Treatments for Genital Anesthesia specifically ?

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PSSD_Throwaway28
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Treatments for Genital Anesthesia specifically ?

Unread post by PSSD_Throwaway28 »

Hi everyone,

As I mentioned in my intro, I suffer from PSSD after being on a fairly high dose regimen of Pristiq (100mg - tapered to 50mg after 6 months) about a year and a half ago. I've combed through a lot of threads here looking for possible treatments for mechanical and erogenous genital anesthesia (which is my main symptom), but it is a bit hard to sort through things because PSSD is associated with such a broad range of symptoms. Further complicating my search is the fact that many of the posts reporting successful treatment windows seem to focus primarily on libido and erectile functioning, and when they do mention improvements in genital sensitivity it is often not clear whether the person had genuine genital anesthesia to begin with versus decreased erogenous sensitivity due to low libido.

So I'm just wondering whether anyone here with full or partial genital numbness (i.e. significant reduction in sensation to touch, pressure, and heat both when aroused and not aroused) has seen any significant reversal of this symptom through the use of some prescription medication or nutraceutical? The only thing I have tried so far is 3g of L-Citrulline per day for about 3 and half months now. This has made blood flow to the penis better (though I didn't have ED before) and improved erogenous sensitivity a modest amount (initial gains in eregenous sensitivity were somewhat higher, but effect has leveled-off to some extent), but there has been no sustained improvement to mechanical sensitivity.

My PSSD is fairly mild overall by the standards of this forum so I'm not looking for a miracle cure, but if anyone has had noticeable improvements after suffering from moderate-severe mechanical/erogenous numbness (e.g. you have had times where you can pinch the skin of the glands and not feel very much) I'd love to here from you (especially if you are a male like I am since male genital numbness seems somewhat more recalcitrant for whatever reason).
sovietxrobot
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Re: Treatments for Genital Anesthesia specifically ?

Unread post by sovietxrobot »

Genital numbness seems to be the least studied of all the sexual side effects. The only reference I have seen suggests it is due to excess serotonin, but I wouldn't be surprised if it was caused by something else. It is indeed unusual to see numbness without the other common PSSD effects but everyone is different. You mentioned also having some cognitive/affective issues, which suggests dopamine expression is somehow altered. Did you get lab work done? High prolactin levels would also be a sign of dopamine disregulation.

You could try buspar, trazodone, or mirtazipine. They all target different serotonin receptors (5HT1A, 5HT2, 5HT2/3), which play different roles in sexual response. As mentioned, the only publication I found on genital numbness indicated 5HT2/3, but it wasn't well explained. These all impact dopamine expression, so it may address your other issues.
JP1985
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Re: Treatments for Genital Anesthesia specifically ?

Unread post by JP1985 »

PSSD_Throwaway28 wrote: Sat Apr 25, 2020 3:05 am Hi everyone,

As I mentioned in my intro, I suffer from PSSD after being on a fairly high dose regimen of Pristiq (100mg - tapered to 50mg after 6 months) about a year and a half ago. I've combed through a lot of threads here looking for possible treatments for mechanical and erogenous genital anesthesia (which is my main symptom), but it is a bit hard to sort through things because PSSD is associated with such a broad range of symptoms. Further complicating my search is the fact that many of the posts reporting successful treatment windows seem to focus primarily on libido and erectile functioning, and when they do mention improvements in genital sensitivity it is often not clear whether the person had genuine genital anesthesia to begin with versus decreased erogenous sensitivity due to low libido.

So I'm just wondering whether anyone here with full or partial genital numbness (i.e. significant reduction in sensation to touch, pressure, and heat both when aroused and not aroused) has seen any significant reversal of this symptom through the use of some prescription medication or nutraceutical? The only thing I have tried so far is 3g of L-Citrulline per day for about 3 and half months now. This has made blood flow to the penis better (though I didn't have ED before) and improved erogenous sensitivity a modest amount (initial gains in eregenous sensitivity were somewhat higher, but effect has leveled-off to some extent), but there has been no sustained improvement to mechanical sensitivity.

