I scoured the various PSSD community spaces on the Internet, read hundreds of testimonies of healing or improvement, classifying them according to the substances mentioned, the evolution of symptoms and cross-referencing them with data from the scientific literature.
I would like to point out that I have two university degrees, one in cognitive science (I took courses in neurobiology) and the other in sexual health. I have made my working document freely accessible (still in progress, depending on new developments).
PSSD is a complex disease
It can manifest through a series of different symptoms that considerably alter quality of life:
* Genital numbness / Sexual anaesthesia (inability to perceive mechanical touch information such as hot, cold, pressure and speed)
* Loss of sensations of hunger or thirst
Consummatory anhedonia (inability to experience pleasure, through the senses) :
* Reduction or total absence of sexual pleasure (often at 2 or 3/10 and may drop to 0/10 for the most severe cases),
* Reduction or total absence of emotional arousal (touching a partner, being touched)
* Reduction or absence of pleasure on the rest of the body (arms, belly, thighs, back, nipples)
* Reduction or absence of pleasure involving senses other than touch, such as listening to music, enjoying food, etc.
* Reduction or total absence of emotional arousal during a sensory activity (sex, food, social interaction, music)
* Reduction or total absence of pleasure at the moment of orgasm
Anticipatory anhedonia (inability to feel aroused by the idea of a pleasurable future activity)
* Decreased or total absence of libido (urge to masturbate and/or urge to have sex with other people)
* Reduction or total absence of emotional arousal (planning vacations, social events)
Physiological changes
* Erectile dysfunction / vagina becomes flaccid
* Inability to reach orgasm (the reflex enabling pelvic floor spasms is not triggered)
* Reduced lubrication / Change in semen quality and/or quantity
* Soft glans (both penis and clitoris)
* Rarer but possible: Shrinkage of genitalia (both penis and clitoris)
Cognitive impoverishment
* Aphantasia : inability to mentally evoke images (imagine your child's face, artistic work)
* Fewer or no dreams (not just erotic ones)
* Brain fog,
* Short term and long term memory loss
Emotional and affective impoverishment
* Inability to feel emotions of love
* Reduction or loss of attraction to sexual partners
* No motivation
* Depressed mood
* Rarely mentioned but surely more widespread than reported : reduced perception of certain types of bodily pain
Others :
* Fatigue,
* Eye floaters, etc.
In short, this disease is not “psychological”, but undoubtedly involves numerous dysfunctions - at least - in the central nervous system.
Some patients appear to have a cognitively dominant symptom profile, describing aphantasia / blank mind as "the worst symptom," while others appear to suffer more from anhedonia, describing "numbness" as the worst symptom.
In any case, their symptoms considerably impoverish their inner life and alter their quality of life.
Cognitive and sexual alterations can be caused by multiple factors/triggers (single or combined):
* Having taken or stopping SSRIs / SNRIs
* Anti-androgen drugs such as finasteride
* Rapid changes in dosages or molecules
* Anti-psychotic drugs
* Taking medication at the time of puberty
* Emotional abuse during childhood and/or adolescence
* Peptides or research drugs
It's important to keep an open mind, as even drugs identified as “pro-sex” can cause or worsen PSSD-type symptoms.
* Bupropion / Wellbutrin or PT-141 / Bremelanotide (MCT-4 agonists)
* Flibanserin / Addyi (scientific source)
* Buspirone (scientific source)
But without wanting to be dramatic, some cases can also be relieved and cured with these same drugs.
Any attempt at healing carries the potential for lasting recovery... But also for worsening (no one can predict in advance).
But the body is adaptive, the brain is malleable, and the possibilities for recovery are truly there... Even when you've tried so many things and endured the symptoms for so many years.
Several theories have been formulated to explain biologically the emergence of so many alterations:
* Receptor desensitization
* DNA hypermethylation and gene silencing
* Dysbiosis: alterations in the microbiota
* Mitochondrial dysfunction
* Maladapted cell memories
* Neuronal atrophies
Ok, so... How to promote healing processes?
The PSSD community tries a variety of treatments (medications, hormones, supplements, lifestyle changes). And most see little or no benefit.
According to my observations, people with “recent” PSSD (<3 years) are the most likely to recover naturally, with the passage of time, by exercising, managing their stress and distress in relation to PSSD and/or opting for a better diet.
Several prescription medications can provide symptomatic relief such as bupropion, buspirone, cabergoline, and even naltrexone...
