PSSD after trazodone, need help

Hello everyone,

I have similar sexual problems as some other forum members after taking trazodone. I decided to post here because I realized that Area-1255 forum members know a lot about the stuff. My story will be long so please be patient. English is not my mother's tongue so I apologize for any grammar mistakes.

I took trazodone for about 25 days (first 8 days 50 mg, following 8 days 100 mg, and after that 150 mg for around 10 days more) to treat my anxiety and sleep better. I quit cold turkey after around 25 days. I began experiencing severe sexual side effects after roughly 3 weeks on trazodone. They included:

- complete impotence (inability to achieve erection no matter what and even when I managed somehow erection was like semi-rigid)
- total loss of libido and total inability to achieve arousal
- delayed ejaculation (even when I managed to get hard it took eternity to ejaculate)
- low quality, watery semen
- no ejaculatory push force
- slight testicular shrinkage (only left testicle)
- total absence of nocturnal/morning erections
- total indifference when looking at the attractive women. It appeared as if I was looking at the men instead
- many people report having genital numbness, however I don't seem to have it, or it is in some mild form that I barely notice. My glans and inner foreskin were still very sensitive to touch.

Now I'm 2 weeks after withdrawal and many of those symptoms resolved. However, there are still few symptoms which bother me and which reduced my quality of life to the point that I'm in despair. I know that 2 weeks are still a short period of time since withdrawal but I'm nevertheless too scared. I become potent about 9-10 days since withdrawal and I began experiencing nocturnal erections again which gave me a bit of relief. I am able to get full rock-hard erection sometimes even by visual stimuli only such as reading erotic stories. Also, semen quality seems to have improved (no more watery semen) and sometimes there's even pushing force during ejaculation like before. Symptoms which have still not resolved include:

- very low libido (it probably improved to a certain degree (5-10% or so) since 2 weeks ago but it's still pretty low as I barely have any desire for sex)
- delayed ejaculation. Now, this symptom actually improved a bit but it's still harder to ejaculate than before. I need 4-5 mins more to achieve it than I could prior to trazodone. Could it be related to low libido and not a symptom on its own?
- my left testicle has not regained its size by now

Low libido is symptom which bother me the most. If it improved I would most likely feel normal again.
So what's your take on this? Could you please give me some insight based on those symptoms and what actions should I take now?

Thank you very much

Please anyone? I'm desperate with suicidal thoughts

Hello,
First of all don't take drugs for sleep, there are herbs for it. Drugs for sleep likely detrimental for health.
Moreover often people restore their health worse when they switch drugs. You can see that on pssdforum.

Your cortisol and prolactin (which can be measured) might be high and these hormones effectively remove sexual thoughts.
https://www.ncbi.nlm.nih.gov/pubmed/4055985
(this is a study for mCPP, but trazodone is converted to it - see wiki)
Prolactin can be lowered with mucuna prurience.
Do you see nightmares? Cortisol signalling (CRF/CRH) was linked to suicidal thoughts (although it's not the only marker).
MANY things depend on your DIET. I recommend drinking raw cold ginger powder (about 1 table spoon). THis can change situation.

Thanks. I dream a lot, almost every night even after I stopped trazodone. Sometimes dreams are unpleasant but not true nightmares. Next week I will have hormone testing results so I will post them here.
I'm suicidal because I'm afraid I will never be able to enjoy sex again. And I don't hold much hope because other people on internet forums who have similar problems are still struggling with this even years after without significant improvements. Only one guy out of several with this problem was cured. I think my life is ruined.

I think when you can feel pelvic tension you can reverse delayed ejaculation and glans problems. Especially if you say you don't have profound numbness. Sperm count increasing is a good sign.

kpavel wrote:I think when you can feel pelvic tension you can reverse delayed ejaculation and glans problems. Especially if you say you don't have profound numbness. Sperm count increasing is a good sign.

Hi, kpavel. For the few days until today I was completely impotent, basically nothingness. Today I had a window with slight libido and for the first time my brain reacted to porn and I truly wanted to masturbate.
What's interesting is that there was no delayed ejaculation anymore; I ejaculated within the same time frame as before trazodone. Sperm quantity is actually good too. However, I now have moderate erectile dysfunction and still my libido is very low.
As far as the numbness goes, I think my penis is 100% sensitive as it was before trazodone (masturbation was pretty enjoyable). But why do my symptoms fluctuate so much? One week i get strong erections but can't orgasm, yet another week my erections are weaker but able to orgasm normally.
I also want to add that I get nocturnal erections every night.
This is so weird.
Im still waiting for the sex hormone testing results.

I would say yohimbine can make penis somewhat more sensitive and more noradrenaline may help with ejaculation. I mention it because trazodone blocks alpha adrenergic receptors which make erections worse but ejaculations probably stronger/faster. So it could be your fluctuations in noradrenaline. That you have a good amount of sperm is a good thing. People tend to have low FSH. But you should avoid strong social stress to save this and be close to Mediterranean diet. No fatty foods every day like cheese.

kpavel wrote:I would say yohimbine can make penis somewhat more sensitive and more noradrenaline may help with ejaculation. I mention it because trazodone blocks alpha adrenergic receptors which make erections worse but ejaculations probably stronger/faster. So it could be your fluctuations in noradrenaline. That you have a good amount of sperm is a good thing. People tend to have low FSH. But you should avoid strong social stress to save this and be close to Mediterranean diet. No fatty foods every day like cheese.

Hormone testing results are all within normal limits, however testosterone, FSH and LH are on the very low side while estradiol and DHEA-S04 are on the very high side within normal ranges. Is there anything we can conclude from this?

My symptoms continue to be weird and very severe. I get regular nocturnal erections which are usually very strong. Often when I roll on the bed in the morning right after I wake up and think about sex I can get strong erection but as soon as I get up and try to masturbate on purpose my erectile function goes back to zero. This is very weird. About 15 days ago I began getting "windows" of high libido which usually occur in the morning upon waking up. They usually last for a very short period of time, sometimes measured in minutes up to hours. Once this window even lasted for 2 two full days which mistakenly made me think that I was cured. During these windows even erectile function improves to a certain degree but far from what it should be. Arousal capacity is also solid during those windows but sadly it's rarely followed by erection. I usually drink one beer per week and this windows often come the morning after consumption. Is this common? I also noticed that skin on my penis is very rubbery even though I can feel erotic sensations and it does not appear to be particulatly numb. Orgasm are very pleasurable, however I think that it's a different kind of pleasure than it used to be before.

My other symptoms include excessive sleepiness. Even though I sleep well for 8 hours and get a good night's sleep with dreams I always wake up sleepy with a need to get more sleep. Also I've been very depressed over this matter but I don't know whether it's a direct consequence of the drug or because of PSSD. Is there anything I can do to control depression while I battle with this?
I've also felt strong fatigue especially after orgasm or sport activity but it seemed to resolve for the most part know.

Sorry for the long post but I tried to include as much details as possible for you to grasp my situation.

What are your thought on this? Thank you

Your parts on 'getting it up' after getting up from bed are exactly like my experiences, and numbness part too (which is most disturbing now).
I never understood properly how windows feel. I usually have a steady improvement and can have like negative windows sometimes I don't drink beer though. Hops for example is estrogenic. Actually to increase FSH standard practice is clomiphene and estrogen receptor modulator. There are other conventional practices, I even have a very good 2013 pdf on what usually done in clinic.