PSSD Post-SSRI sexual dysfunction

[Tolk90]

4 hours ago, Leonardo said:

Мне нужно, чтобы ты развеял некоторые сомнения. Я не принимала лекарства 1,5 года. У меня была ужасная абстиненция, как и у многих здесь. Психологически я нахожусь на 80% и постоянно совершенствуюсь.

Что касается сексуальных проблем, у меня были такие симптомы:
- эректильная дисфункция
- слабые оргазмы
- отсутствие чувствительности
- отсутствие либидо.

 

На данный момент с каждым месяцем оргазмы становятся все лучше и лучше, чувствительность улучшилась и я была поражена этим, эрекция стала сильнее, мое либидо вернулось и стабилизируется. Каждый раз я чувствую себя лучше на всех уровнях.

 

Но кажется, что за это время мой пенис уменьшился примерно на 2 см. Это обратимо? Вернется ли он со временем к своему нормальному размеру? Я полностью одержим этим и беспокоюсь, что он не вернется к своему первоначальному размеру.

 

PS: также прочитал в Интернете, что сокращение полового члена - это нормально с возрастом, ожирением и некоторыми лекарствами, и что он восстановится - это нормальное положение, если вы ведете здоровый образ жизни.

Hi, I think it's related to the blood flow to the genitals, it should improve over time and return to its original state. I also looked at your old messages, back in September 2023, you suffered from a lack of libido and did not feel emotions. It's been 9 months and you're improving. Isn't this a miracle!!!You know what I've learned in my 34 years. We will always be unhappy with something, and when we focus all our attention on it, life goes by. And the best thing to do, as many people write on this forum, is to let go of the situation and enjoy life. Things will get better over time.

[SomethingAnonymous]

I'm really struggling with this today. There has been a lot of crying. I have started sleeping with someone but it doesn't feel good and I'm still struggling to understand what's going on. The biggest issue I'm having (when it comes to penetrative sex) is vaginal dryness and pain. We tried with tons of lube and it still felt dry and tight so I couldn't really focus on any pleasurable sensations because it was too sore and felt weird. I also couldn't tell when he was inside me as had no sensation (other than pain around the opening). Technically I had sex but it really doesn't feel like I did as it was such a different and bizarre experience. 

 

I'm still worried this is a sign I'm too old now. I'm only 37 though and have regular periods. It does feel dry all the time though and I noticed about half a year ago my discharge drying up a bit. But the doctors tell me to stop worrying about hormones because my period is regular. I'd find it so reassuring to just have "normal" sex so I can see I still can. 

[Tolk90]

I wanted to ask and get some advice. Who suffered from pssd, was there a stage when there is a strong arousal, that it causes some discomfort, from which an erection disappears?

[Ariel]

1 hour ago, Tolk90 said:

I wanted to ask and get some advice. Who suffered from pssd, was there a stage when there is a strong arousal, that it causes some discomfort, from which an erection disappears?

 

The strong arousal combined with discomfort sounds a bit like PGAD. 

Regardless of whether this is that or maybe just an aspect of PSSD, or maybe something else entirely, don't worry. 

Based on your previous posts, you are clearly healing and will continue to heal. 

Give your bits a rest, leave the body alone to relax and recover. It's not helpful physically or psychologically to constantly "test" one's function, it can exacerbate symptoms much like when we pick at a sore and irritate the wound. 

Take a break from stimulation, distract yourself by doing something else, and things will improve soon enough. 

 

[Ariel]

17 hours ago, SomethingAnonymous said:

I'm still worried this is a sign I'm too old now.

 

You are not too old! You will heal. 

 

17 hours ago, SomethingAnonymous said:

I'm only 37 though and have regular periods.

 

Your age is fine. There's no evidence for age being a barrier to healing in WD or PSSD. 

There are members here who have healed well into their 60s and 70s and are now doing better than ever!

 

Don't despair. Worrying is unpleasant and only ever makes things worse. 

You might want to take a break from sex for a while to give both body and mind a rest.

Best not to focus on symptoms. Distract yourself with other activities. Practice non-drug coping skills.

 

It gets better, healing is happening all the time, whether or not we consciously perceive it <3 

[Ariel]

On 5/17/2024 at 4:00 PM, Tolk90 said:

You know what I've learned in my 34 years. We will always be unhappy with something, and when we focus all our attention on it, life goes by. And the best thing to do, as many people write on this forum, is to let go of the situation and enjoy life. Things will get better over time.

