Pssd relevant hormones

December 2022 - unsure when in cycle (still on meds)

• Total testosterone: 1.3 nmol/L

• LH: 8.94 IU/L

• FSH: 2.05 IU/L

• Prolactin: 16.63 µg/L

  
  
  May 2025 - unsure when in cycle (3 months in)

• Total testosterone: 2.1 nmol/L — high

• SHBG: 22.9 nmol/L

• Estradiol: 742 pmol/L

• LH: 8.9 IU/L

• FSH: 3.3 IU/L

• Prolactin: 7.2 µg/L
  
  August 2026 - 6 days before cycle (18 months in)

• Estradiol: 477 pmol/L

• Progesterone: 33.2 nmol/L

• DHEA-S: 9.1 µmol/L

Edited September 8Sep 8 by wheretogonow

Between 2022 (still on med) and 2025 (acute WD) Your total testosterone increased to 2.1 nmol/L, and the lab flagged it high above <1.8. Your SHBG was 22.9 nmol/L, barely above the lower limit of 20.

That combination matters because SHBG is one of the proteins that binds testosterone. So, in general endocrine physiology, higher testosterone plus relatively low SHBG can create a stronger androgen effect than total testosterone alone suggests. Your report itself even notes that total testosterone may not reflect biologically active testosterone when SHBG is abnormal.

Edited September 8Sep 8 by wheretogonow

2022 (while on meds)

• TSH: 1.86 mIU/L

• Free T4: 12 pmol/L

• (unsure when in my cycle I was at the time)

• Total testosterone: 1.3 nmol/L

• LH: 8.94 IU/L

• FSH: 2.05 IU/L

• Prolactin: 16.63 µg/L

2025 (off meds, 3 months in pssd)

• TSH: 0.94 mIU/L

• (unsure when in my cycle I was at the time)

• Total testosterone: 2.1 nmol/L — high

• SHBG: 22.9 nmol/L

• Estradiol: 742 pmol/L

• LH: 8.9 IU/L

• FSH: 3.3 IU/L

• Prolactin: 7.2 µg/L

• DHEA-S: 9.1 µmol/L

2026 (off meds 18 months in pssd)

• TSH: 3.17 mIU/L

• (bottom 3 were taken 6 days before my period started)

• Estradiol: 477 pmol/L

• Progesterone: 33.2 nmol/L

• DHEA-S: 9.1 µmol/L

So my TSH went 1.86 (2022) → 0.94 (2023) → 3.17 (2025). But I also lost about 25 pounds between 2022 and the 2025 results, also was doing keto and had insomnia during the 2025 results. During my 2026 result I did not do keto, was sleeping normally again however weight was still fluctuating. What do you think? Impactful for pssd or no?

My testosterone increased since 2022 while I was on meds (slightly above normal ranges). Which makes sense since as soon as I got off meds I got this horrible hisutism. Do you think it has any impact on pssd?

I will get a T4 and free testosterone lab done too

Edited September 8Sep 8 by wheretogonow

Hey. What are your current main symptoms? I assume low libido? Anything else?

I'm personally good at reading bloodwork. I have done extensive bloodwork myself which cost me a lot of money. Even though I'm on TRT I had absolutely excellent bloodwork.

Personally I have extreme doubts about PSSD being a bloodwork issue.

I'm more in the camp believing its GUT related. Since most recovery stories tends to healing your gut and time itself.

My personal belief its a body being stuck in maladaptive state until you find the right trigger to push it out. [Im not saying its a medical intervention to be clear] Been purposed as a theory aswell in one scientific paper.

Edited September 8Sep 8 by Vercis

22 minutes ago, Vercis said:

Hey. What are your current main symptoms? I assume low libido? Anything else?

I'm personally good at reading bloodwork. I have done extensive bloodwork myself which cost me a lot of money. Even though I'm on TRT I had absolutely excellent bloodwork.

Personally I have extreme doubts about PSSD being a bloodwork issue.

I'm more in the camp believing its GUT related. Since most recovery stories tends to healing your gut and time itself.

My personal belief its a body being stuck in maladaptive state until you find the right trigger to push it out. [Im not saying its a medical intervention to be clear] Been purposed as a theory aswell in one scientific paper.

Hi Vercis thanks for the comment, what type of bloodwork have you done?

wbu anhedonia do you think that could be a bloodwork issue? My main symptom is anhedonia, feeling asexual, depression. I had a window month 7-10 where I felt 80% healed.

