Gradually more numb during sex

[dandelion5]

I'm female, and I'm noticing now, that when having sex, the good news is I'm starting out less numb with some sensation, but as things continue, I get more and more numb by the second, resulting in an orgasm that's not nearly as satisfying. And it takes so much pressure for it to even happen.

It's just so strange because the sensation dramatically decreases during, and it's not like from friction, like a skin sensation that's dulled, it feels neurological.

And then, after any orgasm, the following few days, the numbness dramatically increases to the point where I have no libido at all again.

I guess these are the windows and waves, but it's just so interesting because it almost feels like I "run out of" a hormone or chemical that's necessary to maintain the sensation and create a satisfying climax. And the same thing with the 3 day windows, it's like I've run out of something. As though there's a shortage of dopamine or oxytocin or serotonin (haven't done nearly as much research as you guys, I'm uneducated on this, so bear with me), but does anyone else have this feeling? Like you're low on something and then it just significantly drops?

I guess, if I compare myself now to February, back when I stopped Prozac, I'm improving but ever so slowly and with lots of steps backwards, which is frightening and discouraging sometimes.

[kpavel]

It could be nerves and some type of receptors/channels overabundance or deficiency. It could be lack of a substance. And oxytocin makes it easier to orgasm. As for sensations I wouldn't say I will be very numb after orgasm and it can even be an enhancement of sensation next morning (although it's typically more difficult to orgasm from morning erection). In pre-pssd time I had initially much more itchiness. (Mesolimbo described one technical moment related to this.) For me now process begins with a period of totally unsatisfying numbness followed soon by much better sensation and feeling 'closer' when I feel excited, strangely it is much easier to do from memory than from video or with partner.

[Numby82]

Agree 100%. You describe exactly what I continue to experience.

[Missano20]

I also have this issue often. Not always. My numbness and libido changes literally day to day, but I frequently experience the increased numbness during sex like you've described. It doesn't really affect my ability to orgasm though, it's just annoying. My orgasms actually feel MUCH better on days I'm not feeling much down there, which seems strange. And on my "better" days where I have more sensation, or say caffeine which increases my libido, my orgasms aren't great. I either have one or the other, always been like that too.

[Mesolimbo]

I'm female, and I'm noticing now, that when having sex, the good news is I'm starting out less numb with some sensation, but as things continue, I get more and more numb by the second, resulting in an orgasm that's not nearly as satisfying. And it takes so much pressure for it to even happen.

It sounds like an over-rapid adaptation/desensitization to the the stimulus. Do you feel the physical sensation but not the accompanying pleasure? or do you lose both sensations?

[Numby82]

@Meso I have the same issue. For me it feels as if I lose the sexual pleasure during sex although I can still feel the physical sensation. At first, things feel rather normal (maybe 80 %) and at the end there’s maybe 20 %. The next day I often realize that my clitoris feels a little sore because I had to stimulate it too heavily in order to at least feel some pleasure.

I don’t recall having had this feeling before PSSD. My clitoris was very sensitive and easy to stimulate. I remember that I told my boyfriend not to touch it directly because it was so extremely sensitive. When I started taking Bupropion in 2017, my clitoris felt 100 % normal for some time. So I guess there is dopamine involved.

What do you mean by “over-rapid adaption”? What could be the cause?

[Mesolimbo]

@Meso I have the same issue. For me it feels as if I lose the sexual pleasure during sex although I can still feel the physical sensation. At first, things feel rather normal (maybe 80 %) and at the end there’s maybe 20 %. The next day I often realize that my clitoris feels a little sore because I had to stimulate it too heavily in order to at least feel some pleasure.

I don’t recall having had this feeling before PSSD. My clitoris was very sensitive and easy to stimulate. I remember that I told my boyfriend not to touch it directly because it was so extremely sensitive. When I started taking Bupropion in 2017, my clitoris felt 100 % normal for some time. So I guess there is dopamine involved.

What do you mean by “over-rapid adaption”? What could be the cause?

I'll explain it first in scientific terms:

When erogenous tissues (clitoris, penis, nipples) are stimulated, two areas of the brain that are present in the parietal lobe called the postcentral gyrus and the paracentral lobule light up on fMRI. They send downstream signals to regions responsible for libido and sexual pleasure (i.e. mPOA/NAcc) to release a phasic/burst of dopamine and beta-endorphin.

Over-rapid desensitization happens when this sexual stimulus isn't enough to pass the action potential threshold any longer. One region that plays an important role in this sexual 'tolerance' to stimulus is the dorsal anterior cingulate cortex.

In non-scientific terms:
Think of it as listening to the same song over and over again until your brain "gets bored of it" and no longer finds it pleasurable. You can still hear the music, but no longer feel the pleasure. This soundtrack starts sounding like just noise to you. This is 'tolerance' or habituation to a stimulus.

This process takes a relatively long time for the normal brain. In the PSSD-brain, it happens over-rapidly, within minutes.

What can we do about it?
The main culprit for inducing this is cortical serotonin. Reducing serotonin in the cortical areas limits their inhibitory effect on sub-cortical limbic areas.

Another thing we can do is improving glutamate firing. SSRIs upregulate GR expression, leading to blunting of HPA axis. Cortisol is a glutamate enhancer, so you end up with less glutamate firing and beta-endorphin. Glutamate is absolutely crucial for the pleasure response.

Last thing we can target is AR activation. Serotonin might downregulate central and peripheral AR expression. Lowering serotonin is an important part of the puzzle, but if that's not enough, improving testosterone level might be needed.

Summary:
- Reduce central serotonin.
- Increase glutamate firing.
- Increase testosterone.

Optional:
- Increase phasic dopamine and beta-endorphin firing within the pleasure pathways (amphetamine and, to a lesser extent, bupropion).

[dandelion5]

Thank you so much for your response, @Mesolimbo. @Numby82, you described exactly what my experience is. I also couldn't tolerate my clitoris being directly touched either prior to Prozac.

@Mesolimbo, is there anything I can do naturally to accomplish these things? My testosterone level is high-normal. How would I reduce central serotonin or increase glutamate?

[Dalmatian]

Hello, I'm male but I've been experiencing something similar as you. I've been also getting windows of high libido which usually last 2 days or until I orgasm after which I lose both erections and libido and it takes few days to recover, and so it happens in cycles. My orgasms have always been pleasurable no matter how long I masturbate, so it's a little bit different than your case, but those crashes are inevitable. I'm pretty much convinced that this is a hormonal issue, or a combination of hormones and anxiety which puts pressure on our pelvic floor muscles. Have you tried any relaxation techniques?

[dandelion5]

@Dalmatian, my orgasms are also pleasurable regardless, but they're just not nearly as intense. Just kind of disappointing. Muted somehow. I haven't tried relaxation techniques- what do you mean by that? During sex or just throughout the week?

I agree with you. It's hormonal, chemical somehow. It definitely does not feel physical in the sense that it would be actual like nerve damage, because clearly, it comes in waves and it does improve, and also, it's not a matter of friction either. It feels like it is neurological. It's just so strange because I'll have days where I think I've really recovered only to crash again and have the numbness return. I'm having a bad few days right now, and it's always very upsetting.