Proctalgia Fugax: The Home Guide
176 pages on one small, savage, extremely common problem that almost nobody talks about — and everything I have learned in twenty years about making it stop.
Why I wrote it
I was fifteen the first time, and my first clear thought was that something inside me had torn. Nothing had torn. Twenty minutes later it lifted, and by morning there was no evidence anything had happened at all — which is exactly why I said nothing about it for the next decade.
When I finally found the name, what I found alongside it was a scattering of thin medical summaries and a lot of frightened people in forums at three in the morning, each convinced they were the only one. There was no single place that explained the whole thing: the mechanics, the fear, the dream, the days afterwards, what to do while it is happening, and what to change so it happens less.
So I wrote that. It is the book I needed at fifteen and could not find.
What is in it
-
Part One
What Is Happening To You
The night I was certain I was dying at fifteen. What proctalgia fugax actually is, the anatomy in plain English, why it comes at night — and the red-flags chapter, placed early on purpose.
-
Part Two
The Full Shape of It
An episode minute by minute. The dream problem and the fear nobody says out loud. The “stiff prostate” days afterwards. Fainting, sweats and referred pain. What other sufferers describe.
-
Part Three
Why It Happens
The trigger stack — baseline, background load, and the acute push. Dehydration, sitting and the modern pelvis, sex and ejaculation, and a personal trigger audit you actually run.
-
Part Four
Stopping an Attack
The Attack Protocol, step by step. The twelve interventions ranked by evidence. What makes it worse, including things people recommend. The 72-hour aftercare protocol.
-
Part Five
Never Having It Again
Breathing. Down-training the pelvic floor and why kegels may be hurting you. Bowel mechanics. Surfaces, seats and sleep positions. Minerals and what the evidence really says. The mind side.
-
Part Six
The Medical Route
How to talk to a doctor about this without dread. Every medical treatment that exists, graded honestly. Pelvic floor physical therapy, and why it is the referral to fight for.
-
Part Seven
The Programme
A 30-day reset that sequences everything above, and an honest chapter about where it leaves you.
-
Appendices
The Tools
Episode log template, weekly baseline tracker, the printable Emergency Card, a plain FAQ, and the full source list.
Read a piece of it first
A fair chunk of the book's substance is already on this site, free, in the same voice. If you want to know whether we are going to get on, start here:
- What proctalgia fugax is — the definition, the anatomy, and why every test comes back normal.
- The 3 A.M. attack protocol — the nine steps, and the bedside kit to assemble tonight.
- The dream, and the fear nobody says out loud.
What it is not
It is not medical advice, and it does not pretend to be. I am not a doctor. Proctalgia fugax is a diagnosis of exclusion, which means the reassurance in these pages is only worth something once a clinician has crossed off the things that matter — and the red-flags chapter is deliberately placed early, before any of the self-management, for exactly that reason.
It is also not a cure, because I do not think one exists. What it is, is a way to have far fewer of these, to handle the ones you do get, and — the part that surprised me most — to stop being afraid of them.