PE & ED: Let's try to make sense of that combination

General discussions. Feel free to use this like a support group also.
ytho
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Re: PE & ED: Let's try to make sense of that combination

Unread post by ytho »

SertralineSurvivor wrote: Fri Dec 17, 2021 2:36 pm I am having similiar issues with you buddy. I also had this issue after quitting SSRI's. My first trial will be with inositol + (something like choline) and then I will try something else. I have this issue for almost a year now. I am afraid of trying stuff because I am scared of accidentally turning my mild pssd to a severe one like people around here.
I can totally relate. It’s the same for me. And while it’s not much, I still have some function to lose, so it’s not easy to decide the next steps. Inositol is definitely on my list as well as other things I’ve seen people having success with.
OCDemon
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Re: PE & ED: Let's try to make sense of that combination

Unread post by OCDemon »

I got severe PE from Rexulti. Rexulti is a 5-HT1A agonist (a very strong one), and a Dopamine D2 agonist. It also moderately antagonizes 5-HT2C. Not being an SSRI, but being a unique antipsychotic in its strong affect on serotonin receptors, it's worth considering in the grand scheme of things with PSSD. There is so much focus on SSRI's specifically, but looking at people like me who developed sexual dysfunction from other medications will prove to be enlightening, and help us unravel this nightmare.

Conventional thinking would say that it should cause delayed ejaculation, as 5-HT1A stimulates ejaculation, so you'd think the body would de-sensitize the receptor when it's being flooded with input from the medication. But this is not what happened. I got *severe* PE. Clearly, the theories of how and why this happen need to be revised. It is certainly not so simple, as you pointed out in your post. Why do some people develop opposite dysfunctions? It seems like it makes no sense. But remember -- it always makes sense. There is something clear happening on a neurological level that would explain this, but no one has pinpointed it yet.

It also affected ejaculation function. I remember I used to stay hard for a while after ejaculating. Now, on top of PE, my erection is basically gone halfway through ejaculating. I lose my erection so quickly upon ejaculating that I'll continue to ejaculate a bit while completely soft. Absolutely never had this before.

It's been over 2 years since I stopped taking the medication, and no improvements at all.

Why? That's the golden question. I would say looking into ejaculation function, what causes the refractory period and loss of erection/libido upon ejaculation, is worth looking into. I'm thankful to still be able to get an erection easily, but my toleration for stimulation is so bad that it hardly matters anyway -- sex is absolutely impossible for me, and I've tried dozens of times. I will also ejaculate spontaneously occasionally, while having an erection at least -- but with no stimulation at all.

I also have the same symptoms of not feeling love/romance. Looking at these symptoms strictly through a neurological lens could be interesting. It may seem like a gamble with these medications, but the truth is that they are causing some specific kind of changes in the neurological structure of the brain, how the neurotransmitters are interacting, etc. We just don't know what they are.

But the more case reports, and the more 'anomalies' like me, the clearer the picture will become.
Integra
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Re: PE & ED: Let's try to make sense of that combination

Unread post by Integra »

We have a lot of cases and there is not any clear.
Alte.Brown
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Re: PE & ED: Let's try to make sense of that combination

Unread post by Alte.Brown »

In my experience, before escitalopram I’ve never had a problem with PE, I could endure as much as I wanted (in fact, zero sexual problems of any kind). When the PSSD symptoms begun ( during or after taken Escitalopram, I coulnd’t say exactly when they started) severe PE was among them ( and it still is).

Among the few research papers on PSSD there are even fewer that touch upon the PE issue.
There is a paper from Dr. David E. Adson from Minnesota University about a 43 year old guy who developed PE after citalopram whitdrawal.

https://www.researchgate.net/publicatio ... Withdrawal

I contacted Adson because for me it was not clear enough from the paper if PE had resolved after some time and he told me that if he was not mistaken that it had resolved for this guy (he didn't sound pretty convincing :D ).
In my case, after 5 years of PSSD, PE symptom got a little only a little bit better since 2 years ago when I started developing LUT symptoms.
OCD. Escitalopram from Aug 2016 until Sep 2017 (up to 40 mg/day).Then, some 6 months of benzos for sleeping. PSSD since Mar 2017.
ED, premature eyaculation, low libido.
Brain food
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Re: PE & ED: Let's try to make sense of that combination

Unread post by Brain food »

Alte.Brown wrote: Sun Dec 26, 2021 11:12 am In my experience, before escitalopram I’ve never had a problem with PE, I could endure as much as I wanted (in fact, zero sexual problems of any kind). When the PSSD symptoms begun ( during or after taken Escitalopram, I coulnd’t say exactly when they started) severe PE was among them ( and it still is).

Among the few research papers on PSSD there are even fewer that touch upon the PE issue.
There is a paper from Dr. David E. Adson from Minnesota University about a 43 year old guy who developed PE after citalopram whitdrawal.

https://www.researchgate.net/publicatio ... Withdrawal

I contacted Adson because for me it was not clear enough from the paper if PE had resolved after some time and he told me that if he was not mistaken that it had resolved for this guy (he didn't sound pretty convincing :D ).
In my case, after 5 years of PSSD, PE symptom got a little only a little bit better since 2 years ago when I started developing LUT symptoms.
What’s LUT?
ytho
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Re: PE & ED: Let's try to make sense of that combination

Unread post by ytho »

Thanks for all your inputs guys. Let’s keep this thread going.

