Doctor is Skeptical about PSSD

[Themyandude74]

Hello

Yesterday I had an appointment with my doctor regarding sexual dysfunction. I had already seen a Urologist and had some hormone tests done, and they all came back normal- great testosterone levels, normal estrogen,thyroid, prolactin etc. hormones are normal.- lack of physical abnormalities seen from the Urologist’s assessment as well.

She doesn’t seem to think I have a physical problem. She suggests that the persistent sexual dysfunction is psychological, that I have a “mental block” and that my focus on the sexual concerns is unhealthy, and contributing to the problem. She seemed very skeptical about PSSD, saying that she had never heard about it, did not want to prescribe me any medications, and basically suggested my problems are psychological and lifestyle related issues.

This is frustrating because I’m pretty sure I have PSSD from citalopram (genital numbness, ejaculatory anhedonia, libido loss etc). I schedule a doctors appointment hoping I at least leave with a prescription for something like viagra or busiprone to try and help the problem, but no nothing. To be honest it’s awkward talking to a physician about it, the challenges here are probably why PSSD is so underreported- the problem is swept away as hypochondria, or patients don’t know how to talk about it to their doctor like with myself…

This is the fourth medical professional I’ve met that doesn’t really seem to believe in PSSD despite the fact it’s been confirmed to be a rare but serious problem caused by SSRI’s. It’s just difficult to believe my doctor won’t work with me on this…

She’s a great doctor, who is good and cares about her patients, but her approach to PSSD is one of great skepticism and disbelief. I could print out several papers about PSSD but I feel like that could be seen as just bothersome and pedantic. It’s just unfortunate that this is the way things are right now.

[sovietxrobot]

I have found that you need to have a very specific approach to get doctors to take you seriously. You need to see a urologist and rule out hormonal/physical issues (which you have done). You need to be seeing a therapist (preferably a sex therapist) or they will say its all in your head. I avoid using the term PSSD at all, and be very cautious about mentioning anything that you read on the internet- they will immediately dismiss you as a hypochondriac. I've yet to meet a doctor that was willing to look at any papers, but I wrote a short summary of case reports and clinical studies, and my current psychiatrist was willing to look at that. Its also important to chart your symptoms regularly (preferably daily), its one of the few things multiple doctors have accepted.

[arahant]

I have found that you need to have a very specific approach to get doctors to take you seriously. You need to see a urologist and rule out hormonal/physical issues (which you have done). You need to be seeing a therapist (preferably a sex therapist) or they will say its all in your head. I avoid using the term PSSD at all, and be very cautious about mentioning anything that you read on the internet- they will immediately dismiss you as a hypochondriac. I've yet to meet a doctor that was willing to look at any papers, but I wrote a short summary of case reports and clinical studies, and my current psychiatrist was willing to look at that. Its also important to chart your symptoms regularly (preferably daily), its one of the few things multiple doctors have accepted.

That was pretty much my approach at a psychiatrist, the first appointment was long and I mostly focused at symptoms only. It's better than going into an useless fight trying to convince the doctor whatever you read on the internet and self diagnosed. It's truly an easy way to be dismissed as hypochondriac, because hypochondriacs do google symptoms and self diagnose. It's about 2-7% of patients that seek help. It's safe to assume they see it everyday. It's unlikely they will ever read pubmed links you sent them because of available time and the reasons above.
If you wanna get any care just focus on your symptoms telling about it indirectly, because patients that doesn't Google symptoms will never mention technical terms like "anhedonia" or "emotional blunting" straight to their face.
Best of luck

[Themyandude74]

That was pretty much my approach at a psychiatrist, the first appointment was long and I mostly focused at symptoms only. It's better than going into an useless fight trying to convince the doctor whatever you read on the internet and self diagnosed. It's truly an easy way to be dismissed as hypochondriac, because hypochondriacs do google symptoms and self diagnose. It's about 2-7% of patients that seek help. It's safe to assume they see it everyday. It's unlikely they will ever read pubmed links you sent them because of available time and the reasons above.
If you wanna get any care just focus on your symptoms telling about it indirectly, because patients that doesn't Google symptoms will never mention technical terms like "anhedonia" or "emotional blunting" straight to their face.
Best of luck

Yes, thank you for the advice, perhaps I just shouldn’t have mentioned PSSD at all in the first place to my GP, because that’s what I did via a phone call appointment. And yes, hypochondria is a common thought because SSRI’s are literally prescribed for anxiety disorders, so that’s the go to reasoning of a lot of doctors who are presented with a patient with PSSD unfortunately.

