Sexual Performance Anxiety

[Tentaikun]

Any way to reduce it? I'm using viagra as it tends to make me feel more relax but harder to cum.

[xylphz]

Originally Posted by Tentaikun

Any way to reduce it? I'm using viagra as it tends to make me feel more relax but harder to cum.

Do you always watch porn often ?

If yes, it might be the cause as you are so conditioned to get turned on by pixels on screen,

but not in the exact moment when the actual flesh is in front of you therefore,

making it harder to cum coz your mind is confused what is that in front when having real sex

[Tentaikun]

Originally Posted by xylphz

Do you always watch porn often ?

If yes, it might be the cause as you are so conditioned to get turned on by pixels on screen,

but not in the exact moment when the actual flesh is in front of you therefore,

making it harder to cum coz your mind is confused what is that in front when having real sex

Hi bro thanks for the advice. Stop watching for 2 months already. Still can erect normally but when nearing the date I book FL i will get very anxious and excited but worry cannot erect and cannot cum. So I tried viagra and it makes me feel more relax. I'm also on anti depressant and anxiety medication.

[sammyboyfor]

Originally Posted by Tentaikun

Hi bro thanks for the advice. Stop watching for 2 months already. Still can erect normally but when nearing the date I book FL i will get very anxious and excited but worry cannot erect and cannot cum. So I tried viagra and it makes me feel more relax. I'm also on anti depressant and anxiety medication.

If you're on an SSRI anti depressant it is probably the cause of your difficulty in reaching orgasm.

I would advise you to stop taking those drugs ASAP. They can cause all sorts of problems with sexual function especially with long term use. Anxiety medication viz the benzos can also cause ED. I was prescribed diazepam a few years ago when I had trouble sleeping from breaking my wrist. My dick stopped working almost immediately and did not recover till 48 hours after my last dose!!!

Switch to a non SSRI anti depressant if you really need drugs for the condition. My recommendation is Zyban as it actually improves sexual function. Google for more info.

However my sincere advice is to get off ALL your drugs as using chemicals to fix the mind is not the way to go. There is very little evidence that anti depressants actually work. Studies have shown that they perform no better than a placebo in most studies. The only ones benefiting are the pharma companies. Even if they help marginally the downsides are not worth the risk.

There is loads of information out there regarding how to handle depression and anxiety in a holistic manner. Depression is not a chemical imbalance in the brain it's a state of mind brought about by an erroneous approach to what life is all about.

PM me if you need more info.

[xylphz]

Originally Posted by Tentaikun

Hi bro thanks for the advice. Stop watching for 2 months already. Still can erect normally but when nearing the date I book FL i will get very anxious and excited but worry cannot erect and cannot cum. So I tried viagra and it makes me feel more relax. I'm also on anti depressant and anxiety medication.

That explains.

Like boss Sam mentioned as above from my reply.

One of anti-depressant medication side effects is that it will disrupt your sex drive / libido :

Managing Antidepressant Sexual Side Effects

Because since you can physically erect during normal days.

Most of the time, the problem lies with psychological first rather the physical part.

Let me share my experience:

Last year there is a 3 months lockdown in SG,
The only way I could release is masturbate.
After awhile I tried to masturbate, I failed to erect and cum.

Realized that I have PIED (Porn Induced Erectile Dysfunction) last year.

Went cold turkey no fap for 9 months to detox my mind's dopamine reactors towards sex.

After 9 months, tried with first 2 FL bookings I messed up, still can't cum.

After the 3rd attempt booking,
This one 90 mins session, I took an hour, manage to successfully cum with pussy penetration.

[sammyboyfor]

https://www.healthline.com/health/er...l-side-effects

Sexual side effects in men

Men are also affected by the serotonin stabilization that SSRIs cause.

Common side effects in men include decreased libido and difficulty getting an erection. Some men have trouble maintaining an erection. Men taking antidepressants also report delayed or blocked orgasm. Some drugs, like Celexa, can cause a man’s sperm count to drop to nearly zero.

