Can I get my mojo back?

November 4, 2022 11:30 PM

NSFWFilter: For the past 3 months I have had not only no libido, but a complete loss of…physical sexual feeling. WTF is going on and what kind of medical professional should I be consulting?

Ok this is really hard for me to discuss, so bear with me.

Cis-female, probably too young for perimenopause. Healthy BMI, fit, no health problems. I’m not on any medication including birth control. I used to take Celexa for a few years but quit four months ago. I have read about “post-SSRI sexual dysfunction” and worry this is what I am experiencing. I am not depressed. I took Celexa for anxiety but I am not anxious either.

What I’ve been experiencing is not just a loss of libido but a complete loss of sexual feeling. Like I don’t feel any pleasure, physically. I can even have an “orgasm” where I can feel the muscles contracting but no pleasure or positive feelings. It sucks. The only time I felt something similar was when I was briefly hormonal birth control, which I haven’t taken for years because of this.

I’ve been partnered for years, our sex life used to be very good and I had a healthy libido even on Celexa. I don’t really mind having sex now and enjoy the closeness with my partner but I also get a bit sad every time at what I have lost. If I were not partnered I feel like I’d be fine never having sex again, but I also feel a loss at something I once enjoyed and wonder if I will ever get it back.

I asked my GP about this and he just looked embarrassed and said he didn’t know anything about this and to just wait if it got better. I feel like I want another opinion but I am not even sure what kind of doctor to see…gynaecologist, neurologist, psychiatrist?

posted by anonymous to Health & Fitness (15 answers total)

This FPP might be useful- a urologist maybe?
posted by freethefeet at 11:52 PM on November 4, 2022

I hope you get some answers from people with relevant personal experience (which is not me). I did a search and one of the articles I found on the topic was maybe the same one you found? It looks like if you click on the author link, there's an email address and a string of titles. The author's titles include: FECSM, Urologist, Sexologist.
posted by aniola at 12:08 AM on November 5, 2022 [1 favorite]

Pelvic floor physical therapist. Also, if you have had covid, this is a symptom I have been hearing about in private groups.
posted by Bottlecap at 12:44 AM on November 5, 2022

One, I’m so sorry you’re experiencing this. Two, your GP is a sorry excuse for a medical professional and you should get a referral to a psychiatrist and also perhaps a urologist per that excellent FPP. (If you feel up to it, I would tell this GP and/or his clinical manager that he needs to be able to discuss sexual dysfunction with his patients.) Three, complete loss of sexual sensation was the reason I stopped taking Celexa twenty years ago - it was making me depressed to be physically unable to orgasm, either with myself or my partner. Sexual side effects on Celexa are pretty common from what I’ve heard in the intervening years - that doesn’t mean you shouldn’t see a psychiatrist or urologist, but that there are probably a wealth of stories out there about sexual side effects with this par that might give you hope about it returning and some sense of the time scale. I wish you luck.
posted by rrrrrrrrrt at 2:54 AM on November 5, 2022 [3 favorites]

What your doctor did was egregious and unforgivable. Just because society does so badly at discussing sex does not excuse his unprofessionalism. He should have at the very least given you a referral somewhere else, or an idea of who else to reach out to. Appalling. I’ll think through more ideas but know that you have every right to have this taken seriously, and to get answers.
posted by asimplemouse at 3:51 AM on November 5, 2022 [12 favorites]

I’m not going to be helpful, but that’s just because I don’t know the answer. I’ve had this since April/May, same general age and fitness level. For me, I can still orgasm but it is very mechanical and unsatisfying, sexual desire and excitement has vanished.

My gyn wanted me to wait a few months to see if anything changed, assuming hormones. I have a friend who has suggested thyroid issues, potentially.

All I’ve got is solidarity, I really really miss feeling aroused.
posted by lydhre at 4:40 AM on November 5, 2022

Definitely get it checked out. Pelvic floor therapy, gyno, sexual health professional, therapy, endocrinologist, your medication prescriber, naturopath, maybe someone who can check out the nerves... I'd just start seeing people and keep on with it until someone has an answer.

I'd try to cover health basics like food, water, sleep and stress.

This is also a covid follow-on for some people. If it's something like that I'd focus on accepting it in the moment and looking for mindful ways to keep engaging pleasure somehow—bath, massage, scalp scratching, non-sexual touch. Stop pushing at it (if you are) and allow that this part of you may hibernate for a season. It'll more than likely come back. And whatever is happening, it may be able to reconnect through a circuitous path. This can help avoid a secondary defensive or tension reflex so when it does come back online, you'll be ready to enjoy it fully.
posted by rockyraccoon at 6:27 AM on November 5, 2022 [1 favorite]

I used to be very happy about my sex life and all the great feels around that, from about 22-40. I went through menopause with a significant loss of desire and feeling. It made me very sad to lose such a great joy in life. Even with mental stimulation such as porn, I felt nothing. Without SSRIs or any other meds, still no interest, yet a longing for the feelings to come back. My Gyno had zero recommendations, as any libido inducing meds are not helpful to post menopausal women. Eventually I was prescribed a dopamine agonist to alleviate restless leg syndrome and that magically had me feeling sexual again, psychologically and physically . I don’t take it every day because I don’t get RLS every day, but it does help feeling sexual. There are issues around taking this medication wrt compulsive behaviors and augmentation of RLS after prolonged use but I haven’t experienced that yet. My RLS seems fine for a few days after one dose.
posted by waving at 7:38 AM on November 5, 2022

