Patient: Hi, I am a male and I’m 19 years old and I’ve got a question regarding something that has been happening to me recently that I can’t explain and would love if you could help. It’s been happening for just under a month now, well it’s been happening ever since I started to notice it (which I think could be part of the problem). Whenever I’m around someone that makes me very nervous or anxious I start to worry. However, I seem to notice a feeling particularly in my penis. It’s often the case that for some reason (possibly due to my anxiety or insecurity about my sexuality) I get this sort’ve tingly sensation in my penis. Sometimes it feels uncomfortably sensitive and other times it just feels like a very uncomfortable pressure. When I experience it, it makes me feel very uncomfortable and the more I focus on it the more intense it feels. I often feel it in awkward situations or inappropriate situations where I’m anxious or nervous about getting aroused by people I know I’m not sexually attracted to in any way and it’s almost a knee jerk reaction now where if I’m in an environment that makes me worried in that way I’m always concerned and being very aware of any sort of feelings or slight movements in the lower area of my body and I can’t help but focus on that area which makes it worse. It’s becoming a regular and uncomfortable experience for me and I feel if I could get some sort’ve explanation for why this actually happens it could help control it and it wouldn’t make me so uncomfortable and distress me. I feel like I do suffer from some anxiety related disorder but I’d like to know why this is happening from a biological/scientific perspective. Is it because I’m focusing on my penis involuntarily because I’m worried about what’s going on down there? It’s also worth mentioning that the tingly sensitive feeling feels kind of similar to arousal but not how I usually feel when I’m sexually attracted to someone and get sexually aroused by them (I’m sexually attracted to women). This feels different and is very uncomfortable and occurs when I catch a glimpse of someone or if I enter an environment that makes me nervous. In these situations I often feel my heart jump first from fear and then the tingly sensitivity sensation in my penis. Finally, because it’s so sensitive in this state in feels like if I accidently hit it or rub it against something it’d get slightly bigger. I’d really appreciate if you could help explain what is going on here and why. Is it anything to worry about/is it normal? Is this representing some form of sexual arousal or is this because of my anxiety/worry? It could be nothing but I’d just like to make sure and get a better understanding of how my body works. Thank you.
Symptoms: Heart jumping, weird tingly sensation, sometimes increased heartbeat
Doctor: Hello,Thanks for writing to us.I have read your case and can understand your worry.Since this physical sensation i s not present all the time it may not be organic in nature.Usually extreme anxiety can certainly contribute greatly to perceiving abnormal body sensations and this is what panic attacks/ anxiety disorder are all about – they are misperceiving normal body sensations as abnormal, and escalating from there.You seem to be having genitally focussed physical symptoms of anxiety which includes getting tingling and burning sensation, minor pain, uneasiness and even arousal in anxiety situations.This can be associated with other physical symptoms like palpitations, tingling and numbness in body, sweating, trembling,etc.This can be treated by use of anxiolytics like SSRIs mainly Paroxetine, Fluoxetine, etc.. Benzodiazepines like clonazepam, lorazepam etc can be given to treat acute anxiety reaction .Psychotherapy mainly CBT ( Cognitive behaviour therapy) may also help to get relief by working on your cognitive distortions.It is advisable for you to visit your doctor who may prescribe you with one of above options and also guide you with psychotherapy if required.Hope this helps.Feel free to refer back.Regards
Comments / Follow Ups
Patient: Hi thankyou for your answer. I’ve just got a couple of things i’d like to follow up with. Firstly forgive my lack of knowledge but what do you mean by ‘organic in nature’ ? Also, so it’s not due to any hidden sexual desire or attraction im not aware of to anything that i come across and these genetially focussed symptoms from my anxiety are only due to that, my anxiety? Thankyou
Doctor: Thanks for writing back
Your concern for your health is appreciable.
Organic pathology means problem pertaining to organs of body. This is worrisome usually which is not in your case.
These symptoms which are mainly limited to your genitals are due to anxiety as they mainly happen in some social situation or when you are anxious. This refers to problem in underlying anxiety and may be situational/ social anxiety disorder.
Taking course of anxiolytics should help.
Hope this helps
Feel free to write back.
Patient: Thankyou so much doctor i was very worried but this has cleared things up and i will see if i can be put on a course of anxiolytics. Just one final thing, do you know what happens in the body or brain (biologically) that causes these genetially focused symptoms such as arousal? Why does anxiety result in such symptoms? Thankyou
Thanks for writing back your query
Causes of anxiety are multiple as in genetic, environmental, substance/ drug abuse, medical factors, family conflicts, stress at work or in relation.
Biologically there is deficiency of serotonin and to some extent dopamine hormones which cause combination of physical and psychiatric symptoms related to anxiety. Anxiolytics raise serotonin and dopamine and therefore symptoms improve.
Hope I could solve your query
Feel free to write back
Patient: Hi, sorry this is the very last thing i want to ask about it. You mentioned genetially focussed symptoms, it often feels like a tickling sensitivity rather than a painful tingle. Its more of an uncomfortable tickle is that still a typical symptom of this genetial focussed anxiety?
Thanks for asking query.
The physical sensations related to anxiety are usually uncomfortable than being painful.
These symptoms can be present anywhere in body but focussing repeatedly on uneasiness in genitals would increase the awareness of symptoms there than any other part. You are required to stop yourself from paying attention towards that sensation which would require psychotherapy as well apart from medications.
This seems to be anxiety related than any worrisome cause.
Hope this helps.