[sammyboyfor]

https://medlineplus.gov/ency/article/004024.htm

Drugs that may cause erection problems

Many medicines and recreational drugs can affect a man's sexual arousal and sexual performance. What causes erection problems in one man may not affect another man.

Talk to your health care provider if you think that a drug is having a negative effect on your sexual performance. Never stop taking any medicine without first talking to your provider. Some medicines may lead to life-threatening reactions if you do not take care when stopping or changing them.

The following is a list of some medicines and drugs that may cause erectile dysfunction (ED) in men. There may be additional drugs other than those on this list that can cause erection difficulties.

Antidepressants and other psychiatric medicines:

Amitriptyline (Elavil)
Amoxapine (Asendin)
Buspirone (Buspar)
Chlordiazepoxide (Librium)
Chlorpromazine (Thorazine)
Clomipramine (Anafranil)
Clorazepate (Tranxene)
Desipramine (Norpramin)
Diazepam (Valium)
Doxepin (Sinequan)
Fluoxetine (Prozac)
Fluphenazine (Prolixin)
Imipramine (Tofranil)
Isocarboxazid (Marplan)
Lorazepam (Ativan)
Meprobamate (Equanil)
Mesoridazine (Serentil)
Nortriptyline (Pamelor)
Oxazepam (Serax)
Phenelzine (Nardil)
Phenytoin (Dilantin)
Sertraline (Zoloft)
Thioridazine (Mellaril)
Thiothixene (Navane)
Tranylcypromine (Parnate)
Trifluoperazine (Stelazine)

Antihistamine medicines (certain classes of antihistamines are also used to treat heartburn):

Cimetidine (Tagamet)
Dimenhydrinate (Dramamine)
Diphenhydramine (Benadryl)
Hydroxyzine (Vistaril)
Meclizine (Antivert)
Nizatidine (Axid)
Promethazine (Phenergan)
Ranitidine (Zantac)

High blood pressure medicines and diuretics (water pills):

Atenolol (Tenormin)
Bethanidine
Bumetanide (Bumex)
Captopril (Capoten)
Chlorothiazide (Diuril)
Chlorthalidone (Hygroton)
Clonidine (Catapres)
Enalapril (Vasotec)
Furosemide (Lasix)
Guanabenz (Wytensin)
Guanethidine (Ismelin)
Guanfacine (Tenex)
Haloperidol (Haldol)
Hydralazine (Apresoline)
Hydrochlorothiazide (Esidrix)
Labetalol (Normodyne)
Methyldopa (Aldomet)
Metoprolol (Lopressor)
Nifedipine (Adalat, Procardia)
Phenoxybenzamine (Dibenzyline)
Phentolamine (Regitine)
Prazosin (Minipress)
Propranolol (Inderal)
Reserpine (Serpasil)
Spironolactone (Aldactone)
Triamterene (Maxzide)
Verapamil (Calan)

Thiazides are the most common cause of erectile dysfunction among the high blood pressure medicines. The next most common cause is beta blockers. Alpha blockers tend to be less likely to cause this problem.

Parkinson disease medicines:

Benztropine (Cogentin)
Biperiden (Akineton)
Bromocriptine (Parlodel)
Levodopa (Sinemet)
Procyclidine (Kemadrin)
Trihexyphenidyl (Artane)

Chemotherapy and hormonal medicines:

Antiandrogens (Casodex, Flutamide, Nilutamide)
Busulfan (Myleran)
Cyclophosphamide (Cytoxan)
Ketoconazole
LHRH agonists (Lupron, Zoladex)
LHRH antagonist (Firmagon)

Other medicines:

Aminocaproic acid (Amicar)
Atropine
Clofibrate (Atromid-S)
Cyclobenzaprine (Flexeril)
Cyproterone
Digoxin (Lanoxin)
Disopyramide (Norpace)
Dutasteride (Avodart)
Estrogen
Finasteride (Propecia, Proscar)
Furazolidone (Furoxone)
H2 blockers (Tagamet, Zantac, Pepcid)
Indomethacin (Indocin)
Lipid-lowering agents
Licorice
Metoclopramide (Reglan)
Nonsteroidal anti-inflammatory drugs (NSAIDs, ibuprofen, etc.)
Orphenadrine (Norflex)
Prochlorperazine (Compazine)
Pseudoephedrine (Sudafed)
Sumatriptan (Imitrex)