@OCDemon You got some valid points. I agree that it all makes sense on a neurological level which just hasn’t been unraveled yet in terms of PSSD. Sad thing is that it will probably take many more years for research to understand the hidden effects here.

I seem to notice the same with regards to quickly losing the erection after ejaculation. I don’t lose it during ejaculation, but very fast afterwards, which was never the case pre pssd.

Another thing, which is positive I think: I consider myself to have lost my libido, but whenever I ejaculate, I still get that „post nut clarity“ feeling, like those minutes where you really really don’t have any libido and you are almost grossed out by sex or your fap material. So that at least makes me think that a) I had some kind of libido before ejaculating and b) my body still does the correct hormonal procedures after orgasm.

@Alte.Brown thanks for the case report. You are correct, there are not many reports about PE in regards to pssd, most discuss the delayed ejaculation part. Was there anything you tried to alleviate your pssd symptoms in these past five years?
Numbtomind 2
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Re: PE & ED: Let's try to make sense of that combination

Unread post by Numbtomind 2 »

Is there any reason why I can't get get turned on to erotica or get stimulated to any thing sexual? What do you think is going on neurologically in the brain. My plumbing still works, but I can't get the brain stimulated witch sends the signal down to the genitals.

The connection is severed. I hope it's not permanent
75mg Clomipramine. june-july 2018
(Anxiety/Ocd)

Current symtoms I'm experiencing.
Emotional numbness, Pleasurless activities, Complete sexual system shutdown.
Alte.Brown
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Re: PE & ED: Let's try to make sense of that combination

Unread post by Alte.Brown »

Brain food wrote: Sun Dec 26, 2021 11:30 am
Alte.Brown wrote: Sun Dec 26, 2021 11:12 am In my experience, before escitalopram I’ve never had a problem with PE, I could endure as much as I wanted (in fact, zero sexual problems of any kind). When the PSSD symptoms begun ( during or after taken Escitalopram, I coulnd’t say exactly when they started) severe PE was among them ( and it still is).

Among the few research papers on PSSD there are even fewer that touch upon the PE issue.
There is a paper from Dr. David E. Adson from Minnesota University about a 43 year old guy who developed PE after citalopram whitdrawal.

https://www.researchgate.net/publicatio ... Withdrawal

I contacted Adson because for me it was not clear enough from the paper if PE had resolved after some time and he told me that if he was not mistaken that it had resolved for this guy (he didn't sound pretty convincing :D ).
In my case, after 5 years of PSSD, PE symptom got a little only a little bit better since 2 years ago when I started developing LUT symptoms.
What’s LUT?
Lower urinary tract symptoms (LUTS), includes:

Increased frequency of urination
Increased urgency of urination
Urge incontinence
Excessive passage of urine at night
Incomplete voiding
Urinary retention
OCD. Escitalopram from Aug 2016 until Sep 2017 (up to 40 mg/day).Then, some 6 months of benzos for sleeping. PSSD since Mar 2017.
ED, premature eyaculation, low libido.
Alte.Brown
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Re: PE & ED: Let's try to make sense of that combination

Unread post by Alte.Brown »

@ytho

Well, it’s quite confusing how you can end up with PE from a drug that it’s supposed to treat PE; it’s like getting an infection out of antibiotics.. But, since I am 100% sure that it was escitalopram the one that triggered my PE you can understand how scared I am from SSRI, I told my urologist about my PE and of course as an urologist he suggested me dapoxetine, which is obviously another SSRI. It would be like “SSRI reinstatement”. In my case, the use of Cialis to help with my ED also helps me with PE to endure a bit more and also basic techniques to prevent PE ( breathing, squeezing etc) makes it enough for sexual intercourse, of course I have days on which I perform better than others..
OCD. Escitalopram from Aug 2016 until Sep 2017 (up to 40 mg/day).Then, some 6 months of benzos for sleeping. PSSD since Mar 2017.
ED, premature eyaculation, low libido.
ytho
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Re: PE & ED: Let's try to make sense of that combination

Unread post by ytho »

Alte.Brown wrote: Mon Dec 27, 2021 7:04 am @ytho

Well, it’s quite confusing how you can end up with PE from a drug that it’s supposed to treat PE; it’s like getting an infection out of antibiotics.. But, since I am 100% sure that it was escitalopram the one that triggered my PE you can understand how scared I am from SSRI, I told my urologist about my PE and of course as an urologist he suggested me dapoxetine, which is obviously another SSRI. It would be like “SSRI reinstatement”. In my case, the use of Cialis to help with my ED also helps me with PE to endure a bit more and also basic techniques to prevent PE ( breathing, squeezing etc) makes it enough for sexual intercourse, of course I have days on which I perform better than others..
Thanks for your reply. Obviously they would give us another SSRI to treat our PE, thats what their books tell them. I am very reluctant to take one every again, as Escitalopram also caused all my current issues, no doubt about that. But on the other hand, thinking about PE somehow always brings me back to think it has to be because of low serotonin. Maybe thats why some people experience relief from PSSD on a (low dose) reinstatement?

Does Cialis give you great erections like pre-PSSD? For me thats not the case. Any PDE5i medication works very poor on me since PSSD, while they worked amazing when I tried them before. I guess thats because of the low libido? Not sure though.
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