Erectile Dysfunction After Quitting Antidepressants (PSSD)

I am a 36 year old male who has developed erectile dysfunction, *after* I stopped taking an antidepressant (Citalopram, an SSRI). I didn’t go off of it cold turkey, but I slowly weaned myself off the medication, and completely stopped in April of 2020. I noticed that I was having erectile issues before stopping the medication, and that was the main reason I wanted to quit. What has been extremely puzzling is that as the medication decreased in my body, my erectile dysfunction got worse and worse. I had never had a problem before with masturbation (although I did always require porn to jerk off), but after stopping the medicine, even porn couldn’t keep my dick hard. When I jerk off now, it takes a long time to achieve an erection, and when I have one, it’s also hard to maintain for very long. Before stopping the medication, I could always cum, but now, I can almost never ejaculate. It’s extremely rare. What usually happens is that I’ll feel like I’m cumming, but at most, I’ll only produce a few drops of semen, but very often, I produce absolutely nothing. There have been other times that my dick is still very flaccid, but I can feel so turned on, that I’ll cum, and usually in this state, I produce a bit more semen, however my dick is almost like a noodle, it’s so flaccid. It’s so strange.

This symptom of barely being able to cum, or as sometimes happens, I may cum a bit more when I’m very flaccid, leads me to believe that this isn’t psychosomatic (It’s not in my head), because I never had these symptoms before in my life. These symptoms only started to appear as the medicine was leaving my body, but wasn’t completely out.

After doing some research online, it looks like I may have developed something called PSSD- Post SSRI Sexual Dysfunction. I want to add that this actually started when I was 34. I eat healthy, I’m in good physical shape and I workout. I’ve been to several doctors and have had several tests, including a Doppler Test that ruled out a venous leak. I’ve had ultra sounds done, blood work done, and I’ve even tried Viagra, but 100 mg only seems to help just a bit, and it’s still not enough for me to have penetrative sex. Cialis seems unfortunately to work even less well.

For penis enlargement, I started using Phallosan Forte in August of 2019 and gained approximately half an inch in length from that over roughly 6 months. I did start using the PF before I stopped the antidepressant, and I always used it in the recommended way. But I don’t believe that the Phallosan Forte could have caused this. Has anyone heard of the Phallosan Forte causing erectile dysfunction issues or ejaculation problems?

I feel horny all of the time, so my libido (my desire to have sex) is intact, but my sexual functioning itself (erections as well as ejaculation) isn’t working well. I’m starting to feel hopeless about this issue, because I don’t know how I’ll ever be able to find a partner if I can’t properly have sex.

I just want to know- has anyone else developed this issue after taking Antidepressants (specifically SSRIs), and are you currently doing PE? The doctors can’t seem to help me, it’s already been two years, and I fear that this may be permanent.

I want to add that I started hanging in approximately March of 2021 during the pandemic (didn’t have much else to do at home, so I repurposed my Phallosan Forte to do vacuum hanging). I started extremely light- only with 150 g at the very beginning, and I always slowly increased the weight. I have also always used a heating pad to warm up my dick first (minimum of 10 mins with the heating pad before hanging).

I would always increase by approximately 250 grams, once a week. I got up eventually to 2.5 kg (5.5 pounds), and I could hang for 1 to 2 hours at a time, almost always with breaks in between. After approximately 6 months of doing this, I gained roughly another 0.5 inches. Hanging also seemed to help my erections to an extent.

Because of taking antidepressants, I hadn’t had consistent morning wood in a long time. I started noticing however that in most of March, I would consistently have morning wood, which made me feel good. During the last week of March, I got back up to hanging 2.5 kg.

I took a break for a week, and then tried hanging 2.5 kg, but because there had been a week in between, I think the weight was a bit too high, and I noticed some pain on the left side of my shaft, so I decreased the weight to 2 kg, and continued hanging for an hour. The next day, I did another hanging set of 1 hour at 2 kg. I did notice that I still had a bit of pain on the left side of my shaft from when I had tried to hang 2.5 kg.

I had pain on the left side of my shaft for a few days, but it disappeared somewhere between 3 and 5 days after that small injury.

