Insights into PSSD (Post-SSRI-Sexual-Dysfunctions) Part Two

                                                                                                                                                               After considerable Research and deep-Analysis of the Condition known as "PSSD", I have committed to this following Summary which includes multiple biological changes associated with the condition. This gives us a concise Read on the Factors that are contributing/leading to the negative effects we Associate with PSSD.

Some important notes are below the bulleted-list, which are important after-thoughts and which denote specific cautions in terms of application of the knowledges contained within.

• GnRH Downregulation (Central Gonadotropin-Releasing-Hormone Downregulation, leading to decreased sex hormones; including Testosterone and Estrogen) (1)
• Decreased nNOS protein expression (neuronal-nitric-oxide-synthase), which has much to do with a flood of serotonin activity at the post-synaptic 1A-Receptor/s. (2) (3)
• Increased NAD-PH activity and nitric oxide degradation leading to diminished vascular-smooth-muscle formation and platelet aggregation/s. 
• Long-Term Inhibition of Dopamine-signaling which is additive, to number 1 on this list and apparent to No.6. (4)
• Increased PKC/Rho-Kinase activity which leads to prominent vasoconstriction in Pelvic Muscle and in uterine and penile tissue / smooth muscle. This leads to diminished arousal on a vascular level which is also, additive to the constriction caused by (#2). (5)
• Inhibition and Downregulation of Glutamatergic-Neuron Systems which leads to hypothalamic-HYPOFUNCTION and a diminished HPA/HPG. (6) (7)
• Chronically Increased Cortisol / ACTH leading to a state of hypercortisolism and / or Adrenal Fatigue. (8) (9) (10)
• Increased glucocorticoid Receptor concentration which hastens the above and makes the cortisol excess a stronger Problem - altogether, it is a marvel that most individuals with PSSD haven't lost all hypothalamic function, and interestingly, only a couple have reported complete hypogonadism (Primary, unsurpassed). (11) (12) (13) (14)
• Finally, a unique Histamine-turnover dysfunction is present and the histamine-deficiency accounts for the loss of wakefulness and *NORMAL* cognition Associated with PSSD. (15) (16) 
  □The histamine hypofunction may also lead to Violent/Impulsive behavior as Histamine plays a role in  Regulating impulses. (17) (18) (19)      .

Most, but not all of these effects are a result of desensitized 5-HT(1)A AND 1B-AutoReceptors leading to disproportionate and unusual serotonin EFFLUX and synthesis in key brain regions associated with physiological arousal and sexual desire ( ) ( ). Additionally, SERT-downregulation associated with SSRI-use compounds this Issue - leading to Even More dramatic bursts in Serotonin activity - which leads to these conclusions...

1. DURING & AFTER Long-Term SSRI/SRI Therapy/Treatment/Use - the BASAL (Resting) Serotonin levels and the BURST/REACTIVE/Stress-Associated Serotonin release is also AMPLIFIED. 
2. The excessive resting, pre-training, Stress and substance induced Serotonin responses leads to exaggerated , Glucocorticoid (Cortisol, ACTH) activity, PRL (Prolactin) and other abnormal neuroendocrine-responses. This creates an UNFAVORABLE neurochemistry in any human being.

Many of these chemical changes given they are on both an endocrine and neuroendocrine level, can be lasting or even deemed as 'semi-permanent' - so the resolution/s will be equally as long or at least a period just under a year for many sufferers. Of course, this depends on severity and mental health status as well as genetic and social factors.

I believe that the sad irony is that when a collective solution is presented, it may have application initially but simple differences in character or bodily health on a multitude of other levels will affect the new treatment outcome. This goes with all conditions. Not just PSSD, but also Depression , Anxiety etc...

The new treatment must be adhered to as with Psychiatric medications in much the same time duration in order to provide lasting biological changes in the inverse direction. Because simply put, we are looking to, in some ways, invert the current functional paradigm in terms of that individuals current biological state. 

Because PSSD is a persistent condition which affects not only quality of life in regards to sexual capacity, but also emotional capacity, it may be (for some individuals), a necessary prerequisite to attend self-help classes and / or take part in behavioral therapy (CBT, Counseling etc) before the healing Process can be truly started.

It is likely that given the above list presented, that the answer , even if it affects positively , or prominently, the particular patient, group of patients or large portion of sufferers , will be heavily dependent on that individual, or groups, stride to a better life-Plan and overall health improvement goals. The condition can not simply heal itself based on a drug or medicine alone. They will, however, likely provide symptomatic relief and a short-term or potentially long-term reversal of chemical dysfunctions - but these positive changes will not be complete, or optimal without the above stated overall stride to better Health; both Mental & Physical.