My PSSD is fairly mild overall by the standards of this forum so I'm not looking for a miracle cure, but if anyone has had noticeable improvements after suffering from moderate-severe mechanical/erogenous numbness (e.g. you have had times where you can pinch the skin of the glands and not feel very much) I'd love to here from you (especially if you are a male like I am since male genital numbness seems somewhat more recalcitrant for whatever reason).
Don’t know if this sounds ridiculous but the only thing that helps my sensation is cocaine. I’ve not had it for months as obviously it’s a bad thing to do and only dare have it when drunk.. But the day after having it my sensation and orgasms are good!

If anyone has any proper suggestions to helping me and the original poster it would be much appreciated! Sensation when touched by myself or partner is the main thing I’m looking to sort out!
Last pill March 2019 - Citalopram for 7 years
Numbed penis and weak orgasm
Fatigue
Slightly blunted
Dizziness (this has improved a lot in the last 6 months)
cdraham
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Re: Treatments for Genital Anesthesia specifically ?

Unread post by cdraham »

JP1985 wrote: Fri Jun 05, 2020 9:37 am
PSSD_Throwaway28 wrote: Sat Apr 25, 2020 3:05 am Hi everyone,

As I mentioned in my intro, I suffer from PSSD after being on a fairly high dose regimen of Pristiq (100mg - tapered to 50mg after 6 months) about a year and a half ago. I've combed through a lot of threads here looking for possible treatments for mechanical and erogenous genital anesthesia (which is my main symptom), but it is a bit hard to sort through things because PSSD is associated with such a broad range of symptoms. Further complicating my search is the fact that many of the posts reporting successful treatment windows seem to focus primarily on libido and erectile functioning, and when they do mention improvements in genital sensitivity it is often not clear whether the person had genuine genital anesthesia to begin with versus decreased erogenous sensitivity due to low libido.

So I'm just wondering whether anyone here with full or partial genital numbness (i.e. significant reduction in sensation to touch, pressure, and heat both when aroused and not aroused) has seen any significant reversal of this symptom through the use of some prescription medication or nutraceutical? The only thing I have tried so far is 3g of L-Citrulline per day for about 3 and half months now. This has made blood flow to the penis better (though I didn't have ED before) and improved erogenous sensitivity a modest amount (initial gains in eregenous sensitivity were somewhat higher, but effect has leveled-off to some extent), but there has been no sustained improvement to mechanical sensitivity.

My PSSD is fairly mild overall by the standards of this forum so I'm not looking for a miracle cure, but if anyone has had noticeable improvements after suffering from moderate-severe mechanical/erogenous numbness (e.g. you have had times where you can pinch the skin of the glands and not feel very much) I'd love to here from you (especially if you are a male like I am since male genital numbness seems somewhat more recalcitrant for whatever reason).
Don’t know if this sounds ridiculous but the only thing that helps my sensation is cocaine. I’ve not had it for months as obviously it’s a bad thing to do and only dare have it when drunk.. But the day after having it my sensation and orgasms are good!

If anyone has any proper suggestions to helping me and the original poster it would be much appreciated! Sensation when touched by myself or partner is the main thing I’m looking to sort out!
Chronic cocaine intake will upregulate SERT, no idea if this is why it helps with genital numbness.
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kpavel
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Re: Treatments for Genital Anesthesia specifically ?

Unread post by kpavel »

I guess cocaine, bupropion and ginkgo biloba have something in common.
PSSD_Throwaway28
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Re: Treatments for Genital Anesthesia specifically ?

Unread post by PSSD_Throwaway28 »

kpavel wrote: Fri Jun 05, 2020 10:37 am I guess cocaine, bupropion and ginkgo biloba have something in common.
I made a separate post about this a few days ago, but for what its worth, I started a trial of bupropion (150mg XL/per day) this past Sunday.

For a bit of context, my genital numbness was already improving sporadically for the past few weeks (this largest window I've experienced in a year and a half of PSSD), but improvements regressed for more than a week and I became a bit despondent and decided to give the drug a try.

