However, it can also occur as a side effect of anti-hypertensive medications used to treat high blood pressure.  In the PPOD syndrome patient erectile dysfunction is caused by impairment of the neurologic reflexes that normally lead to engorgement of the erectile tissues in the penis.  As a result, even with intense arousal and physical stimulation the penis remains flaccid and is incapable of becoming sufficiently firm to engage in intercourse.

One of the features of PPOD syndrome related erectile dysfunction is that in most cases (there are exceptions) there will usually be an accompanying loss of sensory perception to touch or contact over regions of the penis.  This loss of sensory perception indicates sensory nerve impairment and is one of the factors involved in disturbing the normal reflex activity associated with penile engorgement.  Refer to cases 5 and 13 for examples of the response of impotence to PPOD syndrome treatment.

Furthermore, in both sexes anorgasmia can occur as a secondary effect of many of the commonly prescribed anti-depressant medications.  The disorder is classified as being either primary or secondary.  Primary anorgasmia exists when a sexually active woman has never been able to experience orgasm at any time in her life.  Studies have revealed that 10-25% of all women have never been able to achieve orgasm, and as a result, suffer from primary anorgasmia.

Secondary anorgasmy, which is present in approximately one third of all women, occurs when a previously orgasmic woman has lost the ability to achieve normal orgasm.  In PPOD syndrome patients anorgasmia is a common symptom occurring in both sexes. In male PPOD patients it is most frequently of the secondary type, usually having developed in association with erectile dysfunction.  However, in the female PPOD patient, anorgasmy can be either primary, as a result of having developed the PPOD syndrome prior to becoming sexually active, or secondary as a result of having developed the PPOD syndrome later in life.

In the female PPOD syndrome patient, anorgasmia is often times found in association with other symptoms of sexual dysfunction such as dyspareunia, vulvodynia and loss of sexual desire or libido.  In men, there may additionally be orchialgia and/or phallodynia.  Fortunately, as is the case with most of the symptoms related to the PPOD syndrome, the symptom of anorgasmia is usually very responsive and effectively treated by PPOD therapeutic protocols.  Refer to cases 4, 7, 10, 11, 12, 14 and 16 for the response of anorgasmia to PPOD syndrome therapeutic protocols.

In others still, there may be a complete loss of bladder function with total urinary retention that either, requires periodic catheterization (the insertion of a tube into the bladder through the urethra) in order to empty the bladder, or, is accompanied by overflow incontinence (incontinence that occurs because the bladder has filled beyond it‘s capacity).

In the early developing stages, when the symptoms of difficulty and retention are relatively mild, there is often accompanying symptoms of urinary frequency and/or urgency. However, when the symptoms of difficulty and retention become more severe the patient will usually find that rather than having to empty their bladder more frequently, they’re actually having to void less often and may even go the entire day without feeling any significant urge to empty their bladder.  Sometimes this will be accompanied by suprapubic distension that gives the impression that the female PPOD syndrome patient may be in the early stages of pregnancy.  Refer to cases 4, 10, 15 and 16 for the response of urinary retention to PPOD syndrome treatment.

With stress incontinence urinary loss occurs as a result of any type of activity that has the effect of raising the intra-abdominal pressure (and hence, pressure within the bladder) beyond the point where the urethral sphincter is able to restrain and prevent urinary loss.  As a result, the high pressure within the bladder forces urine past the urethral sphincter causing incontinence to occur.  Common examples of activities that can raise the intra-abdominal pressure sufficiently to result in urinary loss include coughing, sneezing, straining, bending, lifting and, if the condition is severe enough, even just a change in body position. There are several factors that can contribute to the development of urinary incontinence, but the most common involve injury or damage to the musculature and/or nerves of the pelvic floor that serve to maintain normal support necessary to preserve normal bladder function and urinary control.

Pregnancy, childbirth, accidents and falls are common events or mechanisms that can cause injury to these muscles and nerves, and are also common mechanisms for causing the type of spinal disorder leading to urinary incontinence that develops in the PPOD syndrome patient. While stress incontinence is the most common type of urinary incontinence that occurs overall, it is also the most common type of urinary loss seen in the PPOD syndrome patient. However, urge, mixed, neurogenic and overflow incontinence are also found in the PPOD syndrome patient, and generally respond every bit as well as does stress urinary incontinence to PPOD syndrome therapeutic protocols.  See cases 4, 10, 15 and 16 for examples of the response of urinary incontinence to PPOD syndrome treatment.

