r/DrWillPowers

He talks about PSSD

Was watching Prof. Melcangi’s interview with SIDEfxHUB and he mentions this. This would explain the sexual disfunction cause this enzyme is very important for it. And this enzyme is also affected in PSSD, which can explain the nearly identical sexual issues in both syndromes.

In Addition to Blocking 5α-R, Finasteride Inhibits Adrenaline Production, Possibly Inducing Sexual and Psychological Side Effects, New Research Suggests:

https://www.pfsfoundation.org/news/in-addition-to-blocking-5%CE%B1-r-finasteride-inhibits-adrenaline-production-possibly-inducing-sexual-and-psychological-side-effects-new-research-suggests

Post-Finasteride Syndrome And Post-Ssri Sexual Dysfunction: Two Clinical Conditions Apparently Distant, But Very Close:

https://www.sciencedirect.com/science/article/pii/S0091302223000626

Had no idea about this. Google about how to boost this enzyme:

"Phenylethanolamine N-methyltransferase (PNMT) activity can be boosted biologically through exposure to physiological stress, adequate levels of the cofactor S-adenosylmethionine (SAM), and stimulation by glucocorticoids (cortisol/corticosterone).

How PNMT is Regulated and Supported
Glucocorticoids: High levels of cortisol or corticosterone from the adrenal cortex naturally induce and maintain PNMT gene expression and enzyme activity in the adrenal medulla. [1, 2]

Stress Stimuli: Acute or repeated physiological stressors (such as immobilization stress or cold exposure) significantly upregulate PNMT gene expression and elevate adrenaline synthesis. [1, 2]

Cofactor Availability: SAM (S-adenosylmethionine) acts as the essential methyl donor for PNMT to convert norepinephrine into epinephrine; it also helps stabilize the enzyme structure and extend its half-life. [1, 2, 3]"

I used SAM-e in the past after developing PFS for joints and depression but wasn’t for long. Didn’t have any crash nor improvement and didn’t find anything about SAM-e here but on Propecia Help there’s a post about PSSD induced by SAM-e.

(Im post AI) I personally never crash and just have sexual side effects, my only bad reactions to any intervention is slightly lower libido that is already super low let’s say from 5% to 1%. HCG (all my libido,random erections, pleasure all symptoms resolved within 3h post injection but stoped working after 4months)worked perfect and 2years later my erections are still improved from it. steroids or supplements don’t do shit so my guess is that I’m neurosteroid deficient since no other stuff even changes how I feel. (except cdg which I used for 80days at 3g a day but it only gave me a bit better libido for 2 weeks). My question is, is progesterone therapy worth trying with Sommer or is it out of the window with the new model?

I am mtf and have been on feminizing hrt for 6 years.

When I was a teenager my dermatologist put me on Isotretinoin up to a 80mg/ daily dose. I did this for long courses the longest one being two years.

I think this somehow messed up with my system.

Symptoms:

1- severe genital numbness - I can only sense and get pleasure from the tip of my organ. There is absolutely no sensation or pleasure from being touched on the rest of it.

2- Premature ejaculation and Post Orgasm Illness. Once I organism I am literally knocked out for at least a day. Anhedonia kicks in, and it’s extremely hard to get off the bed or do any task. I recently learned to take hydrocortisone before or after sexual encounter with my partner which helps significantly with the energy and crash but not with the anhedonia

3- After orgasm, this state lasts for roughly 3 days or 4 then slowly I start to recover though only fully at about a week

What helped me a lot is progesterone rectal { I get extreme amount of energy immediately upon the insert, the anhedonia disappears almost fully and I feel like myself again, though the effect only lasts for about 5 hours max once the capsule gets metabolized, If I don’t redose the crash continues. I have a problem with progesterone because it certainly converts to androgens in my body because afterwards I get significantly increased of body hair and some masculanization.

I am looking for alternative things to try, has anyone tried something else that works?