 

@Tolk90

You recently gave someone else this good advice. 

Quoting you back to you ;-)

 

[Tolk90]

12 minutes ago, Ariel said:

 

@Tolk90

You recently gave someone else this good advice. 

Quoting you back to you 😉

 

A psychologist must have a psychologist. Otherwise, no way. 😀

[Ariel]

5 minutes ago, Tolk90 said:

A psychologist must have a psychologist. Otherwise, no way. 😀

 

Haha! 

Indeed. 

(and if more psychologists had good psychologists, there would be more better psychologists!)

[SomethingAnonymous]

4 hours ago, Ariel said:

 

You are not too old! You will heal. 

 

 

Your age is fine. There's no evidence for age being a barrier to healing in WD or PSSD. 

There are members here who have healed well into their 60s and 70s and are now doing better than ever!

 

Don't despair. Worrying is unpleasant and only ever makes things worse. 

You might want to take a break from sex for a while to give both body and mind a rest.

Best not to focus on symptoms. Distract yourself with other activities. Practice non-drug coping skills.

 

It gets better, healing is happening all the time, whether or not we consciously perceive it <3 

Thank you. I don't really feel like I want to take a break from sex because I've only just got back to it after five years. The idea of having to wait longer just feels really upsetting! I might stick to non genital sex for now though because the experience of pain is probably not doing me any good. 

 

I've done loads of thinking over the last couple of days and decided I need to get my life back altogether. I think it's easy to underestimate the impact of the pandemic on mental health. For me there is definitely a pre pandemic life and a post pandemic life and I can see how even if I hadn't taken the pills my sense of self etc has changed so much and I feel so dead inside. I guess if you feel dead inside then it's going to be hard to get your mojo back in any dimension. I'm going to try and build back what I used to have and live more healthily in all kinds of ways and try - TRY - to stop thinking about this. I guess it's hard because I do think about sex a lot (not PSSD, necessarily, just sex) and it's a worry because I'm single and really want a boyfriend. It's a bit scary the idea of having to explain to someone (again) the issues I'm having down there. I hope that when I do find someone we'll be able to at least make me comfortable and pain free. I'm still hoping I might be able to conceive. 

[Catwoman73]

23 hours ago, SomethingAnonymous said:

II'm still worried this is a sign I'm too old now. I'm only 37 though and have regular periods. It does feel dry all the time though and I noticed about half a year ago my discharge drying up a bit. But the doctors tell me to stop worrying about hormones because my period is regular. I'd find it so reassuring to just have "normal" sex so I can see I still can. 

I hear you on this!  I'm 51, and perimenopausal now.  I had minimal sex drive after my first dose of Paxil back in the late 90s, and it has never gone back to normal since.  I'm hoping that finally getting off the drug merry-go-round for good and forever will help me heal, but those doubts keep creeping in.  I mean, 30 years of almost no sex drive- how does that even come back?  I do wonder if the brain damage is permanent, now that so much time has passed.  This is my absolute biggest fear on this journey.  I'm trying to keep the faith though.  And not focus on it too much.  Ariel is right- focussing on other things seems to be the way to go.  I've been on such a journey- I think I have enough healing to do in other areas of my life lol... maybe if I focus on those, the sex drive will magically return one day!  I can hope!

[LukeUK]

Still posts in this thread saying things like "just don't think about it" and words to that effect.

 

Extremely insensitive and uncaring.

[Farm24]

On 5/23/2024 at 12:32 PM, LukeUK said:

Still posts in this thread saying things like "just don't think about it" and words to that effect.

 

Extremely insensitive and uncaring.

I've looked for stats from doctor healy. Have you read any?

[SomethingAnonymous]

So, did anyone else here still have quite a high libido while going through this? I'm finding it a struggle because there's literally no way to keep my mind off it given how much I think about sex. I tend to wake up fantasising (which was my normal pattern before I took the pills too) so I often feel psychologically 'excited' first thing but there's no response in my body so I can't do anything about it. This tends to set me up in the worst way from the very start of the day feeling worried and disappointed. I think at the moment literally the only thing I can do to help myself is try to calm down about it but I'm struggling to find a way to do that. Did anyone come across any helpful thoughts or coping strategies for the times in the day they have a strong desire for sex/masturbation and can't have it?