Opiate analgesics (painkillers):

Codeine
Fentanyl (Innovar)
Hydromorphone (Dilaudid)
Meperidine (Demerol)
Methadone
Morphine
Oxycodone (Oxycontin, Percodan)

Recreational drugs:

Alcohol
Amphetamines
Barbiturates
Cocaine
Marijuana
Heroin
Nicotine

[Tentaikun]

Thank you all bros for your reply. Actually I've delayed ejaculation ever since I started on antidepressants. Last time dose not so much but slowly as the dosage gets high, you will feel harder to erect and cum. Slowly end up getting anxiety before sex. When doing it still ok.

My dosage as follows for depression with panic attack:

Propranolol HCl Tablet
10 mg - BD
Duration/Qty: 10 weeks / -

Other Medication
1 tablet - BD - Deanxit (flupenthixol/melitracen) tablets
Duration/Qty: 10 weeks / -

ClomiPRAMINE HCl Tablet
100 mg - ON
Duration/Qty: 10 weeks / -

Bupropion SR Tablet
150 mg - BD
Duration/Qty: 10 weeks / -

Bromazepam Tablet
1.5 mg - ON - PRN Anxiety
Duration/Qty: 8 weeks / -


Treat quitting but side effect jialat. Hear ringing noise, irrational fear that everybody wanna harm me etc.

Tomorrow my appointment with the doctor will check with her again.

Really appreciate the replys from you all

[sammyboyfor]

Originally Posted by Tentaikun

Thank you all bros for your reply. Actually I've delayed ejaculation ever since I started on antidepressants. Last time dose not so much but slowly as the dosage gets high, you will feel harder to erect and cum. Slowly end up getting anxiety before sex. When doing it still ok.

My dosage as follows for depression with panic attack:

You are on WAY too much medication!!!

Some are being prescribed to mitigate the side effects of others eg bupropion is added to the mix to try to counter the effects of the other drugs.

It's a downward spiral that will end up with developing all sorts of other physical issues as time goes by including an increased likelihood of Dementia as you get older.

You must visualise an end date for all these drugs. Your problems are all in your mind and it is your mind that has the capability of getting you out the valley you're currently stuck in. Chemicals will not cure you all they do is dull all the senses including those you need to enjoy life.

Almost everyone I know has been through bouts of anxiety, self doubt and a sense of hopelessness but with a bit of determination there is a way out without the use of drugs.

[DoctorTan]

Completely agree that over-prescription and polypharmacy are a big problem in today's practice of medicine

Also completely agree that many medicines especially medicines to treat mental health have ED and low libido as a side effect

For patients who really need pharmacotherapy I tend to favor Agomelatine which has fewer sexual function side effects

That said, from your description of your symptoms "Hear ringing noise, irrational fear that everybody wanna harm me" it sounds to me that you may not have just straight forward anxiety. It sounds to me like you may be suffering from early psychosis. So I think it is very important that you continue to see your mental health professional. Have a frank discussion with him/her about your sexual health concerns and try to find a way to improve this without adversely affecting the management of your mental health.

Because uncontrolled psychosis is a very slippery slope and can have rather unthinkable consequences

[sammyboyfor]

Originally Posted by DoctorTan

Completely agree that over-prescription and polypharmacy are a big problem in today's practice of medicine

Also completely agree that many medicines especially medicines to treat mental health have ED and low libido as a side effect

For patients who really need pharmacotherapy I tend to favor Agomelatine which has fewer sexual function side effects

That said, from your description of your symptoms "Hear ringing noise, irrational fear that everybody wanna harm me" it sounds to me that you may not have just straight forward anxiety. It sounds to me like you may be suffering from early psychosis. So I think it is very important that you continue to see your mental health professional. Have a frank discussion with him/her about your sexual health concerns and try to find a way to improve this without adversely affecting the management of your mental health.