Fecal or anorectal incontinence occurs in approximately 10% of both men and women, however, in individuals who suffer symptoms of irritable bowel syndrome, it’s prevalence rises to approximately 20%.  In the PPOD syndrome patient fecal incontinence is usually caused by damage to the nerves that control normal pelvic floor and anal sphincter muscle function. The nerve damage that occurs in these cases is the result of an underlying spinal disorder which results in weakness of the muscles that normally restrain and prevent passage of stool from the rectum.  In this weakened state, the normal peristaltic activity of the large bowel can force stool past the anal sphincter and result in fecal incontinence.

There are generally two variations of fecal incontinence as it typically occurs in the PPOD syndrome patient.  In the first instance nerve damage is confined to the nerves that initiate contraction of the muscles that prevent incontinence from occurring.  In these cases, because sensory nerve function to the rectum remains intact, the individual finds that they are able to consciously sense the leakage of stool as it occurs.  However, because of the weakness of the pelvic floor and anal sphincter, they are unable to contract these muscles with sufficient strength to prevent fecal incontinence from occurring.  In the other variation, some PPOD patients with fecal incontinence have additionally lost normal sensory perception of the lower portion of the rectum and anal canal, and as a result cannot tell when the rectum is full or when they are passing stool.  In these cases fecal incontinence can occur without their consciousness awareness of the event having occurred.  Refer to cases 8, 15 and 16 for examples of the response of fecal incontinence to PPOD therapeutic protocols.

In the PPOD syndrome patient, the pain is usually described as a deep aching or burning pain, however in some individuals it can be a sharp, stabbing or shooting type of pain, while in others still, typically those with accompanying bowel dysfunction of either chronic constipation, diarrhea or alternating constipation and diarrhea, it tends to be more of cramping or spasming type of pain.  Oftentimes it will be aggravated by sitting, sexual intercourse or various types of physical activity.  However, like most of the symptoms associated with the PPOD syndrome, and, as is demonstrated by the case reports, proctalgia usually responds extremely well to appropriate treatment following the PPOD therapeutic protocols.  Refer to Pelvic Pain and Organic Dysfunction cases studies 4, 5, 7, 9, 11, 14, 15 and 16 to see the response of rectal pain to PPOD therapeutic protocols.

Of all of the nearly 4 dozen individual PPOD syndrome symptoms that can potentially develop, chronic pelvic pain is the single most common and prevalent complaint.  However, this one symptom alone can vary greatly from one PPOD patient to the next. For example, some PPOD patients will experience pelvic pain that is confined to a single location, such as the inguinal or suprapubic region.  In other individuals however, their pain may be much more extensive and involve multiple regions within the pelvis, pelvic floor, rectum, vagina and external genitalia (labia, clitoris, scrotum, testicle and penis).  The diagnosis that the individual receives however, is largely dependent upon the specific location of the pain that has developed.

For example, in the absence of some type of abnormality that would otherwise account for their problem, pain in the inguinal region may be diagnosed as inguinodynia or, more generally, simply, chronic pelvic pain syndrome.  Pain in the suprapubic region, depending on whether it is a superficial pain emanating from the abdominal wall, or a deeper pain emanating from the bladder or uterus may be diagnosed as suprapubic neuralgia, cystalgia or cystitis (interstitial), or, metrodynia respectively.  Pain that has developed in the pelvic floor may be diagnosed as pelvic floor myalgia or levator ani syndrome, while pain that develops within the rectum may be diagnosed as proctalgia, prostatodynia or prostatitis.

Although there are exceptions, pelvic pain that develops in the PPOD syndrome patient tends to exhibit certain characteristics. For example, most PPOD syndrome patients will find that their pain will usually be provoked or aggravated, to one degree or another, by various types of movements, positions or activities. Common examples include long periods of sitting or driving in a car, and activities that involve bending, lifting or twisting.  In addition, many PPOD syndrome patients find that their pain is aggravated by intercourse, and, that in a general sense it may exhibit a pattern of being less pronounced in the morning but tending to worsen as the day progresses.