For people with severe and persistent PSSD (< 3 years), things are often different. But lasting recovery can also be achieved. Some patients with PSSD over 5 or 15 years old have recovered.
How do they do it?
Two possible scenarios:
* Take one or more medications/substances (combo) that gradually improve symptoms over several months until complete recovery (after stopping the "crutch" medications, the body is able to function again = the person is 100% cured)
* Rare (often uncomfortable) but possible: very rapid recovery from symptoms by taking a high dose of a substance (and - very important and often overlooked: the person has often been exposed to the same substance for several months or years - which may have "prepared silently" the brain to remodel itself once the substance is taken in large quantities - on a new occasion or in a particular context) => in my opinion, it's impressive to read but this is difficult to replicate - and not the safest. If you analyze carefully, it's not necessarily quicker to achieve this result than the options below.
Here the most promising treatments for lasting healing
Very low dose Kisspeptin-10 (in cycle)
Many people with PSSD have already reported improvements in :
* Libido,
* Pleasure,
* Ability to have an orgasm,
* Erection,
* Cum quality and
* Increase in the size of the genitals.
A synergistic effect has been reported between the peptide Oxytocin and Kisspeptin regarding the improvement of sensations.
→ Read the full testimonials
But what intrigued me most was the story of complete remission after taking a very, very low dose of Kisspeptin 3 times a day for a year (subcutaneous half-life : ~15–20 min).
Quote (August 2024) :
“Symptoms started in 2022, sex drive was super high before hand. I felt like a sex god and fucked like one too.
Symptoms: coldness, numbness, couldn't get all the way hard (women def noticed it and told me it felt like 2 inches, I'm normally between 7.5 and 8.5), reduced volume and count, Ed ofc. constipation, crying spells.”
“I went to an endocrinologist about 2 years ago who started me on hcg and enclomiphene then switched me over to kisspeptin-10“
“Dosage : usually 0.5~1 mcg 3x per day for 5 days, take a day or two off then back again.
Sometimes I'll take 5 mcg at once.
I started off with standard doses of 100-200 mcg and crashed quickly so slowly but surely tapered down to my desired doses.”
“I recovered everything, I can actually feel a dull pain when I get hard enough”
Note: The person stated in a comment that they were also taking buspirone, which has been reported in several testimonies (often in synergy with other substances) to improve PSSD symptoms.
Note 2 : The person appeared to have recent PSSD (< 3 years).
---
How does Kisspeptin work?
Kisspeptin regulates sex steroid, steroidogenesis and spermiation in animal studies (source 1, source 2). In addition, Kisspeptin appears to regulate proliferation and steroid production in luteal cells (in vitro and in vivo study).
Note: it is possible that the molecule may have synergistic effects with others than oxytocin. We'll know more in time.
ALTO-100 (often called : NSI-189)
Symptoms relieved :
* Genital numbness
* Sexual pleasure
* Libido
* Romantic feeling
* Erection
* Orgasm
How ?
One person (who had been suffering for 5 years) took 20 mg for 100 days, saw improvements after 2-3 weeks and then continued to improve in the months following discontinuation... Until she is fully healed. The last symptom to be recovered is sexual numbness.
Another person (who had been suffering for 3 years) took 40 mg for several weeks, experienced improvements and then, impatient, took a massive dose. He felt unwell but the next few days all these symptoms had disappeared.
→ Read the full testimonials
NSI-189 has the rare ability to increase both neuroplasticity and neurogenesis :
* Classified as a "pro-neurogenic compound" (source)
* Stimulates neural stem cell proliferation (source)
* Enhances mitochondrial function by selectively elevating respiratory complex proteins (source)
* Demonstrates neuroprotective properties following neural insult (source)
* Improves performance across multiple cognitive domains following neurological damage
ALTO-100 is being developed for treatment of major depressive disorder, bipolar depression, and post-traumatic stress disorder.
The molecule has already been tested in humans at dosages of 20 to 80 mg/day, without any reported safety issues (scientific sources).
The molecule can be bought for years on sites where the substances are often “for research purposes only”.
Safety consideration: if you want to try it, ensure product purity of 98 or better, 99%+. Also start with the smallest dosage.
Note : This molecule can potentially have a synergistic effect with Omega-3s (DHA), Lithium, Tianeptine, LSD/psilocybine and ACD-856.
ACD-856
ACD-856 functions as a positive allosteric modulator of Trk receptors, particularly enhancing signaling for TrkA and TrkB with impressive potency (source) This modulation is significant because these receptors are activated by neurotrophins including nerve growth factor (NGF) and brain-derived neurotrophic factor (BDNF), which play critical roles in neuronal health and plasticity.
