Understanding Post-SSRI Sexual Dysfunction (PSSD)
Why Lost Libido Isn’t “All in Your Head” — and Why Help Is Possible
Post-SSRI Sexual Dysfunction (PSSD) is one of those topics many people quietly carry but rarely feel able to discuss. If your desire dropped, your arousal feels muted, or orgasms became difficult or impossible after taking antidepressants, you are not imagining it. And more importantly, you are absolutely not alone.
SSRIs and SNRIs are valuable medications, often life-saving. But they can interfere with the natural sexual response cycle. For many people, this settles once the medication is stopped. But for some, the symptoms persist—sometimes for months or even years—leading to what is now recognised as Post-SSRI Sexual Dysfunction.
What Does PSSD Feel Like in Women?
Women who come to Intimacy Matters with suspected PSSD often describe:
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Loss of libido
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Reduced genital sensation or numbness
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Difficulty becoming aroused
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Inability to orgasm or delayed orgasm
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Emotional blunting
It’s a deeply frustrating mix of physical and emotional disconnection. But it is not your fault, and it is not a sign of being “broken.”
PSSD Affects Men as Well
Although it’s often discussed in relation to women, PSSD affects men too—and often just as profoundly.
Men may experience:
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Erectile dysfunction, even if erections were previously strong
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Loss of morning or spontaneous erections
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Reduced penile sensitivity
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Difficulty reaching orgasm or inability to orgasm at all
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Weak or “muted” orgasms
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Drop in libido
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Genital numbness
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Emotional flatness that makes intimacy feel distant
Many men describe feeling confused or ashamed, especially if these changes continue long after stopping their medication. They often worry about what this means for their masculinity, their attraction to their partner, or their relationship. It’s incredibly important that men know: these symptoms are a recognised neuro-chemical effect, not a sign of failure or lack of desire.
Why Does PSSD Happen?
Research points to long-lasting changes in serotonin and dopamine pathways—systems that govern desire, arousal, orgasm, and emotional connection. In some people, these pathways don’t automatically reset after the medication ends.
This is physiological. Not a psychological weakness.
The Good News: Sensual Rehabilitation Can Help
A major part of my work at Intimacy Matters is helping women and men rebuild their sexual confidence, sensation, and pleasure—regardless of the cause.
People with PSSD often benefit from:
1. Mind-body reconnection
Gentle guided touch, conscious breathing, and slow sensual mapping help re-activate suppressed neural pathways.
2. Pressure-free sensual massage
This allows the body to rediscover arousal without expectation.
3. Rebuilding sensitivity
Specialised techniques encourage sensory awareness where numbness or reduced response has set in.
4. Emotional reassurance
Shame shuts the body down; safety can open it back up.
If You’re Struggling, Please Don’t Stay Silent
Whether you’re a woman or a man, PSSD is real, valid, and treatable. You deserve a sexual self that feels alive, responsive, and connected.
If you’re experiencing low libido, reduced sensitivity, erectile changes, or difficulty reaching orgasm after using antidepressants, reach out. There is a path forward, and you don’t have to walk it alone.
Treatments for post-SSRI sexual dysfunction (PSSD) vary, and there is no single, definitive cure, though some options may help with specific symptoms. Options include medication, such as PDE-5 inhibitors (like sildenafil or tadalafil) for erectile dysfunction, or adjunctive antidepressants like bupropion to increase libido and arousal. Lifestyle changes and psychological support, including therapy and sensual massage, can also be beneficial in addressing emotional and relational impacts.
How Sensual Massage Helps Reignite Arousal
One effective way to support people with PSSD is through structured sensual massage and guided touch.
Sensual massage is not simply pleasure-focused — it is nervous system rehabilitation. When arousal pathways go dormant, they can often be gently reactivated through slow, attentive, pressure-free touch. The body is wonderfully adaptive, and with the right conditions, the neural circuits responsible for pleasure and sensation can begin to “wake up” again.
Here’s why it works:
1. Sensual touch helps rewire neural pathways
Touch sends information directly into the brain via the somatosensory and limbic systems. When these pathways have gone quiet due to PSSD, consistent and focused sensual stimulation encourages them to re-establish communication. This is the same principle used in neuroplasticity-based rehabilitation.
2. It reduces anxiety and overthinking
One common symptom of PSSD is “dual awareness”: the mind observing the body and anxiously waiting for it to respond. This tightens the nervous system and blocks arousal. Sensual massage removes performance pressure and allows the body to move at its natural pace.
3. It activates the parasympathetic nervous system
Pleasure needs safety. When touch is slow, warm, intentional and safe, it encourages the parasympathetic system (“rest and receive”) to dominate — a prerequisite for arousal, lubrication, erection, and orgasm.
4. It restores emotional intimacy with oneself
Many people with PSSD also feel emotionally flat. Sensual massage can soothe and reawaken the emotional body, helping pleasure and connection feel accessible again.
Erotic Intimacy and the Nervous System
Erotic energy isn’t just sexual — it’s biological, emotional and psychological nourishment. When reintroduced gently, erotic intimacy supports:
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stress reduction
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emotional softness and openness
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a sense of being alive in one’s body
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increased sensitivity and sensual awareness
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improved mood and well-being
This can be especially profound for women who’ve been “stuck in their head” or for men who feel disconnected from their erotic identity.
You Don’t Need to Navigate This Alone
PSSD is real. It affects thousands of women and men. And although it can feel frightening or lonely, genuine hope remains. With the right guidance, the right environment, and the right touch, your body can relearn how to feel sensual, alive and responsive.
If you’re experiencing low libido, reduced sensation, erectile changes or anorgasmia after antidepressants, reach out. Sensual rehabilitation is not only possible — it can be transformative.
Below is a first-hand testimonial of a female client who experiences PSSD
In Search of Pleasure
a personal account by Julia