For gut, I actually just got a microbiome test kit today and am waiting to poop to complete it lol. I have done a sibo test before I will share my results:

I got this test done August 2025, and my big window came September 2026. However I wasn't fully healed in that window, and this wave ended up coming. So it's really unclear to me if my SIBO had something to do with WD or not. I also might have had it before I ever went in WD or even before went in meds. I don't really have many SIBO symptoms.

What do you think?

5 minutes ago, wheretogonow said:

Hi Vercis thanks for the comment, what type of bloodwork have you done?

wbu anhedonia do you think that could be a bloodwork issue? My main symptom is anhedonia, feeling asexual, depression. I had a window month 7-10 where I felt 80% healed.

For gut, I actually just got a microbiome test kit today and am waiting to poop to complete it lol. I have done a sibo test before I will share my results:

I got this test done August 2025, and my big window came September 2026. However I wasn't fully healed in that window, and this wave ended up coming. So it's really unclear to me if my SIBO had something to do with WD or not. I also might have had it before I ever went in WD or even before went in meds. I don't really have many SIBO symptoms.

What do you think?

Blood count / red blood cells: hemoglobin, hematocrit, red cells, white cells, MCV, MCH, MCHC, reticulocytes.

Iron and vitamin status: iron, transferrin, transferrin saturation, ferritin, B12, folate, vitamin D.

Blood sugar/metabolic: glucose, HbA1c and fasting insulin.

Electrolytes/minerals: sodium, potassium, calcium and magnesium.

Kidney function: creatinine, estimated GFR and uric acid.

Liver/tissue markers: AST, ALT, LD, GGT, alkaline phosphatase and pancreatic amylase.

Inflammation: CRP.

Cholesterol/cardiovascular risk: total cholesterol, HDL, LDL, triglycerides, ApoB, lipoprotein(a) and homocysteine.

Thyroid: TSH, free T4 and free T3.

Hormones: testosterone, free testosterone index, SHBG, estradiol, LH, FSH, prolactin and progesterone.

Also used sensitive testing for some aswell.

If you don't mind me asking... you are not numb down there? Since its hallmark for PSSD. If you are not, then you have highly likehood of NOT having tested and truth PSSD. Even if you do. Don't fret, people tend to recover either way. You also experienced massive window of recovery at some point aswell.

By looking at the graph you sent me it tends to point that you have intestinal methanogen overgrowth. Which can contribute to depression and deplete essential nutrients like B12. Mods will kill me for making such diagnostic but seems to be the case. Im not saying its cause of your symptoms or anything. Do you have any GI issues overall?

I personally want to do a SIBO test aswell but its not easy where I live.

Edited September 9Sep 9 by Vercis

3 hours ago, Vercis said:

Blood count / red blood cells: hemoglobin, hematocrit, red cells, white cells, MCV, MCH, MCHC, reticulocytes.

Iron and vitamin status: iron, transferrin, transferrin saturation, ferritin, B12, folate, vitamin D.

Blood sugar/metabolic: glucose, HbA1c and fasting insulin.

Electrolytes/minerals: sodium, potassium, calcium and magnesium.

Kidney function: creatinine, estimated GFR and uric acid.

Liver/tissue markers: AST, ALT, LD, GGT, alkaline phosphatase and pancreatic amylase.

Inflammation: CRP.

Cholesterol/cardiovascular risk: total cholesterol, HDL, LDL, triglycerides, ApoB, lipoprotein(a) and homocysteine.

Thyroid: TSH, free T4 and free T3.

Hormones: testosterone, free testosterone index, SHBG, estradiol, LH, FSH, prolactin and progesterone.

Also used sensitive testing for some aswell.

If you don't mind me asking... you are not numb down there? Since its hallmark for PSSD. If you are not, then you have highly likehood of NOT having tested and truth PSSD. Even if you do. Don't fret, people tend to recover either way. You also experienced massive window of recovery at some point aswell.

By looking at the graph you sent me it tends to point that you have intestinal methanogen overgrowth. Which can contribute to depression and deplete essential nutrients like B12. Mods will kill me for making such diagnostic but seems to be the case. Im not saying its cause of your symptoms or anything. Do you have any GI issues overall?

I personally want to do a SIBO test aswell but its not easy where I live.

Where do you live? Have you tried doing an elimination diet to rule out SIBO? Or a carnivore diet? Or tried some herbal antimicrobials? What symptoms do you have rn? My main sibo symptom is constipation.