ACD-856 demonstrates remarkable neuroprotective capabilities. Research shows it protects neurons against both amyloid-beta toxicity and energy-deprivation-induced neurotoxicity (source). These protective mechanisms could potentially address neuronal damage that might underlie persistent conditions like PSSD.
In aging models, a single treatment of ACD-856 restored cognitive function in 18-month-old mice to levels comparable to 2-month-old mice, demonstrating powerful neurorestorative potential (source). This suggests capacity for reversing established neurological deficits rather than merely preventing progression.
According to several studies carried out in Sweden, the compound has proved safe at several different dosages : https://www.alzforum.org/therapeutics/acd856
* 10 to 90 mg/jour : https://www.sciencedirect.com/science/a ... 0724001687
Potential Synergistic Effects
While no studies directly examine the combination of ACD-856 and NSI-189, their complementary mechanisms suggest potential synergy:
1. Complementary Neurotrophin Effects: ACD-856 enhances TrkB signaling while NSI-189 promotes neurogenesis, potentially providing both enhanced signaling and new neuronal substrate (source 1)(source 2).
2. Mitochondrial Support with Enhanced Signaling: NSI-189 improves mitochondrial function which could support the energy requirements for enhanced neuroplasticity promoted by ACD-856 (source 1)(source 2).
3. Multi-level Neuroprotection: Both compounds demonstrate neuroprotective effects through different mechanisms, potentially providing more comprehensive protection against various forms of neural stress (source 1)(source 2).
The combination of ACD-856's ability to increase BDNF levels and modulate TrkB signaling with NSI-189's pro-neurogenic and mitochondrial-enhancing properties could theoretically create a more robust response than either compound alone, particularly in treatment-resistant conditions.
While neither compound has been directly tested for PSSD, their neurological effects provide rational basis for further investigation. For individuals with severe, long-standing PSSD, these compounds represent investigational approaches rather than established treatments.
This compound has recently become available to the r/NooTopics community. As far as I know, a patient informed me on Discord that he had improved tactile sensitivity after adding 25 mg of ACD-856 to his stack.
Only time and data accumulation will tell if it can make a difference.
BPC 157 (in cycle)
at doses lower than those usually usedSymptoms relieved :
* Sexual pleasure / sensitivity
* Orgasmic pleasure
* Libido
* Erection
How ?
BPC-157 is a synthetic peptide derived from a protective protein found in the stomach. It has shown remarkable healing properties in preclinical studies, especially in nerve repair, blood vessel regeneration, and anti-inflammatory effects.
→ More informations
A person with 6-year-old PSSD posted a testimonial, and I then spoke to him to get more information.
The person initially experienced 2/10 sexual pleasure and low libido.
He began to feel improvements after a week.
He was afraid of getting worse (his PSSD improved then worsened with Clomid), so he took the substance in cycles, taking it for 2-3 weeks at a time, stopping, and starting again.
With BPC-157, he even experienced a more powerful orgasm than he had experienced before the PSSD.
After 4-5 cycles, his pleasure had a new baseline of 7 or 8/10.
When I asked the person if they were taking any other supplements along with BPC-157, he replied, "Maybe vitamin D."
Although these improvements are considerable, the patient reports that the soft glans symptom has not improved with BPC-157 (research continues).
LSD and / or psilocybin
The most impressive testimonies I've read stem from the dazzling speed of almost complete healing during a trip with psychedelics (LSD, psilocybin mushrooms).
This included a man who had suffered from PSSD for over 15 years !
Genital numbness, libido, orgasm, feelings of love... These substances seem very powerful.
→ Read the testimonials for LSD
→ Read the testimonials for psilocibyn
But be careful, a single trip probably won't do anything for you. And many people with PSSD have not reported good experiences, or even crashes.
These substances have potential, but the dosage, duration and basic biological context certainly play a big part in the effects felt.
By analyzing healing stories in more detail (by asking more questions), I noticed that the sudden improvements didn't just happen.
In fact, the people had been using the same (or similar) substances for months or years.
This cumulative exposure may have created a "more favorable neurological context" for triggering healing processes.
"The straw that broke the camel's back"
In my opinion, these experiences are not necessarily the easiest to replicate.
And guess what, the mechanism of action of LSD/Psilocybin appears to be similar to ACD-856
Another possible option: small daily doses might do the job (hypothesis).
