Post-SSRI Sexual Dysfunction Treatment: All You Need to Know About

Post-SSRI Sexual Dysfunction Treatment: All You Need to Know About

“There is a feeling of numbness, emotionally and physically blunt … some kind of barrier between my skin and the pleasure of touch.” This is the most familiar story of people suffering from Post-SSRI sexual dysfunction. However, what is Post-SSRI sexual dysfunction, its causes, the symptoms, and most importantly, the treatment? This article will dig deeper into Post-SSRI sexual dysfunction, its symptoms, post-SSRI sexual dysfunction treatment: all you need to know about it.

What Is Post-SSRI Sexual Dysfunction?

Depression, anxiety, stress –  antidepressants are the most chosen answer for the patients suffering from these issues. However, these antidepressants often lead to conditions that affect your health and your mentality, feelings, emotion, relations, almost every aspect of your life.

 

A scary fact is close to 100% of people taking antidepressants for several conditions face severe sexual side effects. Whether it’s SSRI, SNRI, or some tricyclic antidepressants, people experience a certain degree of sexual side effects, especially genital numbing.

 

So, what is Post-SSRI sexual dysfunction?

 

Post-SSRI sexual dysfunction, aka PSSD, is an iatrogenic condition – an illness caused by medical treatment. It primarily arises from your antidepressants treatment – where your sexual function does not return to a normal state even after discontinuing the medication.

 

You may ask, antidepressants are several, which one causes the problem?

 

There are several types of antidepressants. However, selective serotonin reuptake inhibitor (SSRI), a serotonin-norepinephrine reuptake inhibitor (SNRI), and some tricyclic antidepressants (clomipramine and imipramine) are there that doctors prescribe more.

 

SNRI and others cause plenty of sexual side effects, but SSRI is to blame for PSSD most. The common SSRIs that doctors usually prescribe or patients use – paroxetine (Paxil, Seroxat), fluoxetine (Prozac), sertraline (Zoloft), citalopram (Celexa), escitalopram (Lexapro), and vortioxetine (Trintellix).

 

Both men and women encounter PSSD: however, men are prone to PSSD more. The severity, symptoms, and side effects vary from person to person. The conditions often appear after stopping your antidepressants medication or reducing the dosage.

Antidepressants: Why You Take SSRI?

SSRIs or Selective Serotonin Reuptake Inhibitors are a type of antidepressant that operates by boosting serotonin levels within your brain. Many refer to them as “feel-good hormone.”

 

So, how does it work?

 

Serotonin is a neurotransmitter that conveys messages between brain cells. It plays a significant role in contributing to your overall well-being, good mood, appetite, regulating the sleep-wake cycle and internal clock in your body.

 

When you take SSRIs, they increase the serotonin levels in your brain by preventing the serotonin reuptake or absorption by your nerves. Moreover, the message transmission becomes easier when you have increased serotonin in your nerve synapse.

 

SSRIs are usually the primary choice to deal with depression. They effectively improve your mood with less severe or fewer side effects than other antidepressants and have fewer side effects.

What SSRI Manages?

SSRIs are usually the foremost medication for depression. They help manage various symptoms of depression that include-

 

  • Low mood
  • Irritability
  • Feelings of worthlessness
  • Restlessness
  • Anxiety
  • Difficulty in sleeping

 

With depression, doctors also prescribe SSRIs to treat various other health conditions, including-

 

  • Anxiety
  • Bulimia nervosa
  • Fibromyalgia
  • Panic disorder
  • Premenstrual dysphoric disorder
  • Hot flashes
  • Obsessive-compulsive disorder
  • Post-Traumatic Stress Disorder

 

However, few – SSRIs cause several life-affecting side effects such as PSSD – affecting your health, emotional, and psychological condition.

PSSD Symptoms

“I am unable to feel attraction, arousal, or orgasm – as if living in a dark place, losing my sexuality” – the word of many PSSD patients.

 

PSSD poses various life-bothering symptoms. Sometimes they are fully present and noticeable; sometimes partially present, depending on your condition.

 

Some common symptoms of PSSD include:

  • Reduced genital sensation or genital anesthesia
  • Erectile dysfunction
  • Decreased vaginal lubrication
  • Delayed or inability to orgasm (anorgasmia)
  • Pleasureless or weak orgasms
  • Anhedonia or inability to feel pleasure
  • Decreased libido
  • Reduced reaction to sexual stimuli
  • Decreased or loss of nocturnal erections
  • Premature ejaculation
  • Reduced nipple sensitivity
  • Flaccid glans during erection
  • Cognitive dysfunction and brain fog
  • Blunted emotion
  • Insomnia
  • Intense anxiety
  • Panic or paranoia

PSSD Diagnosis

There is no more straightforward way or specific test to diagnose PSSD.