 

I've tried reframing it to myself like "yes I can't wait to have that back, that's something I really look forward to" but at the moment I've been feeling really sad for the hopeful younger woman I was who had thoughts like that about other things in life, knowing now that those things weren't going to happen for her, so blind hope/ faith makes me feel sad at the moment. 

[6Eggs]

I have had sexual problems for over 10 years now, most of which came from the meds but nothing was really consistent and symptoms came and went and changed over the years until I was put on the last two meds in my sig that really messed things up.

So as I came off the drugs, I got my libido come back more often than not, but the antidepressant I was on (not the drug that initially caused sexual dysfunction) caused lots of issues where I feel the antipsychotic that triggered the PSSD initially has mostly resolved in it's specific symptoms (except the burning pain, although it went away and came back with the AD, so not entirely sure which belongs to which now)

One of them problems is this hypersexuality but at the same time some ED and also PE which the latter I never had before.  I also have pain in my bits, legs and mouth and is triggered by sexual arousal almost always as of the last several months, I have less PSSD than I had initially (soft glans syndrome and total loss of sensation, the latter resolved long ago) and now because of the AD I have PGAD which fits my symptoms far closer than PSSD which are the hyper sexual symptoms, pain and sensitivity in the genital/anal area worst and followed with the same pain and sensitivity in the legs and mouth, PE is also common symptom and is painful and will often trigger a wave (severe body wide pain for a few hours to days, urinating and #2s also trigger the pain for some time but not as bad.

But on my good days, I have close to normal sexual function, even long standing symptoms like the soft glans all but go away which is pretty amazing considering how catastrophic my WD and PSSD were at the start.  But currently not having many good days and in fact some of my worse in nearly 3 years as of the last few months, the waves that is, I go from extremely unwell to close to normal functions like some extreme bipolar.

interestingly, my hypersexuality and PE are all part of the waves and bad symptoms, when I am good I have high libido but doesn't feel hypersexual, feels like my normal baseline pre drugs, even though I would be classed as hypersexual by others, so you can imagine how my definition of hypersexual must be to others if they knew how it felt, and yes, I get the genital disconnection when this happens which is counter intuitive.

[LukeUK]

On 6/16/2024 at 12:44 AM, Farm24 said:

I've looked for stats from doctor healy. Have you read any?

I don't know what you're referring to, apologies.

[Farm24]

3 hours ago, LukeUK said:

I don't know what you're referring to, apologies.

Oh sorry. Stats on pssd and recovery. 

[LukeUK]

1 hour ago, Farm24 said:

Oh sorry. Stats on pssd and recovery. 

 

I do not have any statistics from Dr. Healy. You are probably better off contacting him directly for this.

 

I doubt that anyone is even collecting statistics.

[Moe96]

Do orgasms trigger waves for some people? They do for me. They last like a day or 2. 

[6Eggs]

6 hours ago, Moe96 said:

Do orgasms trigger waves for some people? They do for me. They last like a day or 2. 

 Yes absolutely!  But for me it depends on how well/bad I am already, if I have no to little pain and discomfort in my genitals and the rest of the body and sexual arousal and activity feels normal or pretty close to and without the feeling of this discomfort and PE/ hyper sexuality, then orgasm is great and I feel fine and often good  afterwards.

If I have the above symptoms and carry though to orgasm, the orgasm is very intense and abnormal from a sensory perspective and painful as well (causes pain throughout the body as well), this leads to the pain worsening over the next few hours and remains for days sometimes and almost 100% of the time causes the wave to either come quicker and more intense, or triggers a wave outright on the spot.

I have had this very often in the last 6 months, where as the last few years not so much and has been more of a PGAD thing than PSSD itself. I came off two meds, one an anti psychotic which triggered the PSSD, the antidepressant tapering lagged by more than 6 months, the PSSD symptoms eventually mostly resolved to somewhat of a non issue but the antidepressant delayed WD causes the emergence of PGAD in place, it is very slowly getting better though but my windows and waves are extremely erratic and unpredictable at the moment and have been over the last 4 months or so. I can have some of the best sexual function in over a decade to some of the worse in this whole WD saga within a span of a week.  But when I am good I continue to see closer and closer to my former sexual function from my 20s. I am in my late 30s now.