Interventions on the microbiota
Like many, I was skeptical that the microbiota could have such profound effects on cognition and sexuality.
And yet! I was so surprised to read so many stories of recovery involving substances that regulate the microbiota.
Furthermore, more and more studies are showing alterations in the microbiota in major neurodegenerative diseases like Alzheimer's and Parkinson's, and this can even occur up to 30 years before the onset of neurological symptoms!
And guess what, most dysbiosis is asymptomatic. And asymptomatic doesn't mean without consequences.
In short, taking care of your microbiota is a public health issue.
After all, isn't it in our gut that we can feel fear, love, and anxiety?
From an evolutionary point of view, the digestive system appeared long before our cortex... So wouldn't our first brain be our microbiota? We still have a lot to discover. But it's clear that there's something to be done with it to alleviate the symptoms of some people with PSSD (perhaps the majority? Time will tell).
If you suffer from PSSD, clearly, you should seriously consider the possibility of microbiota imbalance. To check if this is relevant for you, you can take SIBO/SIFO tests. Many patients test positive and experience significant improvements with a plant-based protocol.
Healing your gut is a multi-step process. There's rarely one single fix — you need to tackle it from different angles and persevere over time :
1. Kill the harmful microbes & fungi
Natural options:
* Raw garlic / Alicine (broad-spectrum antimicrobial)
* Oil of oregano (potent but use with caution) - 10 testimonials !
* Berberine (targets both bacteria and blood sugar) - 7 testimonials !
* Neem (broad-spectrum antimicrobial) - 6 testimonials !
* Peppermint oil (especially for IBS-type symptoms)
* Caprylic acid (especially useful for SIFO)
* Cut added sugar and refined carbs (fuel for overgrowth)
* Low-FODMAP or antifungal diets can also help in the short term
Pharmaceuticals (often prescribed):
* Rifaximin (targets bacteria in the small intestine)
* Neomycin (sometimes used alongside rifaximin for methane-type SIBO)
* Fluconazole / Nystatin (for fungal overgrowth like candida/SIFO)
* Metronidazole / Tinidazole (for mixed or parasitic infections)
2. Break down the biofilms
Overgrowth often hides behind biofilms, which protect them from treatment. Disrupting biofilms increases effectiveness.
Options:
* Tributyrin (also supports gut lining and butyrate production)
* NAC (N-acetylcysteine)
* Serrapeptase (enzyme that digests protein-based biofilms)
Pharmaceutical options:
* EDTA (used off-label in advanced protocols)
* Bismuth subsalicylate (Pepto-Bismol — low-level biofilm disruption)
3. Recolonize with beneficial bacteria
Once the overgrowth is under control, rebuild a healthy ecosystem.
* Spore probiotics / Soil-based probiotics (SBOs)
* L. reuteri (can also help mood, sexuality via oxytocin)
* Fermented foods (sauerkraut, kombutcha, kefir...)
* Prebiotics (PHGG, inulin, acacia fiber — start low, go slow)
Pharmaceuticals & clinical tools:
* Vivomixx / VSL#3 (prescription-strength probiotics in some countries)
* FMT (Fecal Microbiota Transplant) — experimental / supervised use
High doses of omega-3 may help with healing
I've come across a dozen recovery stories where omega-3 supplementation was a recurring element. It's likely they represent part of the solution, especially when integrated into a broader neuroregenerative approach.
Omega-3 fatty acids — particularly DHA (docosahexaenoic acid) and EPA (eicosapentaenoic acid) — play a critical role in brain function, neuroplasticity, and gut-brain communication. While often associated with cardiovascular health, their impact on mood, cognitive repair, and the microbiome is increasingly recognized.
Omega-3s and the brain
DHA is a major structural component of neuronal membranes, especially in the cortex and hippocampus. It supports synaptic transmission, neurogenesis, and the expression of BDNF, a key neurotrophin involved in emotional regulation, sensory pleasure, and motivation. EPA, meanwhile, helps regulate neuroinflammation, balancing cytokines that can otherwise impair neurotransmission and mood.
Omega-3s and the microbiome
Emerging research shows that omega-3s also shape the gut microbiota — promoting the growth of beneficial bacteria such as Bifidobacterium and Akkermansia, while reducing intestinal permeability and systemic inflammation. This is especially relevant in conditions like SIBO/SIFO, where restoring microbiota balance is part of broader neural and immune recovery.
What dose is actually effective?