What are you deficient in currently and are you taking anything?

I am very low in B12, D and a little low in Iron. I want to take supplements but I'm so scared of any type of pill...

I don't have numbness but I feel aromantic and asexual so it comes under sexual dysfunction. Not that I want to have pssd or anything but don't know how else to describe it.

Do you have access to microbiome testing?

@wheretogonow I think that PSSD is not an endocrine or hormonal issue. If that was the the problem, then some pattern of abnormality from an endocrine aspect has been already seen by people with PSSD. But it wasn't. After all, if something was to low or too high why some people with PSSD are "switching" to PGAD or hyper-sexuality sexuality sometimes?

But it sounds great that you and @Vercis mentioned gut aspects. I believe that the answer is gut related. Not just regarding PSSD, but also everything else and I hope that more people will do gut test soon. I mean, 9/10 people on this forum did mentioned some gut issues...

@wheretogonow According to theory, as you know, IMO (methane overgrowth which is also in the large intestine) causes constipation, because methane is slowing down stool transition and I wonder if you spoke with a doctor about trying an antibiotic neomycin for this type of SIBO??

Now, I have my own love story with story, but the this remain unclear in my case. I don't know if I should talk about it... I think now that SIBO is probably not an answer to everything , rather just a symthom of something else gut related...

1 hour ago, The Dust said:

@wheretogonow I think that PSSD is not an endocrine or hormonal issue. If that was the the problem, then some pattern of abnormality from an endocrine aspect has been already seen by people with PSSD. But it wasn't. After all, if something was to low or too high why some people with PSSD are "switching" to PGAD or hyper-sexuality sexuality sometimes?

But it sounds great that you and @Vercis mentioned gut aspects. I believe that the answer is gut related. Not just regarding PSSD, but also everything else and I hope that more people will do gut test soon. I mean, 9/10 people on this forum did mentioned some gut issues...

@wheretogonow According to theory, as you know, IMO (methane overgrowth which is also in the large intestine) causes constipation, because methane is slowing down stool transition and I wonder if you spoke with a doctor about trying an antibiotic neomycin for this type of SIBO??

Now, I have my own love story with story, but the this remain unclear in my case. I don't know if I should talk about it... I think now that SIBO is probably not an answer to everything , rather just a symthom of something else gut related...

I wouldn't confidentaly call it a gut issue because gut issues are notoriously hard to resolve and don't want to bank my healing on something so finnicky. Also it could be the gut issues are a downstream result of the main issue (CNS/vagus nerve disruption)

And I would absolutely never take a SIBO antibiotic I know someone who got nightmarish PSSD from that. Besides 2/3 ppl will get SIBO back after the antibiotics

What's your story?

9 hours ago, wheretogonow said:

Where do you live? Have you tried doing an elimination diet to rule out SIBO? Or a carnivore diet? Or tried some herbal antimicrobials? What symptoms do you have rn? My main sibo symptom is constipation.

What are you deficient in currently and are you taking anything?

I am very low in B12, D and a little low in Iron. I want to take supplements but I'm so scared of any type of pill...

I don't have numbness but I feel aromantic and asexual so it comes under sexual dysfunction. Not that I want to have pssd or anything but don't know how else to describe it.

Do you have access to microbiome testing?

12 hours ago, wheretogonow said:

Where do you live? Have you tried doing an elimination diet to rule out SIBO? Or a carnivore diet? Or tried some herbal antimicrobials? What symptoms do you have rn? My main sibo symptom is constipation.

What are you deficient in currently and are you taking anything?

I am very low in B12, D and a little low in Iron. I want to take supplements but I'm so scared of any type of pill...

I don't have numbness but I feel aromantic and asexual so it comes under sexual dysfunction. Not that I want to have pssd or anything but don't know how else to describe it.

Do you have access to microbiome testing?

12 hours ago, wheretogonow said:

Where do you live? Have you tried doing an elimination diet to rule out SIBO? Or a carnivore diet? Or tried some herbal antimicrobials? What symptoms do you have rn? My main sibo symptom is constipation.

What are you deficient in currently and are you taking anything?

I am very low in B12, D and a little low in Iron. I want to take supplements but I'm so scared of any type of pill...

I don't have numbness but I feel aromantic and asexual so it comes under sexual dysfunction. Not that I want to have pssd or anything but don't know how else to describe it.

Do you have access to microbiome testing?

I ordered some herbal antimicrobials which I know is usually recommended. Also ordered berberine which is a personal favourite. Shows a lot of promises. Want to order also special honey for this aswell.

