Sexual stimulation feels good but orgasms feel like nothing? Is this PSSD or something else?

[faygochugger]

I'm a 25 year old man and between the ages of 18 and 20 I was pressured into taking antidepressants by my parents and doctor. I was never warned of any side effects, but as soon as I started taking my first antidepressant (an SSRI, I forget which one), I had severely decreased sexual sensations and my orgasms stopped feeling good at all. After several months of this I couldn't take it anymore and switched to a different SSRI but had the same problem. Finally, I was put on Wellbutrin which I took for almost a year, but I still had the same symptoms, though not as bad. I remember that I would skip days just so that I could have pleasurable sexual stimulation, so my sexual side effects were going away immediately if I skipped my pills even for just a day, I hope that's a good sign that I don't have PSSD. Eventually I just quit cold turkey because I was sick of sexual dysfunction. If I remember correctly, my sexual function came back immediately upon quitting, but I may have slowly lost it in the weeks-months after, it was years ago and I was smoking marijuana heavily at the time so I honestly don't remember.

Now 5 years later I'm having sexual dysfunction. I honestly am not sure if it's been happening since I quit SSRIs or if it's more recent. Like I said, I was smoking marijuana heavily for the last 5 years and only quit 3 months ago. It seemed to help my sexual dysfunction and mask the symptoms I'm dealing with, but now that I've quit they are impossible to ignore. I have mild ED, I don't get spontaneous erections and my morning wood is semi flaccid. If I don't receive constant stimulation I immediately lose my erection. My glans has trouble getting hard even with constant stimulation. Worst of all my orgasms are very muted similar to how they were when I was taking antidepressants. I produce very little semen and it just dribbles out instead of shooting out, and I lack the waves of pleasure that an orgasm is supposed to give you throughout your whole body. But I still have a high libido and sexual contact feels good, it's just my orgasms that feel muted.

I know this because about a month ago I had a real orgasm. Semen shot out of my penis instead of dribbling, my penis felt really good, and my whole body felt waves of pleasure. I felt like my brain was swimming in dopamine for like 20 mins afterwards. I've definitely had orgasms like this since I quit SSRIs, but they are very rare, only a few time a year and I can't tell what causes them. I really wish I could have orgasms like this every time, like when I was a teenager, but usually they feel like almost nothing.

I have some other issues that might be causing this, so I'm not sure if it's PSSD. I have a really tight/dysfunctional pelvic floor that I just started physical therapy to fix. I'm also fairly sure that I have gut issues that might be related to or even causing my pelvic floor issues and sexual dysfunction. I have gas, bloating, and frequent constipation/inability to evacuate my bowel. I am seeing a gastroenterologist but they are backed up due to covid so I cannot see them for 5 months. I also wake up multiple times every night and feel tired every day no matter how much I sleep. My testosterone is low for my age at 400, but from what I've read that isn't low enough to cause my symptoms.

Does anyone have any advice on what to do? I have normal orgasms every once in a while so I'm definitely capable of it, I just need to figure out how to have them regularly.

[Jcumbo]

Not sure what's happening with you it might be related the SSRIs, but I would look into iliopsoas muscle exercises if you say you have tight pelvic floor muscles