Most standard supplements (with 100–200 mg of DHA/EPA) are too low to significantly impact brain health. For a measurable effect on cognition, mood, or neuroinflammation, a minimum of 1000 mg of DHA and 1000–2000 mg of EPA per day is recommended — ideally over several weeks.
Therapeutic ranges:
* General brain support: 500–1000 mg DHA + EPA
* Neuroplasticity / mood recovery: 1000+ mg DHA + 1500+ mg EPA
* Inflammatory conditions / gut-brain axis repair: up to 3000 mg combined (under medical supervision)
Capsule quality mattersChoose products that are:
* High in DHA and EPA content
* In triglyceride or phospholipid form (better absorption than ethyl esters)
* Tested for heavy metals (especially mercury, PCBs)
* Fresh (rancid oil = pro-inflammatory)
For those who are sensitive to the smell or taste of fish oil, algae-based omega-3 capsules (containing pure DHA) are an excellent alternative: they are mercury-free, and often more palatable.
Two small molecules with big actions
When I first started researching PSSD, I probably underestimated the role of something as "basic" as vitamin C and vitamin D.
But the more I read recovery stories and dug into the biology, the more I started to reconsider.
Vitamin C plays several key roles:
* It’s a cofactor for demethylation (relevant if epigenetic silencing is involved in PSSD)
* It supports collagen synthesis, blood flow, and tissue repair
* It also boosts neurotransmitter production (like dopamine and norepinephrine)
Of course, vitamin C alone won't cure PSSD. But in some cases, it may help unlock subtle shifts — especially when combined with other targeted compounds.
Vitamin D (especially when paired with K2) may support PSSD recovery through multiple mechanisms:
* It helps regulate hormonal balance (testosterone, dopamine, mood)
* It modulates inflammation and immune response — key for healing at the cellular level
* It supports neurogenesis and brain plasticity by boosting the expression of BDNF (Brain-Derived Neurotrophic Factor)
* It helps maintain mitochondrial function, which is crucial for energy production and tissue repair — especially in complex syndromes like PSSD
It won’t fix everything on its own, but it might prime your system — especially if you're deficient or have signs of neuroinflammation or low energy metabolism.
In the right combination, vitamin D + K2 can be a quiet but powerful ally — not a miracle, but a foundational layer that supports the deeper work.
Future research perspectives
While certain molecules — from sex steroid modulators like Kisspeptin-10 to pro-neurogenic agents like NSI-189 — may have the potential to reverse symptoms on their own, it is increasingly clear that a more integrative and systems-level approach may prove more effective in many cases, especially when microbiota disruption, early pharmacological exposure during puberty, or developmental trauma are involved.
One of the key limitations in current academic research is the tendency to rely on group-level statistical analysis, often at the expense of understanding individual recovery paths. A longitudinal, N-of-1-inspired design, where each symptom cluster (sensory pleasure, brain fog, libido, etc.) is tracked over time and in relation to specific interventions, would offer far more granularity.
This would allow us to answer not just "what works on average?", but rather "what works, for whom, when, and in what sequence?"
Another critical variable is duration of the disorder. Individuals in the first 1–3 years post-onset may still retain a degree of neuroplastic responsiveness less seen in chronic cases. Comparing early-stage (<3 years) and late-stage (>3 years) PSSD may reveal important differences in treatment responsiveness and neurological flexibility.
In individuals experiencing emotional symptoms, such as the inability to feel love, bonding, or pleasure, there is a compelling rationale to explore emotion-focused therapeutic modalities.
Approaches of interest include:
* Bilateral stimulation (inspired by EMDR) centered on positive or loving memory traces
* Emotionally focused therapy (EFT) centered on positive or loving memory traces
* Therapeutic hypnosis centered on positive or loving memory traces
These methods may synergize with neurochemical strategies by restoring not just the biochemical capacity for affect, but the subjective experience itself — the felt sense of joy, closeness, and desire that many report as missing.
Final thoughts
There's so much more to be said about treatment options, taking into account the particularities of each individual.
But I believe I have succeeded in synthesizing the most promising treatments by 2025 for this terrible disease that hardly anyone really understands.
I hope you find this publication inspiring, reassuring and hopeful. Because yes, as long as there are possibilities, there is hope.
But remember, the road to recovery doesn't have to be “impressive” - it can happen in small steps over many months.
The path to recovery is unique and specific to each individual, so much so that it depends on the symptoms and their severity.
I hope from the bottom of my heart that your story of healing will be the next one I read.
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