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Research for Post-SSRI Sexual Dysfunction (PSSD)

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GI Tract Problems

Every so often, I am confronted with a case that forces me back to the GI tract. While I am uncertain of the legitimacy of these cases, I believe that their repeated occurrence deserves them a spot on this site.

This began in 2015 when PSSD forum user iggy131313 posted about anecdotal reports of help from anti-fungals. These findings can be summarized on this site’s page dedicated to Nystatin. Licorice Root has also been hypothesized to help PSSD due to its anti-fungal properties.

 

In the spring of 2018, PSSD forum member afx posted about his PSSD success with anti-fungals, which has been edited down (…) and proof-read for [minor] punctuation.

I am 7 years sufferer from PSSD after 3 years of extensive use of antidepressants…I ended up with all the PSSD symptoms, all of them, You name it. I tried lots of stuff and I know how it is frustrating when nothing really works…My improvements so far – Sensation +++ Orgasms +++ Libido ++ Erection ++ Arousal ++ Basically, everything keeps on improving. What is the medication?

Itraconazole 100mg capsules (taken 2x in the morning and 2x in the evening so totally 400mg daily, started with 100mg a day to see if there is no adverse reaction of the body) + quality probiotic… I have noticed some results after only 2-3 days of Itraconazole.

Itraconazole is a very potent antifungal. I also tried Nystatin for over a month (5 M.U. daily) with absolutely no effect. Nystatin first of all is NOT a SYSTEMIC ANTIFUNGAL (works only locally in the gut)… There are also few people who tried Fluconazole (Diflucan) but for very limited time and in small doses and it may not work in all cases also because it has smaller spectrum of action than Itraconazole.

Go to a lab a get Your blood tested – for Candida, Aspergillus and all possible Fungi, Molds, Yeasts that they offer. Antigens, antibodies and IgA IgG IgM, simply all methods possible…Problem with these pathogens is that once they multiply and migrate and are present in some parts inside of the body they release multiple toxins that PREVENT in our case sexual [organs] from… using our own body hormones (testosterone) as [they] should.

[Itraconazole] does work for me and keeps healing my symptoms of PSSD everyday that I have been suffering for over 7 years. Chunk by chunk, not artificial boosts like from other medications that is one day perfect next smaller then good again then fades away completely… It is best taken alone or with synergic antifungal like Terbinafine, but I did not try this combination myself yet…

– afx, April 2018 @ http://www.pssdforum.com

 

I am taking this for almost a month and I have noticed some very nice successes that keep building up so far mostly in sensation and orgasms, but other sexual aspects like libido are also improving

– afx, May 2018 update

 

In the summer of 2018, a reddit user claimed he had received a:

“Diagnosis of chronic gastrits with helicobacter pylori. Eradicated them and gone on healthy varied diet. PSSD has been gone within 3 months. thats it. Deficient of some nutritions…Check GI Tract.”

– r/PSSD user

After I reached out for specifics he responded cryptically:

Usage of antibitotics + Prilosec.

– r/PSSD user

This user also was unable to tell me which antibiotics he used, but I am very confident that they were clarithromycin and amoxicillin (Look under the H. pylori section at the bottom of this page for my explanation of why I believe these are the antibiotics that he took). Prilosec is a Proton Pump Inhibitor (PPI). It’s designed to reduce stomach acid by inhibiting its production in the stomach.

Has this been documented in other cases? David Hompes (BSc, MSc), reports very PSSD-like symptoms during his infection with H. pylori.

 

When I had H. pylori, parasites and a fungal infection, my sex drive was on the floor. I didn’t feel like having sex and I wasn’t getting morning erections.

In addition to my digestive woes, I also did some hormone testing and found that my stress hormones were too high at night, and too low in the morning, and that my testosterone level was too low.

90-days was all it took for me to resolve the majority of my symptoms. In resolving my digestive problems, I also increased my energy, vitality and sex drive.

-David Hompes

He claims that success is found with the following steps:

Bad foods like gluten, soy, vegetable oils, excess sugar and processed grains
Bad bugs like H. pylori, parasites and fungal overgrowth
Bad toxins like pesticides, solvents, mercury, arsenic, lead, and so on

At the same time it is important to replenish good things that may have been depleted:

  • Good foods
  • Good bugs (they are anti-stress when used correctly)
  • Good nutrients

-David Hompes

The rest of the article is him shilling his book, which I have not researched enough to recommend. At the very least, I believe that these pieces of information combined are sufficient to warrant further testing from the PSSD community. Here is the Direct Labs Link for H. Pylori. Read more about Direct Labs here.

Things get even more interesting when the pelvis is implicated in H. pylori infection. A 2016 study from Nasrat et al. shows that this might be the case.

Colonic H. pylori strains were found frequently associated with pelvic congestion; H. pylori were considered as a possible underlying etiologic pathology in cases of pelvic pathology in general. The increased mucosal production of inflammatory cytokines of H. pylori could play an integral role in the pathogenesis of ED. The association of the colonic H. pylori strains with pelvic pathology, the role played by the inflammatory cytokines and the therapeutic effect of NO in ED were the scientific reasons to employ colon clear and blood-let out (BLO) cupping therapy in cases of ED. 40 patients with ED positive for colonic H. pylori strains were selected in two age groups; young and older age groups. They were scheduled for three sessions of colon clear, one each month, and a procedure BLO cupping therapy one week after the last colon clear. Marked improvement and most patients recovered their usual EF and sexual satisfaction. Employment of combined colon clear and cupping therapy in cases of ED is promising.

…

In addition, the increased mucosal production of inflammatory cytokines of H. pylori could play an integral role in the pathogenesis of ED [18,19].

