My issues with PMO have been primarily associated with efforts at pain relief. I have come to the following conclusions about pain relief.
My physical history has left me with a base line of pain of about a 2, on a scale of 1-10 with 1 being a twinge (0 would be totally pain free) and 10 being totally unbearable "make you pass out" pain. What I discovered years ago is that my body does NOT respond to "normal" pain medicine, whether it be aspirin, Tylenol, Ibuprophen, more exotic NSAIDs or even opiates. I found only two things that actually helped numb pain...O and alcohol. Alcohol was always only minimally effective, and had unacceptable side effects. Misunderstanding O and thinking it had zero side effects made it the "logical" choice for pain management. PMO could be an acronym for "Pain Management through Orgasm". It is the abuse of O as pain management that has slowly, over time, deteriorated my erectile function to the point where full blown ED is the problem. The side effects are definitely not zero.
Due to the diminishing returns in the pain relief value of O, I had also added A (Alcohol) into the mix, even though it has known bad side effects. I had literally degenerated into a drunken porn and masturbation addict with little to no actual life. It has now been over a week since my departure from P and M, and last night was the first A I consumed in that time as well...though I did NOT consume enough to get much in the way of pain relief...I have found that I did not NEED pain relief. 2 I can handle.
Now the revelation on pain management. It is a misnomer. Draw a line on a graph of your base pain level over time...mine is a 2. Taking a drug or otherwise artificially numbing the pain to 0 will NOT remove any pain from the graph...all it will do is move it to the right (future) and STACK it on top of the base line. For illustration, if I bring my 2 down to 0 through drugs, alcohol and/or O for three hours, it will drop the line to 0 for those three but it will INCREASE the line from 2 to 4 for the next three, or something similar. This is part of why an addict must increase the frequency in which they dose whatever it is they are using, because when it wears off the pain is increased from where it would have been. Eventually, critical mass is reached and your pain is 10 for a while. This is where the overdose or suicide usually occurs. What "coming down" means is enduring the stacked pain until it returns to base line.
Traditional western symptomatic management of pain is merely kicking it to the right on the graph. How the pain lands on your graph is not likely linear, more likely exponential with most of the pain stacking up immediately after the effect of the "pain reliever" wears off. Bad news and no better than deficit spending is at managing a budget.
As a young man, I had enough energy sexually to burn some of it for pain relief and still have an active sex life. Unfortunately, due to the stacking nature of pain when "managed" this way, it took more and more of my sexual energy to manage pain until I had none left. This is when P came into the picture in an effort to generate additional sexual energy...but still, all of my sexual energy and then some was consumed for pain management. It was when I attempted to pull my wife into the P in an effort to direct some of the use of my sexual energy back to her, where it belonged that she threw up a brick wall. Her response was "You've got to be f'in kidding me...you're the perv, not me". By this time, we were barely not divorced.
Nevertheless, running into this brick wall convinced me to completely reevaluate my "pain management" strategy.
That marked the beginning of this journey, which is already restoring balance to my life.
Karezza includes an element of what might be termed low impact sensual massage, which is actually an excellent form of pain management. Actually managing to reduce pain by reducing stress. Less stress equals less pain...naturally. I can already tell the difference only one week into this.