After reading scientific literature it's insane how much gut microbiome affects pretty much everything in our body and mind.

My biggest issue is stomach distortion, no appetite and full After few bites. I also found it interesting that my ED issue started mostly after i started having gut issues. Its a bit better now though.

I'm not a doctor or a professor so I would advise you to try perhaps a smaller dose of B12 at first? See how you react. If it goes well eventually I would recommend B complex.

You can also try simple things as oregano oil, garlic extract and since you struggle with constipation. Perhaps a motility supplement.

I personally think if you treat this issue you will feel better. Rather than wait until it goes over. Especially when you have results confirming you have sibo.

Edited September 9Sep 9 by Vercis

@wheretogonow I understand that you don't want to take a risk by taking an antibiotic. But I understand that some people want to try the thing being desperate... On the other hand, some people with SIBO are saying that they have "time of their live" on Rifaximin.

Why do you think it can't be something in the gut? Why should be necessary something in CNS. It could be and problems in gut can be the consequence, but can also be the cause, why not?

I had the same skepticism, just like you. I knew that practically noone solve their SIBO just by Rifaximin. Even though my second breath test was negative, I tried it anyway to see, if there will be anything reveal by it. And I was becoming just more and more bloated and in the end my bloating was much worse. In general, nothing big happened.

Except something. I don't have any desire to have sexual relationship, but I really can't say that I have PSSD. Anyway, after 14 days of Rifaximin I felt numbness in my genitals. It felt like real PSSD. Actually it happened something that has been reported in previous post

1 hour ago, Vercis said:

I also found it interesting that my ED issue started mostly after i started having gut issues. Its a bit better now though.

And I noticed more bloating more PSSD like symthoms, numbness. Clear correlation.

But this is not the en of the story. I tried later oregano oil + berberine. And exactly the same thing happened again!

5 hours ago, The Dust said:

@wheretogonow I understand that you don't want to take a risk by taking an antibiotic. But I understand that some people want to try the thing being desperate... On the other hand, some people with SIBO are saying that they have "time of their live" on Rifaximin.

Why do you think it can't be something in the gut? Why should be necessary something in CNS. It could be and problems in gut can be the consequence, but can also be the cause, why not?

I had the same skepticism, just like you. I knew that practically noone solve their SIBO just by Rifaximin. Even though my second breath test was negative, I tried it anyway to see, if there will be anything reveal by it. And I was becoming just more and more bloated and in the end my bloating was much worse. In general, nothing big happened.

Except something. I don't have any desire to have sexual relationship, but I really can't say that I have PSSD. Anyway, after 14 days of Rifaximin I felt numbness in my genitals. It felt like real PSSD. Actually it happened something that has been reported in previous post

And I noticed more bloating more PSSD like symthoms, numbness. Clear correlation.

But this is not the en of the story. I tried later oregano oil + berberine. And exactly the same thing happened again!

That is definitely interesting, especially since you got the numbness after Rifaximin and then again with oregano oil + berberine.

I don't think that proves PSSD is caused by the microbiome, but it does make me think the gut can influence sexual symptoms in some people.

I also don't really see it as gut vs CNS. The gut can affect inflammation, hormones, immune signalling, autonomic function and the brain itself. So something could start in the gut and still end up affecting the nervous system.

Personally I don't think PSSD is fully caused by the microbiome. But if someone tells me they developed GI issues during withdrawal or around the same time as their sexual symptoms, I think it's worth investigating things like SIBO/IMO or other gut problems instead of automatically assuming everything is CNS related.

There are also quite a few recovery stories where people focus heavily on gut health, diet, exercise and general lifestyle. Obviously that doesn't prove the gut was the cause, because they are changing a lot of things at once, but I still think it's interesting.

We know surprisingly little about the microbiome in general. I just don't think it makes sense to completely dismiss it as a possible contributor.

@Vercis Great post! Great summary!

Yes, very little is known about microbiome. And no-one can predict anything by knowing your bacteria profile. At the end altered gut bacteria can be just an consequence of something like altered gut motility.

On 9/9/2026 at 7:17 PM, Vercis said:

That is definitely interesting, especially since you got the numbness after Rifaximin and then again with oregano oil + berberine.

I don't think that proves PSSD is caused by the microbiome, but it does make me think the gut can influence sexual symptoms in some people.

I also don't really see it as gut vs CNS. The gut can affect inflammation, hormones, immune signalling, autonomic function and the brain itself. So something could start in the gut and still end up affecting the nervous system.

