fuckthisisscience wrote: ↑
Sun Mar 22, 2020 8:11 am
Long story short: I’m convinced that sexual hormones (especially Testosterone and Estrogen) and/or their cellular transmission are the problem regarding PSSD
. My hypothesis: Steroid supply will lead to symptom relief
. Let me explain:
Hey guys I’m a med-student and will finish my studies in half a year (7. year for me now). I’ve been interested in PSSD (and sexual health and psychatry in general) since 4 years. Been reading numerous scientific articles about every possible aspect of the development of PSSD. I know your struggle since I watched countless patient experience reports here in the forum. After finishing my studies I want to do research on PSSD and I already know where to start.
I’ve read quite a few theories about the development of PSSD: Serotonin-transporter/receptor related stuff, Dopamin, glutamate, Acetylcholin (Betanechol!), pelvic floor dysfunction and so on.
In my opinion the most common symptoms fit perfectly the ones of testosterone deficiency
- low/no libido
- erectile dysfunction
- lack of penile sensitivity
- psychiatric: irritability, depression, anxiety, sleep and motivational problems, brain fog, memory problems
- muscular/joint pain
- sensitivity to cold temperatures and so on…
You might be familiar with the fact, that in the PSSD forum there has been quite a few patients, that posted their laboratory findings to the internet, oftentimes with the following results:
- T (Testosterone) too low, borderline low or normal range
I personally don’t remember anybody, having high values. But even if, that doesn’t change my theory:
I’m convinced, that for some reason there is too little sex hormone effect at the effector tissue (testes, penis, brain, skin etc.)
. I want to point out, that T in normal range doesn’t necessarily mean, that the appropriate effects are triggered
. There are numerous possible faults that this might not be the case: receptor problems or abnormal cellular mechanisms being two examples. So that there might be normal hormone levels, but the effector tissue isn’t reacting properly
due to a potential SSRI-damage. We know this effect from the so called ‚Androgen insensitivity syndrome‘
, where the cells are not able to respond to normal levels of androgens.
Unfortunately, there are only a few studies addressing the problem SSRI and sexual hormone production/reactivity. One study shows that application of common SSRI lowers Testosterone (and other hormone) levels in cellular models
(link below). Again, I want to cut it short, so I’m moving on.
There is good chance, that by raising T levels the symptoms can be reversed. As far as I know, few sufferers tried Testosterone treatment: I know two patients that healed their PSSD via testosterone replacement therapy (TRT)
(I have quoted one of them at the bottom of the post; or search reddit sub 'PSSD' for 'testosterone‘).
There are several reason for such few PSSD patients trying T-Replacement:
- just a few get their lab values checked
- and even if: no doctor would prescribe a patient with normal to borderline low T levels a T-replacement therapy, because in almost every case it is not necessary
And the few who tried might have failed because:
- they didnt know what to do
- doctors didnt know what to do
- taking too low doses (supraphysiological doses might be necessary!)
- patient stopping application too soon! -> T replacement often shows first effects after a couple of months (sometimes 6 months or more!), but soonest after 3 weeks
One more fact is interesting: Many of the (often young!) PSSD-sufferers say, that prior to SSRI-treatment their libido was raging high. That might be due to high T levels in their adolescence/early adulthood. Let’s imagine SSRI slightly decreased their T levels to then normal values
, they then would lack their habitual/native values and be symptomatic as long as they get back more T. Just imagine: a lab test would show 'appropriate' levels -> every doc would say, that they're fine! But the latter is just one possible explanation of ‚missing T theory‘.
In our days, testosterone replacement therapy (TRT) is a safe treatment option
(for further information see TRT-guide-link down below) . There are many side effect myths about it
(prostate cancer, heart failure, infertility and so on). Sure, you have to be cautious and be supported by a doctor, but even young men can be treated by TRT and be fertile at the same time!
Please note: As far as I know, T injection is the best method regarding TRT. There are several other methods (SERMs, HCG injection only, T patches and so on) that were not as effective as one injection per week.
And let me stress this one more time: normal hormonal levels don't necessarily mean, that an androgen application might not help you
. In patients with androgen receptor deficiency you may find T values in normal range, too. But they have to be administered high T doses to show some androgenic effects
. I dont believe that patients, that suffer from pssd fit in the "normal value" spectrum, that derived from healthy control people with proper androgen (metabolic) function. So in this regard nobody can really tell you whether a midrange value is a desirable one or not.
By the way, to date doctors more and more tend to describe TRT based on typical symptoms than only based on values.
I know that many of you suffered for a long time and I think it is worth a try. You might hold the key in your hands.
But please be sure to consult a doctor and first get blood work done. Ask at least for:
- LH and FSH
- Total Testosterone
- Free Testosterone (very important)
- Estradiol (ratio between T and Estr. is important!)
If you have any questions regarding the topic/your symptoms/changes with TRT, please tell me (make it short):
- your age/gender
- short history (medication & for how long, what reason/condition, how long pssd till now)
- symptoms and serverity (take the ones I mentioned above as example)
- were the symptoms steady/fluctuating/attenuating/increasing?
- sexual drive before medication (low/normal/high)
- have you ever had bloodwork done (if yes, what has been tested)
Sorry for the long post. Feel free to discuss!
SSRI-Androgen study https://www.ncbi.nlm.nih.gov/pubmed/28179152
TRT guide https://www.t-nation.com/pharma/complet ... eplacement
Quote of a positive treatment report via reddit
'...Ive been suffering from diminished libido, erectional problems and genital numbness after taking high doses of the ssnri venlafaxine, that I laid off 5 years ago. (...) I ordered testosterone enanthate oil (...) and injected 250 ml intramuscularly 1 week ago. Since then my libido has been steadily improving, im really aroused again and the erectile problems vanished. I still have some numbness but its definitely better.'
2 weeks later:
'Still have vivid sexual fantasies, great erections and penile sensitivity has been improving ever since the first dose. All symptoms I had been having the 5 Years since taking Venlafaxine have been alleviated
. So far so really fucking good.'