Post-SSRI Sexual Dysfunction Treatment: All You Need to Know About

Doctors usually determine the condition considering many factors – your medical history, the beginning, the state, and the severity of your symptoms. Often they choose the path of elimination – cutting other possible factors that can cause the issue.

 

Physicians often suggest quantitative sensory testing (QST) of the penis to detect reduced sensitivity in male PSSD patients. Often, they check your testosterone level as PSSD as it leads to low testosterone in your body.

 

However, no specific test can determine PSSD.

 

You can also conclude by considering your condition.

 

Suppose you are a person with a good libido, arousing effortlessly, having a perfect orgasm, and enjoying all the pleasure of sensation before taking antidepressants. However, even after stopping your medication, you witness low sexual desire, difficulty arousing and having weak or no orgasm.

Alarming announcement -you may have PSSD.

Post-SSRI Sexual Dysfunction Treatment: All You Need to Know About

You may ask – is there any Post-SSRI sexual dysfunction cure and treatment?

 

It’s sad, but the fact is there is no known cure. The primary reason is the etiology of PSSD is not yet fully comprehended or understood.

 

However, there are some possible treatment options for several symptoms of PSSD. Few signs show potential treatment options, such as erectile dysfunction, low libido, and overall sexual dysfunction. However, they can only manage your symptoms; can’t fully cure your PSSD.

 

For Post-SSRI ED or erectile dysfunction, oral phosphodiesterase type 5 (PDE5) inhibitors are possible medications doctors usually prescribe. Erectile dysfunction is a male sexual-arousal disorder, the inability to attain or maintain a sufficient penile erection for sexual intercourse.

 

Sildenafil (Viagra), Tadalafil (Adcirca, Cialis), Vardenafil (Levitra, Staxyn), Avanafil (Stendra) are the popular medications patients use to manage erectile dysfunction. Often testosterone replacement therapy is suggested if testosterone levels decrease tremendously.

 

For low libido, Doctors often prescribe switching or adding to bupropion (Wellbutrin SR, Wellbutrin XL), a different type of antidepressant. It usually enhances sex.

 

Doctors also prescribe it for women with sexual interest or arousal disorder. However, you need a higher dose of bupropion to see any significant results, usually 150 mg twice daily.

 

For overall sexual dysfunction, changing the medication often results in significant improvement. For example, switching to nefazodone, an antidepressant with mild serotonin reuptake blocking properties, shows promising results in managing sexual disorders.

You have to remember that the treatment of PSSD depends on your symptoms. However, a combination of medical and behavioral approaches tailored for the individual patient is necessary.

Suppose you enjoyed a healthy libido and pleasurable orgasm in the past, before antidepressants. In that case, a proper combination of medical, psychological, and emotional support can bring you back from the dark tunnel.

Most importantly, you need patience. There are multiple PSSD success stories whose symptoms eventually disappear.

However, remember, there is no specific timescale for recovery. It wasn’t overnight; it took weeks, months, and even years. Some report significant improvement soon, but some may fail to recover even after twenty years. Sad yet fact, for some, PSSD becomes permanent.

How common is PSSD?

PSSD is quite common in both males and females. However, the severity may vary between individuals. Besides, no way is there to specify who will develop PSSD while taking the medication or after discontinuation.

 

Many people often don’t acknowledge they are suffering from PSSD. Many face side effects while taking antidepressants that eventually resolve when they stop the medication. However, their sexual activity or function may not be like before.

 

However, patients whose symptoms are severe enough to make their lives extremely distressful. Everything in life turns numb – emotionally and sexually blunt – even doing things you usually enjoy seem dull.

 

PSSD can be so severe that it often leads to marriage break-up, job loss, and even suicide.

Final Words

Sexuality is an essential aspect of your life, revolving around your identity, quality of life, and connection with others. Now imagine your sexuality is removed or severely declined by a medication?

 

Post-SSRI sexual dysfunction, aka PSSD, is one such condition affecting your sexual activity and function even after stopping the medication, SSRIs. However, where will you go for your post-SSRI sexual dysfunction treatment: all you need to know about it?

 

Hormone Replacement Therapy, LA, is an exclusive healthcare center where you can discuss your issue unhesitant and comfortably. Dr. David Nazarian and his expert team are ready to provide you with medical and emotional support and care. Considering your condition with utmost priority, they will plan the treatment best for you, managing your symptoms and bringing you back to your old self.

 

However, remember that one thing that will help you most is your ability to stay positive, strong, and hopeful. Only then can the light reach you in the deep dark tunnel of distress and disorders.

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Dr. David Nazarian

Dr. Nazarian is board certified in Internal Medicine and practices integrative medicine in the heart of Beverly Hills. In his career he has worked in the Emergency Department as well as in the hospital setting as a hospitalist. He has extensive medical training in hormone replacement therapy.

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