When I feel like crap, I try to refrain from sexual activity even though one of my symptoms of feeling crap is the hyper sexual feeling, it's like a trap.   Feeling bad= need to relieve my self= orgasm= crash= feeling bad x5=> Goto start.

[SomethingAnonymous]

Hello, I'm going to see my GP again soon and because my symptoms are only PSSD (not the protracted withdrawal, as far as I can tell) I want to rule out potential physical causes. I've been thinking that there was a shift while I was on the pills where I went from being sexually inclined but needed tools because I had no sensation to being totally asexual, and that's when I started to very slowly wean down. (The discontinuation syndrome the last time I tried to come off was the most extreme experience I've ever had so I wanted to avoid that). Even at the time, I remember thinking that I didn't think going off the pills would bring my sexuality back because it felt like there'd been some kind of fundamental loss that was different from before, but I brushed that thought off and thought nah its just the pills. 

 

But that thought has come back to me now and I do wonder if something else did happen and the pills were a coincidence - at the very least, I need to rule it out. 

 

I'm going to press my doctor to look at everything she can think of. The conditions I've seen cause this outside of PSSD are almost always hormonal - prolactin or estrogen in women (thyroid conditions, prolactinoma, birth control, breastfeeding, menopause etc)- though my GP actually initially suspected my spine and we haven't completely ruled that out yet. I did speak to one woman months ago who experienced this after a spinal injury. 

 

Did anyone else come across any other differential diagnoses that I can rule out?

 

So far, an expensive specialist told me "it'll get better when you find a boyfriend" *rolls eyes*

[6Eggs]

I'm pretty sure I have spoken to you before about this particular thing. I had to do the same and rule everything else out like spinal injury, GBS, MS etc. Full body MRIs, reflex testing, nerve conduction studies etc... probably 50+ tests, neurologies etc...  Nothing was found and looked healthy.

I had like I mentioned many times before, total loss of feeling in my genital and saddle area, like literally complete loss, more than local anaesthetic loss of feeling. I remember in the hospital the neurologist and nurses poking and prodding down there and I was non responsive to any of the sensation and prick tests.

The feeling started to appear in small amounts some several months later.  Nearly 3 years on now, I have the opposite problem, extremely sensitive and jarring and painful to touch anywhere down there and I have this ever evolving pain and discomfort (mainly in the genital area) and all over my body, inside and out.  So I believe I have had PSSD evolve into PGAD after coming off the 2nd and last med late last year. Although not common for me to have good days since the last few months, at least not like the good and more regular days I had last year, when they are good, my sexual function and feeling is great and symptoms are close to my sexual function from my 20s (late 30s now).

It does get better eventually but it's slow and often all over the shop (the whole waves/windows thing).  Often it gets worse over a long period of time before it gets better. I found this to be the case with me and many others mention worsening of symptoms overall long after being drug free and initially feeling better right after getting drug free. Very frustrating!   But despite feeling worse long after, some symptoms on the better days are 100% way better than even when you felt better overall and better consistently.

[Superwoman]

Have any women here tried using a topical compounded DHEA cream on the clitoris?  If so, what was your experience with it?  I saw a Dr. Batur at the Cleveland Clinic.  She specializes in female sexual dysfunction.  She recommended this treatment to help with the genital anesthesia and pain.  She says that the hormone is not absorbed systemically into the bloodstream and does not affect hormone levels.  She said that it helps to increase sensation and helps with pain. 

[Superwoman]

Does anyone know how long it typically takes for sexual side effects to get better after stopping an antidepressant that you have been on long term?  I googled this and can't find an answer.

[Ariel]

Hi @Superwoman

 

8 minutes ago, Superwoman said:

Does anyone know how long it typically takes for sexual side effects to get better after stopping an antidepressant that you have been on long term?  I googled this and can't find an answer.

 

I'm not sure there is any "typical" length of time. Seems to me it's highly individual. 

 

Do you mean, the sexual adverse/side effects one had while taking the drug, how soon after stopping the drug do they then clear up?

 

I didn't have significant sexual side effects while on drugs (decades), so I can't speak to that directly. 

 

When I got off the drugs and WD set in, I developed both PGAD and PSSD. Both have since resolved. I don't remember how long it took exactly. PGAD went away first, then gradually PSSD got better. 

