the same feeling you get when you eat a couple dozen hot wings or spicy chili. But it didn't go away. I sit all day in an office chair, which doesn't help mask the feeling.

Is this normal, temporary or should I be concerned or have something checked?

Thanks for any help.

Get checked for prostatic hyperplasia caused by TRT.

Could explain the pressure; not necessarily the burning afaik.

I seemed to remember something like this back around month 2 or 3 along with hemorrhoids.
The burning didn't last long the hemorrhoids come and go they are right at the sphincter not deep inside.
I'd just wait it out unless it gets really painful.

I assume you had a PSA run prior to the initiation of therapy, an absolutely essential test.

Yes, PSA was part of the blood test and came back normal.

And to clarify... its not so much a burning feeling... more of a pressure. Just uncomfortable. Not horrible at any stretch... just something I noticed.

moehio said:

Yes, PSA was part of the blood test and came back normal.

And to clarify... its not so much a burning feeling... more of a pressure. Just uncomfortable. Not horrible at any stretch... just something I noticed.

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All kinds of weird things happen as your body starts adjusting to an elevated and artificial T source. Some systems are shutting down some are restarting.
You hear guys talk about the honeymoon period, and lots of strange side effect like skin oil production increase, acne, etc . None seem to last more than a few weeks. I believe that is why it is recommended waiting 5-6 weeks minimum before doing blood tests after a change in your protocol.

increasing testosterone to a high level suddenly can cause a bit of a burning pee and swollen prostate.

moehio said:

its not so much a burning feeling... more of a pressure. Just uncomfortable. Not horrible at any stretch... just something I noticed.

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At all times? Or do you feel it more when you're passing stool?

It's probably your prostate. Is your urine stream weaker? You may have prostate inflammation. An actual large prostate ( bph) in the general sense doesnt usually cause pain or pressure. You can have a very large prostate and never know it. Bph doesnt cause pressure, you feel nothing. You just urinate more and your urine stream is weak.
thats why i think you may have inflammation. Go to a urologist, a regular doctor or TRT doc wont know squat. See a Urologist.
prostate inflammation or prostatitis sometimes feels as if you have something stuck in your rectum.

I would get checked for prostatitis and also Chlamydia (just to be sure). Also, read this info :
Male Pelvic Pain: It's Not Always Prostatitis

Hello! I know this is a super old thread, but was wondering the outcome. I have the exact same symptoms…. The pressure, it’s not terrible, but noticeable. I’m 48, on a much lower dose, 100 wk of cyp, 100iu hcg 2x a week. Along w peptides. I feel wonderful. I’ve worked out since i was 15 and feel better than ever. Anyway, i have the pressure in tailbone/ rectum area, wondering what the outcome was

Superclyde said:

i have the pressure in tailbone/ rectum area, wondering what the outcome was

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Get your PSA tested. Also, read the info above about pelvic pain.

PSA is a normal part of panels pre trt screening, mine went from .7 to .9 which is a very small change.. I was just curious about what OP had as a specific diagnoses.

Thank you for the fast response

Also consider proctalgya fugax and anal fissure

This same thing happened to me on TRT with iron deficiency, my anus/sphincter burning so bad it felt like acid.

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Dr.V.P.C. said:

Also consider proctalgya fugax and anal fissure

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Here is an explanation of proctalgia fugax and anal fissure based on the search results:

## Proctalgia Fugax

Proctalgia fugax is a condition characterized by sudden, severe pain in the rectum or anus that lasts for seconds to minutes, with no pain in between episodes. The exact cause is unclear, but it is believed to be due to spasms or contractions of the muscles in the anal canal or pelvic floor. [1][2][3][4]

Some key points about proctalgia fugax:

- It is a transient, fleeting pain that often occurs at night and can be severe enough to wake the patient from sleep. [1][2][3][4]
- It is more common in women than men, and typically affects those between 30-60 years old. [1][2][3][4]
- Potential triggers include stress, constipation, sexual activity, and menstruation, but episodes can also occur without an obvious trigger. [2][3][4]
- It is considered a benign condition that does not require extensive testing or treatment, as the pain resolves on its own. [1][2][3][4]
- Treatment focuses on managing symptoms through relaxation techniques, warm baths, and sometimes medications to relax the anal sphincter. [2][3][4]

## Anal Fissure

An anal fissure is a small tear or crack in the lining of the anus, often caused by passing hard or large stools. [4]

Key features of anal fissures:

- The pain is typically worse during and after bowel movements. [4]
- There may be visible bleeding from the fissure. [4]
- Anal fissures can cause spasms of the anal sphincter muscle, leading to further pain and difficulty passing stools. [4]
- Unlike proctalgia fugax, anal fissures are a structural abnormality that can be diagnosed on physical exam. [4]
- Treatment often involves stool softeners, topical medications, and sometimes surgery for chronic or severe cases. [4]

In summary, proctalgia fugax is a functional disorder causing sudden, severe rectal pain, while an anal fissure is a structural tear in the anal lining leading to pain, spasms, and bleeding with bowel movements. [1][2][3][4]

Sources
[1] Proctalgia Fugax - Physiopedia https://www.physio-pedia.com/Proctalgia_Fugax
[2] Proctalgia fugax and anal pain - Medical News Today Proctalgia fugax and anal pain: Causes, diagnosis, and home remedies
[3] Proctalgia Fugax: Causes, Symptoms, and Treatments - Healthline Proctalgia Fugax: Causes, Symptoms, and Treatments
[4] Proctalgia Fugax and Anal Pain (Levator Ani Syndrome) - Patient.info Proctalgia Fugax and Anal Pain (Levator Ani Syndrome)
[5] Proctalgia Fugax: Symptoms, Causes, Diagnosis, and Treatment - WebMD What Is Proctalgia Fugax?