PSSD, Hard Flaccid, and Derealization + Anhedonia from Trazodone

Welcome to our community. Please fill in the following template as a way of introducing yourself, and helping others to understand your background and situation.

Where are you from (country)?

How did you find this forum (Google search – if so, what search terms? Via link from a forum or website – if so, what page? Other?)
Google Search; “trazodone”

What is your current age, height, weight?
34M, 5’8", 138 lbs

What specific drug did you use (finasteride, dutasteride, saw palmetto, isotretinoin/Accutane, fluoxetine, sertraline, citalopram, leuprorelin, etc…)?

What dose did you take (eg. 1 mg/day, 1 mg every other day etc.)?
25mg/day at night for 1 month

What condition was being treated with the drug?

For how long did you take the drug (weeks/months/years)?
1 month

How old were you, and WHEN (date) did you start the drug?
33; April 2019

How old were you when you quit, and WHEN (date) did you quit?
33; May 2019

How did you quit (cold turkey or taper off)?
cold turkey

How long into your usage did you notice the onset of side effects?
2 weeks

What side effects did you experience that have yet to resolve since discontinuation?
Hard flaccid, testicular and penile pain, cold and numb glans penis, cold testicles, low libido, ED, anhedonia, breathing trouble, derealization, fatigue

Check the boxes that apply. You can save your post first, then interactively check/uncheck the boxes by clicking on them. If your symptoms change, please update your list.

[x ] Loss of Libido / Sex Drive
[x ] Erectile Dysfunction
[ ] Complete Impotence
[ x] Loss of Morning Erections
[ x] Loss of Spontaneous Erections
[x ] Loss of Nocturnal Erections
[ ] Watery Ejaculate
[ x] Reduced Ejaculate
[ ] Inability or Difficulty to Ejaculate / Orgasm
[ ] Reduced Sperm Count / Motility

[x ] Emotional Blunting / Emotionally Flat
[x ] Difficulty Focusing / Concentrating
[ ] Confusion
[ ] Memory Loss / Forgetfulness
[ ] Stumbling over Words / Losing Train of Thought
[ ] Slurring of Speech
[x ] Lack of Motivation / Feeling Passive / Complacency
[ ] Extreme Anxiety / Panic Attacks
[ x] Severe Depression / Melancholy
[ x] Suicidal Thoughts

[x ] Penile Tissue Changes (narrowing, shrinkage, wrinkled)
[x ] Penis curvature / rotation on axis
[x ] Testicular Pain
[ ] Testicular Shrinkage / Loss of Fullness
[ x] Genital numbness / sensitivity decrease
[ ] Weight Gain
[ ] Gynecomastia (male breasts)
[ x] Muscle Wastage
[ x] Muscle Weakness
[ x] Joint Pain
[ x] Dry / Dark Circles under eyes

[ ] Prostate pain
[ x] Persistent Fatigue / Exhaustion
[x ] Stomach Pains / Digestion Problems
[ x] Constipation / “Poo Pellets”
[x ] Vision - Acuity Decrease / Blurriness
[ ] Tinnitus (ringing or high pitched sound in ears)
[ ] Hearing loss
[ ] Increased hair loss
[ x] Frequent urination
[ x] Lowered body temperature

[x ] Other (please explain)
testicles larger, soggy feeling, hanging very low (resolved). Varicocele (bilateral, resolved to due surgery). Extreme onset sleep apnea (waking up choking; resolved). Developed anal fissure due to hard stools/straining (resolved).

What (if any) treatments have you undertaken to recover from your side effects since discontinuation of the drug?
Bilateral varicocelectomy
Cialis 5 mg as needed
many supplements
Dynamic Contraction Technique/Freedom from Pelvic Pain for 1 year
Benzos to help with sleep and pain/muscle tightness (mixed feelings about this)
Diet improvement

If you have pre or post-drug blood tests, what hormonal changes have you encountered since discontinuing the drug (please post your test results in the “Blood Tests” section and link to them in your post)?
Low T and free T, which increased somewhat after varicocelectomy and diet/stress improvement
Low vit B and D (supplementing)

Anything not listed in the above questions you’d like to share about your experience?

Tell us your story, in your own words, about your usage and side effects experienced while on/off the drug.

At two weeks on Trazodone, I started getting strong nighttime erections, and was noticing a diminishing of daytime erection quality (EQ). At one month, these turned into sleep related painful erections (SRPEs), with deflated glans.

Then one morning, I woke up, and my penis was completely retracted, cold, shrivelled, and numb, and I had to pee about 20 times per day. Urination provided minor relief. I had extreme bloating and constipation. I lost my libido (mentally, emotionally, and the “physical drive”), and had ED (could get to only 60% with much physical stimulation).

I had severe fatigue, and basically lay in bed for two weeks, having been recently laid off from work. I knew something really bad had happened, and I was in tears for much of this time. Things didn’t seem real anymore–say, a sunset: it didn’t seem like it was actually “there”.

After being told told that “there was nothing wrong” by 2 urologists, I saw a third who found the varicocele. Turns out my ultrasound tech had PFS, and hard flaccid, when I brought it up.

After seeing a pelvic floor PT for about 3 months, I started DCT, which I did manically for 8 months. This eliminated 90% of hard flaccid, removed muscle twitching, and some pelvic pain, but did nothing for ED, numbness, cold glans and testes, and low libido.

After the DCT (I feel that I plateaued at 8 months), I had the varicocelectomy, which improved EQ somewhat. 9 months post op, my total T has almost doubled, and I have less muscle pain, insane fatigue, and mental brain fog, but still experience fatigue, low energy, and derealization.

Higher animal protein, plus eliminating caffeine and too many veggies, has helped my digestive issues a lot, plus boosted my Testosterone, I think.

My theory is that I suffered a traumatic injury to the penis during a SRPE, since my genital symptoms are so similar to those of guys who had a sports, sex, masturbation, or penis enhancement injury (numbness, cold glans, pain). But, I have heard of those coming from ADs and Fin, too.

These two years have been hell, and I want to let anyone suffering from this know that they’re not alone. I’m going to do some actual sexual medicine evaluations to determine if there is any vascular, tissue, or nerve damage in Feb 2021.

I have been so depressed about this, covid aside, and my current challenge is to try to avoid more ADs, so I can give myself as much a chance of healing as possible. It was a long road before Traz, and I may add that as a follow-up comment to this post at a later time, so as to help others.


Hello, I have the same symptoms like you from Trazodone since three years. We should stay in contact.