Ghost: regarding PSSD subtypes
Posted: Thu May 16, 2019 11:28 am
Note: This post is merely to help people report me their symptoms quicker. This is not a scientific post, and shouldn't be regarded as such. Take these subtypes with a grain of salt.
Subtypes:
1- Pure PSSD: Pure sexual dysfunction without other symptoms. Symptoms include ED, premature ejaculation or delayed orgasm, genital numbness, etc. These are manifestations of nitric oxide pathway dysfunction, TRPC and TRPV channel dysfunction, sex hormone dysregulation and sex hormone receptor insensitivity, with a possible thyroid involvement.
2- Cognitive PSSD: Sexual symptoms + cognitive dysfunction, but without anhedonia or blunted affect. In this subtype, there's a clear cortical dysfunction (cholinergic and/or glutamatergic, and DA/NErgic) leading to brain fog, reduced intelligence, poor memory, and poor concentration.
3- Excito-inhibitory PSSD: Sexual symptoms + cognitive symptoms + either intense anxiety/obsessions or complete loss of the anxiety response. Either severe insomnia or excessive daytime sleepiness. Symptoms don't include anhedonia and blunted affect, or any mesolimbic-cortical pathway dysfunction. This subtype is due to GABA-glutamate dysregulation. Low glutamate PLUS either low GABA (insomnia, anxiety, OCD, panic, paranoia etc) or high GABA (excessive drowsiness, complete loss of anxiety). This type is related to dysfunction of neurosteroids and allopregnanolone, as well as changes of expression of 3α-HSD and 3b-HSD enzymes and blunting of the HPA axis (GR upregulation).
4- Mesolimbic PSSD: Sexual symptoms + GABA-glutamate dysfunction + mesolimbic pathway dysfunction but without cognitive dysfunction. This subtype most likely involves presynaptic 5HT1A supersensitivity or postsynaptic 5HT1A receptors desensitization, or both, plus phasic (not tonic only) dopamine release dysfunction, and reduced oxytocin and beta endorphin release.
5- Complex PSSD: Sexual symptoms + cognitive symptoms + GABA-glutamate dysfunction + mesolimbic-cortical pathway dysfunction. All previous symptoms PLUS severe anhedonia and blunted/flattened affect. There's a clear central dysfunction involving multiple brain areas, with autonomic nervous system dysfunction on top. This severe subtype most likely involves presynaptic 5HT1A supersensitivity or postsynaptic 5HT1A receptors desensitization, or both. Along with all the previous dysfunctions. There's a cholinergic, dopaminergic, DA/NErgic, GABAeric, glutamatergic, and serotonergic involvement + sex hormone and NO pathway dysfunction on top.
Subtypes:
1- Pure PSSD: Pure sexual dysfunction without other symptoms. Symptoms include ED, premature ejaculation or delayed orgasm, genital numbness, etc. These are manifestations of nitric oxide pathway dysfunction, TRPC and TRPV channel dysfunction, sex hormone dysregulation and sex hormone receptor insensitivity, with a possible thyroid involvement.
2- Cognitive PSSD: Sexual symptoms + cognitive dysfunction, but without anhedonia or blunted affect. In this subtype, there's a clear cortical dysfunction (cholinergic and/or glutamatergic, and DA/NErgic) leading to brain fog, reduced intelligence, poor memory, and poor concentration.
3- Excito-inhibitory PSSD: Sexual symptoms + cognitive symptoms + either intense anxiety/obsessions or complete loss of the anxiety response. Either severe insomnia or excessive daytime sleepiness. Symptoms don't include anhedonia and blunted affect, or any mesolimbic-cortical pathway dysfunction. This subtype is due to GABA-glutamate dysregulation. Low glutamate PLUS either low GABA (insomnia, anxiety, OCD, panic, paranoia etc) or high GABA (excessive drowsiness, complete loss of anxiety). This type is related to dysfunction of neurosteroids and allopregnanolone, as well as changes of expression of 3α-HSD and 3b-HSD enzymes and blunting of the HPA axis (GR upregulation).
4- Mesolimbic PSSD: Sexual symptoms + GABA-glutamate dysfunction + mesolimbic pathway dysfunction but without cognitive dysfunction. This subtype most likely involves presynaptic 5HT1A supersensitivity or postsynaptic 5HT1A receptors desensitization, or both, plus phasic (not tonic only) dopamine release dysfunction, and reduced oxytocin and beta endorphin release.
5- Complex PSSD: Sexual symptoms + cognitive symptoms + GABA-glutamate dysfunction + mesolimbic-cortical pathway dysfunction. All previous symptoms PLUS severe anhedonia and blunted/flattened affect. There's a clear central dysfunction involving multiple brain areas, with autonomic nervous system dysfunction on top. This severe subtype most likely involves presynaptic 5HT1A supersensitivity or postsynaptic 5HT1A receptors desensitization, or both. Along with all the previous dysfunctions. There's a cholinergic, dopaminergic, DA/NErgic, GABAeric, glutamatergic, and serotonergic involvement + sex hormone and NO pathway dysfunction on top.