Pelvic Floor Physical Therapy- Timberline OP

[SufferingfromSSRI]

I'll bite.

I have believed for several years that I have PSSD since taking Lexapro during a particularly (extremely) distressing period in my life in 2015. I shouldn't have taken Lexapro as the issues I were dealing with were situational in nature and passed over time. I only took the Lexapro for maybe a month and I tapered off.

Since this time period the main symptoms that persist for me are loss of sensation, pleasureless orgasms, hourglass shape when semi-engorged and stiff hard flaccid. I still get pretty strong erections, sometimes very strong. My testicles also far more often sit high up and contracted to my body. Cold glans when flaccid. Orgasms can be pleasureless with no force behind the ejaculate, but the (pardon my French) not shooting ejaculations aren't always the case. I feel like my libido is still pretty high, but I lack that deep engaged feeling in my pelvis, balls, through my penis where everything feels so connected and the sensations just go up into your brain. The several partners I have had in this time period I was plenty attracted to and I was engaged in the sexual act but I lacked that deep feeling of connection that seems to emanate from the penis/testicles/pelvis and the sensations have been dull and muted. It is such a strange sensation to make love to someone and feel such a pleasureless climax and therefore the lack of emotional engagement.

So, my endless research at some point in the last month has lead me to believe that I need to rule out pelvic floor dysfunction as I exhibit pretty much EVERY symptom of hard flaccid/PF dysfunction except for the pelvic floor discomfort. I have tightness that I can notice when I relax those muscles but not pain.

I began to do the stretches from this video and noticed just how tight most of those muscles are by default and know from deadlifting and squats that I lacked hip mobility:

https://www.youtube.com/watch?v=J6tueuGlo1Q

I notice some temporary relief in that my penis at times in the last week since doing these stretches every day at times looks and feels like it used to when flaccid which is distended, loose, full instead of hard, contracted, and cold. I haven't noticed any ejaculatory benefit yet, but I feel like my erections have strengthened.

I also bought a Therawand and have used it a few times to try to loosen up the muscles internally, but kind of don't feel like Im able to do much loosening even though I can hit some spots in there that are noticeably more tender than others. I mean, the whole experience is uncomfortable but there are some areas in there that are REALLY uncomfortable but I can't seem to get them to release. Gonna keep at it and hopefully figure out some external trigger point release to hit too.

I got the number of a physical therapist (maybe the only one in my area) that works with males for pelvic floor issues. I will report any positive progress made.

[SufferingfromSSRI]

I just returned from my first pelvic floor PT session. It was mainly a diagnostic session in which I had electrodes connected to my skin on either side of my rectum (and one on my hip) and we measured the tension or "tone" of my pelvic floor muscles in various positions, stretches, and activities. As theorized due to the symptoms I have been experiencing, I have a very high resting tension in my pelvic floor.

So my pelvic floor is super tight, which also makes it WEAK. This is because there is little room for contraction upwards from the resting tense state. I have to perform morning and nightly stretches and pelvic floor exercises (Kegel and Reverse Kegel). Kegel to strengthen, reverse kegel to relax. So my muscles need a LOT of relaxation training and a fair bit of strengthening training with the end goal of restoring a normal resting muscle tone and allowing for a FULL contraction from 0-10 instead of the 7-10 I get currently. Google "Down Training Pelvic Floor". If my resting tone is too tight that would explain the hard flaccid and weak orgasms. I also need to train myself to relax these muscles throughout the day and during various daily activities.

I think I'm on the right track. Even if I have some chemical issues as a result of SSRI, there is DEFINITELY a physiological element at play in my case and the biofeedback from today allowed me to quantify that. I implore everyone to rule this out in their own cases. Perhaps there is a significant correlation between PSSD and weak or tense pelvic floor muscles in men and women, maybe not. Will keep everyone posted as I begin my homework exercises tonight and will have weekly appointments for PT.

[Kiliantkt]

Any updates "SufferingfromSSRI" ?

[Ghost]

I'm getting into this again. It's the persistent theory and project of mine which just won't go away. It's time to go all in.

As to not gatekeep this information any longer, I have seen some erection improvements using red light therapy (660nm /850nm (IR)). I've been doing this about 9 months. Averaging about a treatment a day. It's not going to fully cure you, but it helps. I wanted to wait long enough to be able to say that for sure. This thought is supported in Waldinger's 2014 care report on laser treatment in PSSD.

My core principles are "use it or lose it" and "bloodflow".

In 2018 Goldstein diagnosed me with some penile vasculature issues, decreased nerve function in the pelvic area, and penile fibrosis. I'm thinking about this from a solutions / medical perspective and my goal is to get more bloodflow, less inflammation, and stronger muscles in the pelvic region.

I think red light helps with all 3, but I want to do more. I've been researching ways to strengthen muscles involved in the male sexual response and plan to go to Dr. Goldstein and have him treat the fibrosis issue and vascular insufficiency (using gainswave) - Data is good for both these indications, and there is really good evidence that muscle stimulation combined with training is successful in treating all kinds of erection problems.

I'm not really focused on SSRIs/PSSD in particular at this time. Maybe Lexapro damaged tissue, muscle, nerves, or a combinat of all 3. At this point i don't really care. I think semantics and researching receptors bogged me down in the weeds a bit in my past. But I learned a lot and don't look back in anger at all!

Expect updates soon!