This might be the key! Androgen function in the spotlight.

Post any data on Treatments and experimentation.
Kk88
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Re: This might be the key! Androgen function in the spotlight.

Unread post by Kk88 »

Thanks for this, really interesting.

A little scared at the idea of T, in the same way a guy would be about taking female SH. I want my sexuality back but I don't want a moustache! I don't think my understanding of this is enough to experiment, but it all sounds really promising.

fuckthisisscience wrote: Tue Mar 24, 2020 6:03 pm
Kk88 wrote: Tue Mar 24, 2020 2:57 pm How does this translate to females with Pssd? Thanks
To be honest, I have no clue.
It is well known, that even in women T deficiency may cause loss of sexual desire and function. There are some studies, that investigated women with low T (e.g. after oophorectomy) that were treated with T patches. The results were positive! See the conclusion of one trial:
Total satisfying sexual activity significantly improved in the testosterone patch group compared with placebo after 24 weeks. Treatment with the testosterone patch also significantly improved sexual desire (mean change, 10.57 compared with 4.29, P < .001) and decreased personal distress (P = .009). Serum free, total, and bioavailable testosterone concentrations increased from baseline. Overall, adverse events were similar in both groups (P > .05). The incidence of androgenic adverse events was higher in the testosterone group; most androgenic adverse events were mild.“

Source: https://www.researchgate.net/publication/7873712

Besides that, it is possible, that other hormones are involved e.g. estrogen. Further, it might be, that the ratio between the hormones plays a role. But to be honest: we dont know that. To date, there is not enough scientific evidence to recommend TRT to a woman.
Leb89
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Re: This might be the key! Androgen function in the spotlight.

Unread post by Leb89 »

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!

---------------------------------
Links:
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 (user: u/HoMcShmoe):
'...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.'

@fuckthisisscience: this sounds really interesting! I have done a blood test with all sexual hormones maybe four weeks before I developed PSSD and I have just done one maybe two month ago. I will get the results the next days and upload them to compare.

I have some questions:

1.) Is a permanent testosterone treatment necessary to keep the symptome relief permanently?

2.) I have symptoms since five month. Do you think it is too early to try such a treatment?
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Optimist
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Re: This might be the key! Androgen function in the spotlight.

Unread post by Optimist »

How do I put this theory across to my Endo without sounding like a crazy person?
vkn1
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Re: This might be the key! Androgen function in the spotlight.

Unread post by vkn1 »

I have had PSSD for 12 years and got it from either a Trazodone or Accutane. I took TRT for 4 years, trying all different methods with T levels set to everything from low to average to high. Never ONCE did I witness any benefit at all. Zero.

The idea that all we have is low hormone levels is not new. The first person who ever got PSSD, PFS, or PAS 20 or 30 years ago probably tried hormone therapy. If it has ever worked for anyone then that person probably simply had hypogonadism and not PSSD at all. Countless people here have tried hormone therapy and failed.
Amisrableguy
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Re: This might be the key! Androgen function in the spotlight.

Unread post by Amisrableguy »

What the timeline what do u think gave you pssd traz or acc?
When did u loose morning wood? What have you tried!
What are your symptoms?
fuckthisisscience
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Re: This might be the key! Androgen function in the spotlight.

Unread post by fuckthisisscience »

vkn1 wrote: Thu Mar 26, 2020 2:18 pm I have had PSSD for 12 years and got it from either a Trazodone or Accutane. I took TRT for 4 years, trying all different methods with T levels set to everything from low to average to high. Never ONCE did I witness any benefit at all. Zero.
Hey vkn1,
thanks for your reply. I'm sorry for you going through this hell, and I'm sorry for you trying TRT without benefits. As I wrote in my first post, there might be multiple reasons for this. It's really important that people that failed with TRT post here, too. So that we can find out, what went wrong. But you mustn't generalize your individual case. A brief list on possible faults:
  • PSSD may be a 'syndrom' with different pathomechanisms -> if this is the case, one kind of treatment wouldn't get everybody improvements
  • Trazodone and especially Accutane (!) are no traditional SSRIs; as my theory is refering to traditional SSRIs
  • We dont know your specific kind of T Treatment and your blood levels. I doubt that you tried out T levels that were above the reference value, but this might be the only way to overcome the symptoms
  • this list could be continued...
To date we have three positive treatment reports about TRT. One of them stating, that he needed levels above the reference range! That's a good point to start from. But let's do it scientifical and not everybody, as he/she might think it works.
- Medical Student - finishing in late 2020
- interested in PSSD (and sexual health in general), no sufferer
--> Androgen hypothesis
- wanting to research PSSD
- been reading numerous scientific articles about possible aspects of of PSSD
fuckthisisscience
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Re: This might be the key! Androgen function in the spotlight.

Unread post by fuckthisisscience »

Since 3 days, there is a new positive treatment report via reddit with injection of supraphysiological T doses and HCG (user: u/mrgoodcat1990):

'I cured my pssd with Testosterone . When I say cures I mean cured, fully restored. I had pssd for quite a few years and thought I was going to die without ever recovering. I had very high testosterone , but still had pssd. I did a lot of research spoke to a lot of people and start taking testosterone. I did plenty of medical examinations before hand to check for any underlying health conditions. After 8 weeks I was fully recovered, bare in mind I am planning to stay on for the rest of my life. (...) I took HCG aswell. I'm 30 years old. I took citalopram.'
- Medical Student - finishing in late 2020
- interested in PSSD (and sexual health in general), no sufferer
--> Androgen hypothesis
- wanting to research PSSD
- been reading numerous scientific articles about possible aspects of of PSSD
Leb89
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Joined: Sat Nov 16, 2019 2:50 pm
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Re: This might be the key! Androgen function in the spotlight.

Unread post by Leb89 »

Fuckthisisscience could you please tell us, do people have to take TRT injections permanently to cure their PSSD according to your theory? Wouldn’t that include other health problems?
vkn1
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Re: This might be the key! Androgen function in the spotlight.

Unread post by vkn1 »

I am sure some people who thought they had PSSD actually just had hypogonadism so it’s not surprising some people,have gotten better on TRT. As far as I know, people with PSSD generally do not have abnormal hormone levels, though.
fuckthisisscience
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Re: This might be the key! Androgen function in the spotlight.

Unread post by fuckthisisscience »

Leb89 wrote: Sun Mar 29, 2020 11:44 am Fuckthisisscience could you please tell us, do people have to take TRT injections permanently to cure their PSSD according to your theory? Wouldn’t that include other health problems?
Do you have to take it permanently?
Honestly, I dont know. In fact, we dont know anything about PSSD, except the symptoms. The patients that are taking TRT cause they're hypogonadal have to take it indefinitely to benefit. So TRT might be just a symptomatic treatment.

Will it harm you? To make it short: Most of the side effects are myths. For young (healthy) men, the biggest possible issue is (temporary) infertility. This can be addressed by HCG injections.

In your case you rather have to ask yourself: Will a life without sufficient androgenic supply damage my health? And this is - besides the actual symptoms you now have - highly probable! For example reports indicate that for men with hypogonadism TRT may produce a wide range of benefits that include improvement in libido and sexual function, bone density, muscle mass, body composition, mood, erythropoiesis, cognition, quality of life and cardiovascular disease!

Medicine is benefit-cost analysis.
- Medical Student - finishing in late 2020
- interested in PSSD (and sexual health in general), no sufferer
--> Androgen hypothesis
- wanting to research PSSD
- been reading numerous scientific articles about possible aspects of of PSSD
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