Day one I didn't feel any different, but day two there was a noticeable increase in sensitivity again similar the improvements I was experiencing before (this isn't just a sexual function thing, I had a noticeably greater response to heat and tactile stimulation when not aroused). Now on day six, these improvements have mostly dropped-off, but things haven't gotten any worse for sure. To be honest though, I'm not sure I want to continue the trial. On the one hand, while my sexual functioning certainly isn't great, it has gotten better over the last 5 months or so to where I would now probably classify it as 'passable' under the right circumstances (I have no erectile difficulties, I experience some limited ergenous sensation, and can climax), and I am terrified of losing these gains altogether with a drug like bupropion. Granted, I know this is pretty rare, but it is weighing on my mind heavily. On the other hand, it would obviously be fantastic if bupropion was the thing that actually resolved the numbness altogether (hell even a 50% improvement would have me jumping for joy), and I am becoming increasingly worried that PSSD might cause irreversible degeneration of sensory nerves over time in some cases if it is not resolved. Case in point, I went to the doctor recently to review my symptoms and he administered a poke test to check for nerve density; while most of my penis was more-or-less normal (I have improved enough that I can feel these kinds of direct pokes and pinches now), there was a small patch on the upper right side that exhibited significantly dulled sensation. Of course, this small fibre neuropathy/nerve degeneration theory is controversial, and the fact that I have had modest, sustained improvements in sensation overtime seem to tell against it. Then again, what I interpret as improvements in sensation might actually be sensory disturbances caused my nerve degeneration, so who knows really. I do think permanent neuropathy is somewhat unlikely since (a) many people experience genital numbness on SSRI's for years but regain sensitivity when the drug is removed (which seems to indicate that the physiological mechanism by which SSRI's numb the genitals does not actually damage the nerves) and (b) there have been a few PSSD case reports of people with completely numb genitalia recovering sensitivity after many years.

Anyway, to sum things up, I'm having a bit of a dilemma now.

.
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kpavel
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Re: Treatments for Genital Anesthesia specifically ?

Unread post by kpavel »

Yeah, I also had thoughts that it's not a neuropathy, but a subtype of analgesic signaling. Only which? Opioid? Cannabinoid or Imidazoline? One study I find interesting is Evidence for Dietary Agmatine Sulfate Effectiveness in Neuropathies Associated With Painful Small Fiber Neuropathy. A Pilot Open-Label Consecutive Case Series Study.
I found that SSRI drugs increase agmatine in brain Antidepressant Like Effect of Selective Serotonin Reuptake Inhibitors Involve Modulation of Imidazoline Receptors by Agmatine
In couple with Nitric Oxide Is Involved in the Regulation of Marble-Burying Behavior (OCD behavior) and the finding that Agmatinase, an Inactivator of the Putative Endogenous Antidepressant Agmatine, Is Strongly Upregulated in Hippocampal Interneurons of Subjects With Mood Disorders
it becomes intriguing.
I was going to try agmatine, but am afraid just like you;)
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anacleta
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Re: Treatments for Genital Anesthesia specifically ?

Unread post by anacleta »

Penile Anesthesia in Post SSRI Sexual Dysfunction (PSSD) Responds to Low-Power Laser Irradiation
https://pubmed.ncbi.nlm.nih.gov/25483212/
john099
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Re: Treatments for Genital Anesthesia specifically ?

Unread post by john099 »

I believe its caused by pelivc floor dysfunction - if you look at he CPPS forums they also have numb genitals, no libido, ED, Soft glans, issues with urinating, hard flaccid, etc

So you can see they are similar symptoms due to the nerves being compressed - I have had better orgasms and better sensation after doing DCT - resistance stretching for pelvic floor.

But this is not the cause of PSSD - just one of the many symptons. Others have reported improvement with pelvic floor therapy

Not a miracle cure though - but it helps
tonyareias
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Re: Treatments for Genital Anesthesia specifically ?

Unread post by tonyareias »

A friend tell me that a body wash / shower gel give him some loss of sensation (and coloration) in penis and now he wash penis only with water and getting better.
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