It’s just frustrating because I know that there are some medications that could have a positive effect on sexual functioning, but I wasn’t prescribed anything. I’m not really sure what to do right now…

[Brain food]

Hello

Yesterday I had an appointment with my doctor regarding sexual dysfunction. I had already seen a Urologist and had some hormone tests done, and they all came back normal- great testosterone levels, normal estrogen,thyroid, prolactin etc. hormones are normal.- lack of physical abnormalities seen from the Urologist’s assessment as well.

She doesn’t seem to think I have a physical problem. She suggests that the persistent sexual dysfunction is psychological, that I have a “mental block” and that my focus on the sexual concerns is unhealthy, and contributing to the problem. She seemed very skeptical about PSSD, saying that she had never heard about it, did not want to prescribe me any medications, and basically suggested my problems are psychological and lifestyle related issues.

This is frustrating because I’m pretty sure I have PSSD from citalopram (genital numbness, ejaculatory anhedonia, libido loss etc). I schedule a doctors appointment hoping I at least leave with a prescription for something like viagra or busiprone to try and help the problem, but no nothing. To be honest it’s awkward talking to a physician about it, the challenges here are probably why PSSD is so underreported- the problem is swept away as hypochondria, or patients don’t know how to talk about it to their doctor like with myself…

This is the fourth medical professional I’ve met that doesn’t really seem to believe in PSSD despite the fact it’s been confirmed to be a rare but serious problem caused by SSRI’s. It’s just difficult to believe my doctor won’t work with me on this…

She’s a great doctor, who is good and cares about her patients, but her approach to PSSD is one of great skepticism and disbelief. I could print out several papers about PSSD but I feel like that could be seen as just bothersome and pedantic. It’s just unfortunate that this is the way things are right now.

Themyandude74, when you talk about your doctor, what kind of doctor is she? Is she a GP or a specialist?

[6-Eggs!]

I had a number of doctors disregard my symptoms as psychological too with no physical involvement, but to be fair some of my symptoms do have psychological control so it's not as simple and being pure physical or pure mental in my case but a mix of both.

Took me a number of different doctors and specialists to acknowledge that I have some sort of super rare neurological issue during and post medication. Although I do have PSSD symptoms my condition isn't PSSD strictly speaking.

I have an awesome doctor after trying many, and an awesome mental health/sex therapist specialist who saw me through the emergence of PSSD symptoms while I was seeing her. She agreed that PSSD symptoms are real among all the other weird functional neurological deficits that aren't typical for PSSD.

I also have a good neurologist, which I happen to be seeing tomorrow. He also agrees the drug caused the issues.


Hang in there and keep searing for good doctors. As for prescriptions, unfortunately most people don't fair too well for adding other drugs to try fixing the issue and there is no know standard treatment. I for one am rejecting any push for other drugs. They have done enough damage already. I am lucky that this is working and I am improving constantly. I have come a long way since the whole ordeal 7-8 months ago.

[Themyandude74]

Themyandude74, when you talk about your doctor, what kind of doctor is she? Is she a GP or a specialist?

I spoke to my GP general practitioner two days ago. I have also spoken to two psychiatrist’s and a therapist about it and they were all skeptical, but one of the psychiatrists was hostile to the concept of PSSD and disrespectful to me unfortunately.

[R3m3dy]

Show any skeptical doctors this list of resources https://www.pssdcanada.ca/academic-sources

You can also show them that as of this June 11th 2019 release the EMA acknowledges the existence of PSSD (item #3) https://www.ema.europa.eu/en/documents/ ... rac_en.pdf

I don't know how any rational person couldn't at least acknowledge the possibility of PSSD's existence if they actually looked at what is contained in those links.

[Themyandude74]

Show any skeptical doctors this list of resources https://www.pssdcanada.ca/academic-sources

You can also show them that as of this June 11th 2019 release the EMA acknowledges the existence of PSSD (item #3) https://www.ema.europa.eu/en/documents/ ... rac_en.pdf

I don't know how any rational person couldn't at least acknowledge the possibility of PSSD's existence if they actually looked at what is contained in those links.

I know, thank you for this.

Healy has also published patient experiences with doctors regarding PSSD, so many doctors just don’t want to consider PSSD or treat it: there is this strong apprehension and misunderstanding from doctors about it. After experiencing it, it is very frustrating.

I didn’t even get to accurately describe what the symptoms were, for my doctor to tell me to “focus my mental energy on other things” was just baffling. I can’t just magically stop thinking about serious chronic sexual dysfunction like it’s nothing, that’s not helpful either.

[Themyandude74]

I don't know how any rational person couldn't at least acknowledge the possibility of PSSD's existence if they actually looked at what is contained in those links.

I think one of the biggest reasons more people haven’t recovered from PSSD or had any helpful treatment for it is that most doctors don’t even think there is a problem, so they never even try a medicine that might help PSSD, if the problem is never even taken seriously or reported. It’s so frustrating.