Since your recent heart tests were normal, a serious cardiac issue is very unlikely. Your symptoms, especially the skin sensitivity to clothing, point more toward nerve irritation (such as early shingles or intercostal neuralgia), muscle strain, or acid reflux, which can be triggered by stress and recent tobacco use. Nicotine can increase stomach acid and muscle spasm risk. It is highly reassuring that your heart is healthy. I recommend wearing loose clothing, practicing stress-reduction techniques, and consulting your doctor to address these non-cardiac possibilities, perhaps considering an over-the-counter antacid if reflux is suspected.

Sperm are very fragile and cannot survive once semen has dried, especially after an hour and being wiped with a tissue. For pregnancy to occur, live, active sperm must enter the vagina directly. Since the semen was completely dry, the sperm were no longer alive or viable.

Yes, an MRI is clinically indicated and a very reasonable next step. While X-rays are excellent for checking bones, they cannot show soft tissues like ligaments, muscles, discs, or localized inflammation. An MRI will provide a detailed view of these surrounding tissues to help identify the exact source of your pain. This information is incredibly valuable for tailoring a precise treatment plan to help you find relief. I highly recommend discussing this scan with your doctor to help you take the next step toward feeling better.

Since your lower spine is clear, your symptoms may stem from piriformis syndrome?where a gluteal muscle irritates the sciatic nerve, which is common in cyclists. For next steps, a targeted physical exam of your hip and pelvic region or an electromyogram (EMG) can help locate the nerve irritation. Treatment options include specialized physical therapy, adjusting your bike fitting, and temporary rest. For discomfort, generic anti-inflammatory medications like ibuprofen or targeted nerve-pain medications may offer relief.

Since your urine culture is clear, we can likely rule out a typical bacterial infection. Your symptoms?frequent urination and pelvic pain?are often linked to a condition called chronic pelvic pain syndrome or non-bacterial prostatitis. This involves inflammation or muscle tension in the pelvic floor, rather than an infection. Please be reassured that this is very manageable. I highly recommend consulting a urologist. They can help guide you toward relief, which might include pelvic floor physical therapy or anti-inflammatory treatments.

Since the Candid-B cream hasn't provided relief, the issue may not be a simple fungal infection. Prolonged sitting, heat, and friction can cause conditions like folliculitis (inflamed hair follicles), contact dermatitis, or hidradenitis suppurativa. To help, try wearing loose, moisture-wicking cotton clothing and keep the area dry. I highly recommend seeing a dermatologist. They can properly evaluate the rash and may prescribe oral antibiotics or non-steroidal anti-inflammatory treatments tailored to your specific condition.