Specific local anesthesia/numbness/lack of sensitivity of penis

[MatthiasKDH]

This study talks about nerves of the penis in some detail: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7354288/

The pudendal nerve innervates most of the perineal area. It originates from the of S2–S4 spinal cord segments and ultimately divides into 3 terminal branches: the inferior rectal nerve, the perineal nerve, and the dorsal nerve of the penis (DNP) (11). The sensory fibers of the perineal nerve are distributed across the scrotal and penile ventral area (12,13), while the DNP innervates the penis glans and most of the penile skin (14). The ilioinguinal nerve also supplies sensation to the penis root.

It specifies for example how, while the dorsal nerve of the penis innervates the glans and the upperside and sides of the penis, the underside or ventral area (sometimes called corpus spongiosum) is mostly innervated by perineal nerves.

It also refers to this study that says the latter nerves are partitioned into nNOS positive and negative parts:

Neuroanatomy of the male urethra and perineum - PubMed

All perineal nerves from their main trunk at the ischiorectal fossa until their interaction with dorsal nerve of penis at the base of penis were nNOS negative. After the interaction with the dorsal nerve of penis, they become nNOS positive.

So I wonder if the underside of the penis is mostly affected by numbness for me (or maybe someone else), if it might simply have something to do with nNOS. However these are only some of the most shallow observations, I don’t know if nNOS is actually involved sensation/feeling or just the usual erection stuff.

[Lostinaustin]

Hmmm the underside is way more sensitive to me, whereas the glans is the least sensitive (basically 0) and top of the shaft shifts between 0-50% sometimes.

[PastUser]

@ [MatthiasKDH] I think it’s because of the loss of elastin which causes scaring / plaque

[Waytocure]

I don’t think it matters. Both parts come from the pudendal nerve. Moreover for sure the neuropathy will not only concern the pudendal nerve but also other nerves as ilioinguinal nerve. So, probably sesantion is affected on the upper site and the posterior site.

The pudendal nerve is also important for activating nitrit oxide via the release of acetylcholine.
Also, local DHT is affecting nitrit oxide production. So both low tissue levels of DHT (through tissue specific methylation of the SRD5a2) and neuropathy of the pudendal nerve (which proved Melcangi in PFS patients and which may be caused by demyelination of the pudendal nerve due to low allopregnanolone levels) could contribute to the ED we see in PFS/PSSD /PAS.

[silentpain89]

I hardly think that it is something local to the penis nerves.
Many with PSSD and me (i have PFS) have complete loss of sensation in all body area. I even cant taste or smell like before…Im sure many of you have at least numbing of another area of your skin other than the genital area (a lot dont know about it becuz they dont look around their body and since the penis is the most sensitive it will be the more noticeable when something changes their. Btw many reported numbing of the scalp region for example)…
And that’s why i dont think its a local problem but rather central.

Again its my own understanding and i cant back up anything with scientific evidence

[Waytocure]

Well, let’s imagine the cause lies in low Allpregnanolone levels. In peripheral nerves, Schwann cells build myelin. The myelin of central nerve axons are made by Oligodentrocytes. Both require Allpregnanolone for methylation. Myelination is like cable insulation for nerves. If the insulation is wearing off, nerves have difficulties conducting electric impulses, like sensation.

Or do you think something else may be broken in the brain and what do you think would be a plausible mechanism?

[silentpain89]

If this was the case then we can easily diagnose PFS.
Go to a neurologist and ask him to do a measurement of how fast the nerves are conducting the signal (A very routine diagnostic measure that any neurologist can do), and if it came back pathological then Voila. We can prove we have PFS and that we are damaged.

BUT this is sadly (or luckily) not the case…While i didnt do this measurement yet, i believe many have done it with no pathological results…Im aware of the study that found pathological readings by some of the PFS patients, but to me even this study is really biased and a little pathological readings explains in no way why we have no libido and cant feel orgasms…To me the problem is in the brain.

Again i cant back up anything with scientific evidence, its just my understanding of the things

[silentpain89]

Actually if we talk about SSRIs, it has been proven that Fluoxetine was able to reduce the sensation in the penis 45 minutes after taking it…YES AFTER ONLY 45 MINUTES…

Its just crazy, and in no way any form of de-meylination can occur in that time.
Intresting enough there was a study in germany like 6 years ago (I already posted it) that shows that citalopram was able to suppress the activity of many brain regions acutely after only 30 to 45 minutes of taking it. Like a switch it turned off the signaling in many brain regions…

With Finasteride i have no science to back anything

„Here, we show evidencethat a single dose of a serotonin reuptake inhibitor dramati-cally alters functional connectivity throughout the wholebrain in healthy subjects (n = 22). Our network-centralityanalysis reveals a widespread decrease in connectivity inmost cortical and subcortical areas.“

https://www.cell.com/current-biology/pdfExtended/S0960-9822(14)01037-9

[Waytocure]

Well, my bet is something is broken in the mPOA of the hypothalamus. There lies skin sensitivity, termoregulation, sexual behavior and it has strong dopaminergic connectivity to the nucleus accumbens. Many guys here report the absence of flight fight response. The nucleus accumbens is critical for this.

[sg8627]

Is this potentially even treatable/fixable?

[happy_to_fight]

Yes (if you have a time machine lying around somewhere)

[sg8627]

Cmon man really any need for that?
I’m genuinely asking

[happy_to_fight]

Hard to say, but right now I guess not. I was searching for some studies about it and only one came up “REGENERATIVE GENE THERAPY IN THE HYPOTHALAMUS PROLONGS FERTILITY IN FEMALE RATS” in which female rats stayed fertile for longer. The rest are abou post injury regeneration(so more like recovery). Injury meaning trauma I guess. Maybe if out brains are not damaged, but an epigenetic switch went off then there is a chance.