 

It gets better <3

 

[Superwoman]

21 hours ago, Ariel said:

Do you mean, the sexual adverse/side effects one had while taking the drug, how soon after stopping the drug do they then clear up?

Yes, this is what I mean. 

[Ariel]

Hi @Superwoman

It's really not possible to predict. It differs from person to person, both in healing pattern and duration.

[Superwoman]

On 7/29/2024 at 2:37 PM, Superwoman said:

Have any women here tried using a topical compounded DHEA cream on the clitoris?  If so, what was your experience with it?  I saw a Dr. Batur at the Cleveland Clinic.  She specializes in female sexual dysfunction.  She recommended this treatment to help with the genital anesthesia and pain.  She says that the hormone is not absorbed systemically into the bloodstream and does not affect hormone levels.  She said that it helps to increase sensation and helps with pain. 

I would be willing to try it if it can not do any harm but I don't want to make anything worse.  Does anyone know if it can make the sexual dysfunction any worse?

[Aaron7]

On 8/8/2024 at 7:17 PM, Ariel said:

Hi @Superwoman

 

 

I'm not sure there is any "typical" length of time. Seems to me it's highly individual. 

 

Do you mean, the sexual adverse/side effects one had while taking the drug, how soon after stopping the drug do they then clear up?

 

I didn't have significant sexual side effects while on drugs (decades), so I can't speak to that directly. 

 

When I got off the drugs and WD set in, I developed both PGAD and PSSD. Both have since resolved. I don't remember how long it took exactly. PGAD went away first, then gradually PSSD got better. 

 

It gets better ❤️

 

Ariel, did you experience emotional numbness and anhedonia when you had PSSD?

[Ariel]

3 minutes ago, Aaron7 said:

Ariel, did you experience emotional numbness and anhedonia when you had PSSD?

 

Hi @Aaron7

 

I have experienced emotional numbness and anhedonia throughout WD and PAWS, and still do, to varying degrees.

PSSD has resolved. 

Protracted withdrawal is ongoing. 

 

Take care,

Ariel

 

[Aaron7]

1 hour ago, Ariel said:

 

Hi @Aaron7

 

I have experienced emotional numbness and anhedonia throughout WD and PAWS, and still do, to varying degrees.

PSSD has resolved. 

Protracted withdrawal is ongoing. 

 

Take care,

Ariel

 

Thanks for the reply, I really appreciate it.

 

Is anhedonia and not being able to feel dopamine all part of protracted withdrawal?
 

I have no experience with antidepressants so I don’t understand what is going on.

[6Eggs]

On 8/9/2024 at 4:17 AM, Ariel said:

Hi @Superwoman

 

 

I'm not sure there is any "typical" length of time. Seems to me it's highly individual. 

 

Do you mean, the sexual adverse/side effects one had while taking the drug, how soon after stopping the drug do they then clear up?

 

I didn't have significant sexual side effects while on drugs (decades), so I can't speak to that directly. 

 

When I got off the drugs and WD set in, I developed both PGAD and PSSD. Both have since resolved. I don't remember how long it took exactly. PGAD went away first, then gradually PSSD got better. 

 

It gets better ❤️

 

 As like any individual, mine was way different again.

For me, severe PSSD, mostly resolved after 2 years although I still get symptoms, especially during waves, mainly just some soft glans and moderate ED, no numbness as of Q3 of last year.

But as of late last year I started to get PGAD, it was at it's worst in the last 2 months and I think it might be starting to get better? on my good days I have decent function, but interestingly, some of the new symptoms that appears during the peak of the PGAD are similar to the very common PSSD symptoms others have that I never got during any of the PSSD phase, this is the loss/reduction of feeling of attraction, warmth, affection, loss of interest etc...  But my psychiatric state has been the worst in the last 5-6  months than any of the other points in this ordeal overall, feeling depressed for the first time in my life. Yet I feel an awful sexual compulsion and hyper sexual with feeling of unbearable genital pain and pain throughout my body and dread or something squeamish that I can't describe and have bad PE at the same time that does not improve whatsoever with subsequent masturbations, often bed ridden for those waves.

I always had issues with sexual function on these meds, but the last 2 I was on improved my sexual function to more or less normal for quite some time, then abruptly became the worst I ever had, years into use, so like a very delayed effect.