Since then, I haven’t really had morning wood like I was having in March- it’s been a little over a month since the injury. I haven’t lost any sensitivity in the spot where I had the injury. I should also add that PSSD is known for causing windows where you erection quality will be better for a limited amount of time (sometimes a few days or weeks), before the window disappears, and EQ drops back down to a fairly poor baseline.

I should also add that I did masturbate several times after I had the injury. I would notice the pain a bit, but it wasn’t too bad, and it disappeared after several days anyhow.

I can still get an erection, even now (even though the erection quality isn’t great due to PSSD), but I’m wondering- since my morning wood has disappeared, do you think maybe I could have damaged my dick from those two sessions of hanging, or is it probably just the PSSD?

Also, I really want to continue with PE and growing my dick, also because I’ve had some success, but I’m a bit nervous after this, and don’t want to make my erection problems any worse. What do you guys think? Am I just being more worried here?

I doubt the Phallosan is related to your problem.

I don’t have an answer for you, but over the years several friends of mine have been on antidepressants, and two of them had noticeable erectile problems during and afterward, though perhaps not quite as bad as yours. It wasn’t something they were comfortable talking about, just something that was eating them up and they had to tell someone.

So you’re not alone, for whatever that is worth.

I think you can reasonably discount the possibility of physical damage to your penis. PE shouldn’t be a problem.

Some meds have effects that hang around a long time; the body can take a long time to recover. Eat clean, get plenty of sleep, and do some light jelquing and Kegels for penis health. Try to build a healthy platform for recovery. You’ll probably still worry about it a lot, but try not to let it get you down.

I’ve been keeping detailed logs for almost two years now. One thing I’ve noticed is, EQ often starts to fall before I get sick. If you haven’t had a thorough physical in a long time, you might want to schedule one. Have them check testosterone, vitamin D, and thyroid when they do the blood work.

Thanks for your answer! I also feel like it wasn’t the Phallosan Forte either. I mean, I actually had an injury from jelqing at the beginning of 2018. I think I used a bit too much pressure at the base of my dick while jelqing, and I had pain from it for months on end. It eventually went away, but it can occasionally come back, even now. I only mention that to say that that injury never seemed to impact my erection quality. If anything, after I did the jelqing, my dick would get extremely hard. I haven’t done jelqing since then, and I have no interest either, due to the injury, and the pain afterwards that I had for several months.

I still believe that my erectile dysfunction issues have come about due to antidepressant medication, and not from PE. I think the symptoms that I have (rarely being able to even cum) couldn’t have been caused by PE either.

I also feel like PE didn’t cause any physical damage to my penis. I actually want to continue with PE, but I’m a bit nervous at the moment to make my erection quality any worse. I have also noticed like you said that before I get sick, my EQ tends to fall as well.

As far as getting a physical, I’ve been seeing several doctors about this issue now for at least 1.5 years, and they’ve run various tests, but haven’t been able to find anything. I never knew that antidepressants could be this dangerous, tbh.

Get copies of the blood, urine, and any other labs as far back as you can. Sometimes the lab has normal ranges called out, others you have to look up every test individually on the web. It wouldn’t hurt to start a file or spreadsheet to keep track of the data over time.

If you see something that looks odd, note it and ask the doctor specifically next time you see him. They don’t always catch everything on their own; they have a limited amount of time per patient, so if you want the best results, you have to put some work in too.

Antidepressants are serious, serious shit. The regulations and guidelines for prescribing them are so loose they’re essentially unrestricted. They’ve become a hail-Mary “see if this works” for all sorts of complaints, many of which they’re entirely unsuitable for. Nobody cares; the profit motive is in play with every step from raw materials to the bottle in your hand.

Some people *need* antidepressants. It can make the difference between living like a more or less normal human or being institutionalized. A lot more people, they could make their lives better, if appropriately chosen and dosed. It doesn’t always work out that way.

Sometimes they’re the right answer. But even then, you need to be an informed user. You can’t take any drug that messes with your mind for granted.

The key is nutrients. You said “I eat healthy” but that can mean an ocean of possibilities. If you eat as an allopathic doctor recommend, that is not healthy at all. What exactly do you eat?