This occasionally happens to me but usually resolves within a month or two. I just as inexplicably have periods of super-charged libido. I have always chalked it up to the mysteries of hormones (which is not to say that your doctor is not a useless POS, as so many of them are when it comes to women’s sexual health). You say “probably too young for perimenopause” but how old are you? And even short of perimenopause, hormones can get seriously out of whack. Do you feel like you have the same amount of lubrication (not from arousal, just normal lubrication) as you used to? Has there been a change in appearance in your vulva? Your two best bets are likely a urogynecologist or a menopause specialist (the latter because they spend a lot of time on libido issues). Either one of these may end up referring you to a pelvic floor PT.
posted by HotToddy at 10:57 AM on November 5, 2022

An endocrinologist to check your hormone levels would be my first stop. There are many other conditions than peri menopause that can affect hormones.

After that, a pelvic floor specialist. I think all women should seek out pelvic floor health providers as a general rule since so often we normalize things that really aren't, and can be improved.
posted by ananci at 2:02 PM on November 5, 2022

Are you very stressed? Perhaps on the verge of burnout? In hindsight i realised that this loss of sexual pleasure (but muscles contracting) was one of the first symptoms of burnout, a full year before a complete collapse mentally and physically. Burnout messes with your body, especially hormones. Good news, this year (about 4 yrs later and recovered) pleasure and libido have returned.
posted by 15L06 at 2:20 PM on November 5, 2022

It sounds like post ssri sexual dysfunction. I took citalopram (for only a few months!) and had the same issue, though I think it’s a pretty uncommon side effect so most doctors probably won’t know about it. Dopamine agonists like someone mentioned above can help (ask a smart doctor, but I believe bupropion and possibly stimulants may help at least a bit), though the only real solution is time. Exercise, eat well, reduce stress and let your body bounce back on its own time. You’ve only been off SSRIs for a few months and that’s nothing; recovery from this can take months to years.

I think recovery time and extent depends a lot on the individual. I think some people probably recover fully and many at least partially. For me it took about 3 years to start feeling close to normal again. It’s been many years since I took citalopram and I don’t know if my sexual function is *much* more dampened than it would’ve been had I never took it, but it’s returned over time from zero to a pretty good level.

For me it also correlated with a change in perception of all pleasure, not just sexual. I think SSRIs can seriously mess with dopamine receptors for some unlucky people. Over the years it took to recover it also feels like my brain learned new paths to pleasure. It used to be impossibly difficult for me to think or talk about this because it felt like a terrifying loss. Now I accept that an uncommon weird bad side effect happened, it sucked, I’ve mostly recovered and can feel crazy excitment again though maybe it feels a bit qualitatively “different.” If it is PSSD, your experience may be different, but I’m quite confident that you will be okay! Just be patient.
posted by saturday sun at 4:55 PM on November 5, 2022

I think the first order of business is to go see a much better doctor and get some bloodwork done. Even if everything comes back fine, get a referral to the specialist your doctor feels is appropriate. (If your doctor says, "Well, your bloodwork was OK, so there's nothing else to be done for you," that doctor is no good either.) Instead of going directly to a gynecologist or whatever, you need to start with a good GP. A big part of their job is directing people to the appropriate specialists.

I'm going to be a bit sexist and say you may have better luck with female doctors. They're less likely to have the "Yikes, ladyparts!" reaction your male doctor had. Seriously, if your account of what he said is accurate, that guy shouldn't be practicing.

Are you depressed and anxious otherwise? Is there some big issue in your relationship you're not addressing? It's possible this is something psychological, but if you're feeling OK mentally aside from this sudden loss of libido, I think it's more likely to be something physical. While you're trying to sort this out, I'd suggest experimenting with some different kinks and trying some new sex toys. Experiment with your body and see if you can unlock something. I wish you luck, and spectacular orgasms!
posted by Ursula Hitler at 11:51 PM on November 5, 2022

I'd go to a good gynecologist. I had a partial lack of sensation after childbirth/ surgical delivery; it lasted @ 6 months and was caused by the catheter or some element of labor, pushing, surgery. Nerve issues, and feeling all came back in a few months.

Your GP's response is appalling. Lack of sexual function (that includes sensation/ pleasure) is important and needs to be addressed. I've encountered male docs who get weird about women's bodies and sexuality; it's not acceptable and can cause harm.
posted by theora55 at 6:04 PM on November 6, 2022

Like you, I got the same loss of sexual feeling and orgasms without pleasure when on hormonal birth control. I also get it when I'm depressed (are you depressed in the sense of "not caring about much," which can be harder to recognize than sad feelings?) or after taking antibiotics (because apparently my microbiome is responsible for all of my feelings).

Assuming you can't find a helpful doctor and this lasts more than three months, I'd start by trying out bupropion.
posted by metasarah at 7:08 AM on November 9, 2022