Post-ssri sexual dysfunction (pssd): ten year retrospective chart review

Waraich* Ahad, Clemons Channing, Ramirez Roma, Yih Jessica, Goldstein Sue, and Goldstein Irwin, “Mp78-15 post-ssri sexual dysfunction (pssd): ten year retrospective chart review,” Journal of Urology , vol. 203, no. Supplement 4, pp. e1179–e1179, Apr. 2020

This series of PSSD patients examined clinically is larger than any in the peer-reviewed literature. Consistent with other reports on PSSD, our patients are young, have ED in most cases, and frequently have concomitant HSDD, poor orgasm and decreased genital sensation. New information includes the facts that 1) ED is most often severe, 2) erectile tissue inhomogeneity is common, consistent with erectile tissue fibrosis/decreased erectile tissue expandability as an underlying vascular ED pathophysiology, and 3) decreased genital sensation from neurological dysfunction is frequent in this population. Providers need to be aware that the persistent sexual health consequences following SSRI/SNRI discontinuation are significant and patients should be referred to sexual medicine specialists for management

A crucial recognition of the existence of PSSD published in the journal of the American Urological Association showing physical signs of ED and noting sensory dysfunction and low libido as aspects of PSSD. Unfortunately, no mention of anhedonia, fatigue, or other common non-sexual symptoms among PSSD patients.

These appear to be patients of Dr. Irwin Goldstein’s clinic.


Thanks for posting. Agreed. It’s a pain that like PFS this is likely going to have to be a case of having to demonstrate the symptom profile by drawing on the sum total of many papers. I have no idea why it is so difficult to begin clinical characterisation by what the heterogeneous group of patients are reporting. I suppose the name “PSSD” is a misnomer that only appreciates one part of the symptoms, but at least the erectile tissue inhomogenity is a good clinical observation from this one. Helps point towards PSSD a multisystem condition, and not simply neurological.

Do you think it might basically be because medicine is fundamentally divided up into specialties? I suppose there aren’t really medical experts who both cover sexual function and depression or anhedonia. At least with degree of expert status to be PI for funding. Just wondering. I don’t know anything about medicine. Maybe it’s fact of medicine that research needs to be performed bottom up.

nice find, thanks