Delayed orgasm. Recommendation of doctors/centers.

Any other sexual dysfunctions not properly addressed by medical science.
ondelik
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Delayed orgasm. Recommendation of doctors/centers.

Unread post by ondelik »

Hello.

I developed a type of sexual dysfunction in fall 2019. I first noticed it took a lot longer for me to reach orgasm. This was during masturbation. I didn't have a partner at the time.

Eventually this just got worse over time and the orgasms themselves could also feel a little weaker and shorter, but mainly strongly delayed. While it used to take under 5 minutes for me to reach orgasm with stimulation of the clit with my fingers, it would later take up to 30-45 minutes.

I was on a numerous of medications at the time. The only one that I started shortly before developping the issue was Oxycodone. I had used a little Tramadol and codeine a few weeks before that.

I also had some issues with my left labia falling asleep at random times, but I ignored that.

I switched to Tapentadol a couple of months later.

I saw a sex therapist who suggested I stopped the Tapentadol.

For reasons that I now see weren't very valid I continued the Tapentadol for another 20 months after having developed the problem.

I'm not sure if my libido was affected. I masturbated several times a day during this entire time. I think I didn't want to accept that things had changed, so I made myself achieve orgasms maybe 3-4 times a day even if it took many hours. The other reason is that I still enjoyed the experience, even though less than I did when I came faster.

I used to have more spontaneous feelings down there when thinking about or seeing something sexual and maybe have a little more sexual fantasies before. I have also had spontanous orgasms in the past when I was younger. The main difference has been the delay of orgasm though.

I later in spring 2020 noticed some decreased sensitivity of the clitoris and some decreased sensitivity on the left labia majoris which would also fall asleep at random times.

I later (fall 2020-spring 2021) developed some pain in the left labia majoris that can extend a little down the back of the thigh and feeling of someone pouring hot water in this area on and off. No idea what's causing this. I did use vibrators for a long time in 2019-2020, but I don't know if that has anything to do with it.

I've had some urinary hesitancy at times as well, though I don't know if this is maybe 'normal' to have at times.

I'm looking for a doctor who can help me investigate the issue and perhaps try some medications off-label. I was thinking of maybe trying Oxycontin nasal spray, Bupropion or Sildanefil. Cyproheptadine and Yohimbine as well as pramipexole are mentioned some places. I think I might have a hard time finding a physician who is okay with trying treatments on off-label indication.

I'm also considering getting an evaluation for neurological function in that area as well as checking the vascular function and my hormones. Problems with blood flow and nerves to the genitals both peripheral and central can cause sexual dysfunction and numbness I think. Spinal MRI has been normal, which would exclude cauda equina.

I know there is a thing called opioid induced hypogonadism. According to the sex therapist she thought opioids interfere with oxytocin as well, though I don't know how.

I have been off the opioids for almost two months now. Not seeing a great improvement unfortunately. I don't know how long a change caused by the opioids would take to be reversed, if it was that medication that caused it.

Currently I'm on esomeprazole 20 mg, mirtazapine 30 mg and minimal dosage pramipexole (0.088 mg) as well as 2 mg melatonin for other reasons. I have headache and akathisia like symptoms as well currently, though I'm trying to look for non-medication options for my headache. I had some symptoms similar to depersonalization syndrome in fall 2020 (feeling 'strange' and not in control of my actions as well as out of body/head experiences), though it has gotten better.

Anyone know of a doctor who has a lot of experience treating sexual dysfunctions? Or know of a doctor who has been very helpful to you with this issue? I'm obviously mostly looking for someone who can do something for this type of sexual dysfunction in females. Anyone had sexual dysfunction from any of the drugs I have mentioned here?

I'm ok with trying to contact someone who isn't in my country. At least I can check if they can do online consultation.
arahant
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Joined: Tue Nov 26, 2019 11:54 am
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Re: Delayed orgasm. Recommendation of doctors/centers.

Unread post by arahant »

I'm not sure if my libido was affected. I masturbated several times a day during this entire time. I think I didn't want to accept that things had changed, so I made myself achieve orgasms maybe 3-4 times a day even if it took many hours. The other reason is that I still enjoyed the experience, even though less than I did when I came faster.
Over masturbation can be an issue, dead grip is quite common too. Some get really scared with a side effect so that they enter into a vicious circle. Masturbating to "check" if things are "still fine", sometimes pressing the genital even harder and faster, making things even worse. Have you ever had larger periods of abstinence?, like many weeks or months? Are you doing it harder than before? Depending on the answers, you can rule out a dead grip. Better don't waste your mood in forum broscience, probes, and trials.
Wellbutrin (2007 - 2018)
Wellbutrin + Sertraline (2015)
Wellbutrin + Ritalin (2016 - 2018)
Wellbutrin + Ritalin + Sertraline (3 months in 2018)
Buspirone (Feb 2019 - Today)
Ritalin + Buspirone (Nov 2019 - today)
Janzio
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Joined: Wed Sep 15, 2021 11:09 am
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Re: Delayed orgasm. Recommendation of doctors/centers.

Unread post by Janzio »

Wait which drug caused your PSSD? Was it the tramadol?
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