Question: Excessive Sweat around anal area which produces a strong soap smell and body odor
I am a 43 yr old male that has had a persistent problem since my mid 20’s with excessive sweat and body odor around the anal area after ejaculation. I sweat so much that the seat of my pants/shorts will be soaked to the point that if I am wearing light colored clothing the fabric can become transparent. The sweating sometimes causes a rash around my anus where the skin can split and bleed. The problem is only this extreme for about 4 days after ejaculation. After around 4 days the sweating symptom return to seemingly to normal but I still have a persistence strong soap smell.
Here are the symptoms and complaints from co-workers
•     Excessive sweat between lower back and anus area while at a resting physical state. (No sweat in armpits).
•     Rash around anus if not treated with Zinc Oxide
•     Excessive body odor from anus area either BO or it has been described by a co-worker as smelling like a wet dog.
•     Occasional bleeding from perianal area if not treated with zinc oxide ointment with in a day of ejaculating (either from masturbation or natural intercourse).
•     Excessive soap smell from anus area (co-workers have complained that the smell is so strong that it gives them headaches and causes their eyes to burn/water). I have been asked by my director to stop wearing cologne (2014), however, I do not wear cologne or any type of body spray except underarm deodorant. I attempted to abstain but that only lasted for 3 weeks. (Today I only ejaculate once a week either through natural intercourse or masturbation).
•     I feel an intermittent sensation of heat in my anus followed by what feels like a small amount of fluid seepage; then I notice a strong soap smell and foul gas smell. (a coworker said recently that she thought my deodorant soap is mixing with colostrum causing the soap smell to intensify). When she said that to me I just thanked her for the suggestion, apologized, and said I have sought out treatment but have not found any cures.

Back ground:
In the early 90’s I used crystal meth regularly. While on meth I became hypersexual and would masturbate excessively. (12 hours to 2 days). During masturbation I often sodomized myself with objects and left the objects inserted into my anus for hours at a time. With the exception of one occasion where a meth using friend joined in this was always a solo act. I have only sodomized myself during masturbation a few times over the last 13 years.
I sought out treatment for substance abuse in 1995 for the first time, then again in 1997, and for the last time in 2001. I have been clean and sober since July 12th 2001.
I have seen my regular MD and he checked for hemorrhoid and said that I only have a small internal hemorrhoid (2002). (This has only bothered me sometimes over the last 10 years since diagnosis). He said I have superficial anal fissures and suggested that I treat it with Zinc Oxide Ointment.
I have seen a colorectal surgeon (2002) who prescribed the same treatment of the area. He also said that I have caused some trauma to my rectum but dismissed it as being minor.
I have seen a psychiatrist (2003) and when I described the issues to him he diagnosed me as paranoid delusional with intermittent olfactory hallucinations. He prescribed me Risperdal and Zoloft for a year. (This did not seem to help).
I then saw a psychotherapist who helped me overcome the feeling of humiliation. This helped considerably since I had dropped out of college at the time and went on short term disability (2004). I have since held down long term employment and I have a BS in Psychology and a Masters in Public Administration.
While at a chiropractor getting treated for a strained back (2011), the massage therapist said that she can feel a lot of heat when she moved her hand over my gluts (not toughing me). I overheard her say to the chiropractor that she thought I had a rear muscular condition but she would not comment on it after returning to the room when I asked her about it.
My thoughts,
I have been as transparent to the issue as possible. I usually leave out the sexual history when seeing the Dr for treatment. I believe that anxiety is part of the diagnosis because of the humiliation that I feel especially when a co-worker or someone comments on the smell. As a result, I feel anxiety when I am in a public place as a feeling of humiliation about the smell and excessive sweating. I also think there must be a biological component to the diagnosis since there is a strong smell that has gotten me incorrectly accused of drowning myself in “Gender Natural Cologne” by coworkers and my director.
Please help, I have been able to tolerate the problem in the past because my wife and daughter would use humor to help me with it but now I am divorced (2013) and my daughter is in High School and has been recently expressing that she is embarrassed by me. She points out wet marks that I leave on chairs once I get up, and comments about feeling embarrassed by either a gas smell or strong clean smell (today). She had asked me to stop using body spray but I do not use body spray or cologne.
I feel helpless and need some straight answers. Who should I seek treatment from next? What potential diagnosis could be the problem and what ways are available to treat or improve my condition and quality of life.

Hello,


Thank you for the explanation, I have guessed that the anxiety that I feel from the soap smell is an illusion of transparency. But the strong soap smell has been repeat
Thank you for the explanation, I believe the anxiety that I feel from the soap smell is an illusion of transparency but that the smell itself has been validated on several occasions. If the above diagnosis is true then wouldn't the intensity of the smell be imagined? This is the part of the diagnosis that has led me to doubt it over the years. Will you direct me to some literature that I can read so I can get a better understanding of myself?

"The only thing that can explain most of your symptom is increased dopaminergic activity in certain part of brain particularly in prefrontol cortex and ventral tegmental area. These part of the brain are responsible for foul smelling and increased sweating and this could be the possible reason for your symptoms."

I am currently researching this explanation for a deeper understanding.

Thank you for your time