Signs and Symptoms

The most indisputable, tell-tale sign and symptom of Hard Flaccid Syndrome (HFS) is a penis that remains in a firm, semi-rigid state in the absence of sexual desire or arousal. Men with HFS will describe their flaccid penises as being firm to the touch, rubbery, wrinkly, shrunken and retracted; some refer to this as “turtling,” comparing the behavior of their flaccid penises to that of a turtle’s head as it backs into its shell. This symptom is often made worse when standing.

Other signs and symptoms:

• Cold feeling in the glans, shaft or entire penis
• Erectile dysfunction; difficulty achieving or maintaining an erection, painful or tight erections, no morning, nocturnal or spontaneous erections
• Paresthesia (tingling or pins and needles)
• Dysesthesia (an unpleasant, abnormal sense of touch)
• Complete or partial loss of erogenous sensation to the penis
• Complete or partial loss of tactile feeling to the penis; temperature, pressure, vibration, texture
• Structural changes to the penis, such as indents or “hourglassing” where the flaccid or semi-erect penis will temporarily develop an hourglass or bottleneck shape
• Vascular changes to the penis; engorged veins, spider veins
• Testicular retraction
• Pain in or around the penis or perineum
• Pain in or around the penis or perineum after ejaculation
• Penis feels “hollow,” “disconnected” or unstable, as if it was not a part of the body
• Discoloration of the skin of the penis
• Soft glans
• “Long Flaccid,” where the penis is more extended than it should be and either feels firm or like a balloon filled with water
• Pelvic floor dysfunction
• Tilt of the penis to one side while flaccid, erect or both
• Rotation of the penis
• “Golf ball” feeling in perineum
• Urinary issues, such as incontinence, urgency or duel streams
• Constipation

Mental Health#

Due to the nature of the condition, many men will experience significant mental and emotional distress. Patients frequently experience depression and anxiety due to the persistent and distressing symptoms of HFS, which can severely diminish their quality of life. For some, the emotional burden becomes overwhelming, contributing to suicidal ideation as they struggle to cope with the relentless stress and uncertainty surrounding their condition. The need for effective mental health support is critical to help these individuals manage the psychological impact of HFS.