Personally I don't think PSSD is fully caused by the microbiome. But if someone tells me they developed GI issues during withdrawal or around the same time as their sexual symptoms, I think it's worth investigating things like SIBO/IMO or other gut problems instead of automatically assuming everything is CNS related.

There are also quite a few recovery stories where people focus heavily on gut health, diet, exercise and general lifestyle. Obviously that doesn't prove the gut was the cause, because they are changing a lot of things at once, but I still think it's interesting.

We know surprisingly little about the microbiome in general. I just don't think it makes sense to completely dismiss it as a possible contributor.

@The Dust have you seen the drwillpowers subreddit

On 9/8/2026 at 11:14 PM, wheretogonow said:

So other than expected deficiencies like b12, d and iron, my thyroid has changed since 2022 (on meds), 2025 (acute WD), 2026 (19 months in). This could also be due to weight changes and sleep I think but I'm making note of this anyway

I had unusual thyroid markers in the first 7-8 months of withdrawal, which then normalised.

I haven't had blood tests in the last couple of years to see if they've remained normal, but I don't see why they wouldn't.

10 hours ago, wheretogonow said:

@The Dust have you seen the drwillpowers subreddit

I am familiar with his searching. I read about it on Rxisk.org. He is looking for a specific metabolic patters of patients with PFS and their coexisting genetic vulnerability.

What do you think about it?

I'm going to be trialling a CPAP machine because I had mild-moderate sleep apnea in 2022....however I have lost a lot of weight since then so I might not have sleep apnea anymore but wondering should I trial the CPAP first or do another test first? I might still have sleep apnea

Deciding whether to do a WGS and dutch hormone test or no, not like I can meet with dr will powers for results since he has such a long waitlist...? Current naturopath started out competant but was just lying still doesn't recognise WD. Do I really wanna spend 3000$+ dollars on more testing 😶‍🌫️

Wow so I met someone else like me who nearly healed for 4 months then went back in a wave....wow I met her in the will powers discord. for her she thought it was because she smoked weed but when i asked her more she was smoking weed the whole time and this could have happened on it's own

Is there any point doing a dutch hormone test or a WGS even....

do i want to spend like 3000$ idk

2 minutes ago, wheretogonow said:

2022....however I have lost a lot of weight since then so I might not have sleep apnea anymore but wondering should I trial the CPAP first or do another test first? I might still have sleep apnea

Loosing weight helps a lot. I started to use CPAP after I gained weight 20 years ago. Now, I'm trying to go back to my previous weight before the sleep apnea issue. My doctor saw slightly improved the last time I went, and we hope that going back to my normal weight will help me. I need to drop 30 pounds....after this journey, I'm taking my health seriously.....

but it was nice i guess to talk to someone else let me put the messages here

"I'm not for certain, but it's all I can think of and it wasn't an immediate crash. It was kind of gradual. I've been smoking occasionally since I've had PSSD with no reaction, but in June, I was able to feel high again for the first time so I was smoking more and then it just kind of gradually hit me
I think my brain always wants to find something to blame it on"

Can someone please does it seem like weed crashed her or no? she mentions a gradual slip down that happened to me too. I never did weed. but I had poor diet, including a binge restrict cycle, and bad sleeping habbits plus allnighters. plus a dental cleaning. none of that could cause a wave right?

she is 22 months

1 minute ago, Raymond said:

Loosing weight helps a lot. I started to use CPAP after I gained weight 20 years ago. Now, I'm trying to go back to my previous weight before the sleep apnea issue. My doctor saw slightly improved the last time I went, and we hope that going back to my normal weight will help me. I need to drop 30 pounds....after this journey, I'm taking my health seriously.....

good luck raymond, if you are using CPAP do you need to worry about losing weight for the sleep apnea? wouldn't the cpap help you? yes I agree lose weight but in a healthy way. how old are you?

So it's interesting, I finally talk to someone similar to me. Huge period of healing for 4 months and then slip back in again, around 22 months, had windows and waves from the start. Mild pssd. For her she was unsure if weed or gradual but from what I've read if you crash for weed it happens instantly and for her it was gradual.

What does this mean? I'm lucky enough so that I'm functional, I can wait to heal. But I just need to know 100% healing is there in the finish line. My biggest fear is not waiting but never healing 100%. I just want the anhedonia to go 100%. Would love so badly to just feel deep joy, love and a zest for life again.