Furthermore, in those who have suffered from PPOD syndrome related pelvic pain for a longer period of time they will often reveal a pattern of progressive worsening of their condition where their initial pain has become more severe in it‘s intensity, and, may have additionally spread to involve other regions within the pelvis, pelvic floor, rectum and external genitalia.  Although chronic pelvic pain tends to be an extremely difficult condition to treat by conventional means, when it exists as a component symptom of the PPOD syndrome it usually responds remarkably well to PPOD syndrome therapeutic protocols.  Refer to case reports 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 14, 15 and 16 to see examples of the variability of pelvic pain and its response to the PPOD syndrome therapeutic protocols that we have developed to treat this condition.

In the case of chronic or recurrent diarrhea in the PPOD syndrome patient the situation is effectively the reverse of that of constipation.  The underlying abnormality is one in which there is a state of hyperactivity (facilitation) of the function of the sensory and/or motor fibers that mediate control over the function of the large bowel and rectum.  Whether this hyperactivity involves the sensory fibers, motor fibers or both, the net result is the same.  There will be excessive colonic activity with exaggerated peristaltic action leading to frequent, loose, watery stools which may be accompanied by excessive gas and mucus discharge.  Refer to case number 16 for the response of chronic diarrhea to PPOD syndrome treatment.

Oftentimes the extreme pain and hypersensitivity will additionally impair sensory perception of the genitalia so that, as an accompanying symptom, the ability to achieve orgasm may be impaired. Deep dyspareunia is pelvic pain that occurs deep within the pelvis (usually in the inguinal, suprapubic or rectal regions), and at times may radiate to the back. In most individuals this pain occurs during the act of intercourse, however in some PPOD patients deep dyspareunic pelvic pain will develop following intercourse, and, may persist for several hours or days afterward.

Not uncommonly, the PPOD syndrome patient may experience both types of dyspareunia simultaneously, or, at different times during the evolution and progression of their condition.  Like most of the symptoms that develop in the PPOD syndrome patient, superficial and deep dyspareunia usually respond extremely well to the therapeutic protocols used in the treatment of this condition.  See case reports 4, 6, 7, 9, 10, 11, 12, 14 and 16 to see the response of dyspareunia to PPOD syndrome therapeutic protocols.

In PPOD syndrome patients the vulvodynia type that occurs most often is the so-called dysesthetic vulvodynia, where burning or sharp pain is felt throughout most of the labia and clitoris and sometimes extends into the lower vagina and perineum.  If the condition is not severe, touch of the genitalia may not be particularly painful.  However, if severe, there can be extreme pain and hypersensitivity to even mild touch or contact of any type.

In some cases however, the vestibulodynia type of vulvodynia prevails in PPOD syndrome patient.  In these cases, rather than pain being experienced throughout the genitalia, it tends to be more localized to the tissues immediately surrounding the vaginal opening and there may be accompanying inflammation and redness.  When present as an accompanying symptom of the PPOD syndrome both types of vulvodynia typically respond extremely well to the PPOD therapeutic protocols.  See case reports 3, 4, 6, 7, 8, 11, 12 and 16 to see the response of vulvodynia to PPOD syndrome treatment.

It may be unilateral or bilateral, and when it is present bilaterally, it may be clearly more intense on one side than the other.  When bilateral testicular pain is present and is clearly more intense on one side than the other, any accompanying pelvic pain will usually (although not always) be more intense on the side of the dominant testicular pain.  Regarding phallodynia, pain in the penis can be somewhat variable in it’s description.

In some cases the pain is described as a sharp or an intense burning pain involving the cutaneous (skin) regions of the penis which makes touch or contact of any type extremely painful, a situation analogous to vulvodynia in the female PPOD patient.  Sometimes this painful hypersensitivity will be accompanied by intermittent periods of diminished sensory perception  which can create a confusing state of alternating painful hypersensitivity interspersed with periods of numbness that can additionally impair sexual function.

In other cases, the pain is more of an internal pain that extends down the center of the penile shaft along the distribution of the urethra.  In these cases urination may provoke a sharp or burning pain within the penis along the urethra.  Although usually a painful burning hypersensitivity and/or numbness may involve the majority of the penis, it can be localized or isolated to the distal half of the penis or penile head.  Refer to cases 5, 9 and 13 for examples of the response of these symptoms to PPOD syndrome treatment.