…

17 patients of the first older group with ED restored 75% at least of their usual EF after completing colon clear and 85% of EF few days after cupping therapy. 19 patients of the second younger group restored 80% of EF after colon clear and 90% of EF after cupping therapy. All patients of both groups who responded to therapy expressed their satisfaction of restoring nearly their usual sexual health and having no problem with intercourse.

-Nasrat et al., 2016

 

 

PSSD has been hypothesized to share similarities to Post-Finasteride Syndrome (PFS). A user, saywhatwhat, on http://www.curezone.org posted about his PFS recovery sometime in 2015.

I’m writing this because I was one of the several people who experienced dramatically compromising side effects after taking finasteride in the form of Propecia. Said side effects included an essential collapse of my sexual system (no libido, impotence), brain fog, anxiety issues, depression, ’emotional blunting,’ and fatigue.

It took me 11 years and several doctors, but I finally got a diagnosis and–lo and behold–I’m cured. I’m cured!

It turns out I had a parasitic protozoa called e. histolytica. It’s been mentioned on this website before and it seems exceedingly common globally. An estimated 10% of the population has it, but apparently it’s asymptomatic in most people.

I welcome responses to this message and will be happy to answer questions. Here are answers to questions I can think of:

1. I was diagnosed by an actual doctor.

2. I did eventually come to suspect I had a parasite. The suspicion only aroused once I tried an elimination diet. Wheat was fine, dairy was fine, eggs were fine, but Sugar (sucrose) triggered my symptoms to a terrible degree. The Sugar connection is what eventually led me to question parasites.

3. I did try a few at-home remedies, and some of them were genuinely effective in abating symptoms but none of them cured the infection. It must be treated with antibiotics.

4. Alternative treatments that offered release were avoiding sugar, Humaworm, and ParaGone. I’d personally recommend ParaGone over Humaworm, but I think they’re both effective.

5. I also experienced relief from Lactoferrin (Jarrow’s brand), and found they made the other treatments (including antibiotics) much more effective.

6. The antibiotics that cured me were metronidazole (500mg 3x a day for 10 days) and paromomycin (1,000mg 3x a day for 5 days). Relief came pretty quickly–I felt 90% on top of the world by day three.

7. I have no idea where I caught e. histolytica. I assume it was in my body for a while, and then the Propecia made it rage out of control. I wish I had caught this 11 years sooner, but I’m just glad to have it done with.

If you or anyone you know is having problems with Propecia, please see a doctor about e. histolytica! I had a stool test come back negative initially, but it showed up on a retest. I’d recommend finding an infectious/tropical disease specialist in your area, or a gastroenterologist familiar with e.h.

Again, I’ll try and respond to any replies to this. I wish everyone the best of luck, and I really hope this works for all fellow Propecia sufferers, as I finally feel like I have my life back now.

– saywhatwhat, 2015

SAYWHATWHAT RESPONSES (2017)

—

I had a rectal swab performed by a parasitologist, so he basically took some mucus out of my butt and then looked at it in a microscope.

—

My symptoms were all over the board, but I had a lot of the typical ones: zero libido, impotence, anxiety, fatigue, and shortness of breath. I never had any feminization symptoms like swollen breasts, although I did end up gaining about 40 pounds, which was very very unlike me (I’m naturally pretty slim even without exercise).

For my gastro symptoms, I would get bad anxiety after eating just about everything, especially sugar. I basically never had well-formed bowel movements and peed like a crazy person all the time. I also ended up getting really weird muscle twitches all over my body (esp. hands, calves, eyelids, and the tops of my shoulders), but those all completely disappeared once I was treated for the e. histolytica.

—

I’m not a doctor so please don’t take this as medical advice, but my understanding is that with an e. histolytica infection, Metronidazole needs to be taken initially to kill the adult form of the protozoa, after which Paromomycin needs to be taken to kill the eggs (and I’m guessing any potential retard generation).

That said, you do *not* take these two drugs together. They need to be taken in succession, with Metronidazole first followed by Paromomycin. I hope this helps!

 

Entamoeba histolytica (e. histolytica)

  • Anaerobic parasitic amoebozoan, part of the genus Entamoeba.[1]
  • Predominantly infects humans and other primates causing amoebiasis.
  • Estimated to infect around 50 million people worldwide.
  • Infection can be asymptomatic.
  • Can lead to amoebic dysentery or amoebic liver abscess.[1][5]
  • Symptoms can include fulminating dysentery, bloody diarrhea, weight loss, fatigue, abdominal pain, and amoeboma.
  • The amoeba can actually ‘bore’ into the intestinal wall, and may reach the blood stream. From there, it can reach different vital organs of the human body including the liver, lungs, brain, spleen, etc.
  • Diagnosis is confirmed by microscopic examination for trophozoites or cysts in fresh or suitably preserved fecal specimens, smears of aspirates or scrapings obtained by proctoscopy, and aspirates of abscesses or other tissue specimen.
  • Antibiotics (often 2) are common for treatment.
  • metronidazole , chloroquine , paromomycin, and diloxanide furoate often used.

 

H. pylori

  • Often treated with Antibiotics.
  • The standard first-line therapy is a one-week “triple therapy” consisting of proton pump inhibitors such as omeprazole and the antibiotics clarithromycin and amoxicillin (Source). This is exactly what the Reddit user claimed that he used as his treatment for H. Pylori.

  • Read this post about a description of one suffer’s sexual symptoms, and how he fixed them.
  • Testing information
  • Helicobacter pylori is associated with lower androgen activity among men in NHANES III (Schooling et al., 2013)
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