Because uncontrolled psychosis is a very slippery slope and can have rather unthinkable consequences

The biggest elephant in the room that nobody talks about and that some doctors are unaware of is the fact that sexual dysfunction can continue even after medication is withdrawn. No doctor should prescribe an SSRI/SNRI without first warning a patient of the potential disastrous long term side effects for which there is no known treatment at present.

PSSD

https://www.pssdnetwork.org/

What is Post-SSRI Sexual Dysfunction?

Post-SSRI Sexual Dysfunction is a condition that can arise following the use of antidepressants in which sexual function, cognitive and/or emotional function does not return to normal, or worsens after stopping the medication.

The strict definition of PSSD refers to the persistence of sexual dysfunction after stopping SSRI or SNRI medication, however, significant sexual dysfunction can happen while on treatment and after stopping any serotonin reuptake inhibiting (SRI) drug. Furthermore, there are anecdotal reports of the condition arising after the use of tricyclic antidepressants, atypical antidepressants and antipsychotics.

The medical term, 'PSSD', does not accurately highlight the debilitating cognitive and emotional impairment that many people with this condition also suffer from.

It is common to develop side effects while taking antidepressants, however, it is not currently known what proportion of people recover fully when they stop taking them. For some people, symptoms only start appearing when they stop taking the medication or begin to reduce the dose.

PSSD affects both men and women. It can happen after only a few days of exposure to the medication and can persist for months, years, or indefinitely. There currently is no known cure.

PSSD can be detrimental to the lives of the people it affects. It has caused marriages to fail, unemployment, and in the worst case suicide.

Persistent sexual dysfunction from SSRI/SNRI medications (lasting long after quitting) was acknowledged by EMA (European Medicines Agency) in 2019.

[Tentaikun]

Hi All, just finished my consultation with my psychiatrist. She say that currently not advisable to reduce the medication due to my symptoms of MDD with panic disorder.

She cross taper clomipramine with setraline which seems to be an ssri. And she suggested me to go for cognitive behavioral therapy. I've stopped propranolol as this maybe the cause.

Doctor say maybe clomipramine causing the delay ejeculation as i heard it seems to be used for premature ejaculation.

So meanwhile I'll slowly reduce the lexotan and wait for clomipramine to be remove from my system.

[sammyboyfor]

Originally Posted by Tentaikun

Hi All, just finished my consultation with my psychiatrist. She say that currently not advisable to reduce the medication due to my symptoms of MDD with panic disorder.

She cross taper clomipramine with setraline which seems to be an ssri. And she suggested me to go for cognitive behavioral therapy. I've stopped propranolol as this maybe the cause.

Doctor say maybe clomipramine causing the delay ejeculation as i heard it seems to be used for premature ejaculation.

So meanwhile I'll slowly reduce the lexotan and wait for clomipramine to be remove from my system.

Clomipramine is a TCA (Tricyclic antidepressant) and it's being replaced with an SSRI ie Setraline so I'm not sure if it is going to help at all with sexual dysfunction but everyone is different so only time will tell.

Fully agree that you should move towards treating your condition via cognitive therapy and away from drugs. The sooner you can do this the better. The key ingredient in therapy is the therapist so seek out the best person(s) available.

[Tentaikun]

Originally Posted by sammyboyfor

Clomipramine is a TCA (Tricyclic antidepressant) and it's being replaced with an SSRI ie Setraline so I'm not sure if it is going to help at all with sexual dysfunction but everyone is different so only time will tell.

Fully agree that you should move towards treating your condition via cognitive therapy and away from drugs. The sooner you can do this the better. The key ingredient in therapy is the therapist so seek out the best person(s) available.

Thanks bro. Will give setraline and CBT a try. Worse come to worse I'll opt for those atypical antidepressants instead to replace clomipramine/setraline like mirtazapine, vilazodone etc. Hopefully can come out of all these medication soon!

[larue]

CBT changed my life.