When Viagra Doesn't Work?

[James23]

This may be a question/situation best addressed by marianco. (I've seen a post of yours in the Antidepressant thead regarding ED drugs similar to Viagra.)

What does one do when the issue is completely related to neurotransmitters? That is to say, the erectile response is not inhibited, yet the BRAIN does not respond properly to sexual stimulation.

In my case, my erectile response is fine, but I cannot experience the usual sexual rush. NOTE: I CAN ejaculate and so forth. The plumbing is fine. It just does not register as sexually pleasant in my brain. It all just happens with a slight tickle.

You might suggest it's related to nerves, but it isn't -- every now and then, when I actually feel horny, everything works FINE. Sensation is not a problem, and I can experience pleasure. It doesn't even matter what the source of stimulation is -- if I'm "ready to go", absolutely everything is arousing. So, it's not a "find something that really turns you on" issue, either.

It's literally that my brain is producing something so slowly that it takes weeks upon weeks for it to build up to a level that supports sexuality.

Testosterone doesn't help, either. This problem has been with me since age 13.

What are the neurotransmitters that are necessary to experience sexual pleasure?

[mxim]

low dopamine perhaps. wellbutrin may help/ however,marianco is the one to ask.in fact your thread should be meant for him.resubmit with his name.

[marianco]

Originally Posted by James23

What does one do when the issue is completely related to neurotransmitters? That is to say, the erectile response is not inhibited, yet the BRAIN does not respond properly to sexual stimulation.

In my case, my erectile response is fine, but I cannot experience the usual sexual rush. NOTE: I CAN ejaculate and so forth. The plumbing is fine. It just does not register as sexually pleasant in my brain. It all just happens with a slight tickle.

Every now and then, when I actually feel horny, everything works FINE.

...sensation is not a problem, and I can experience pleasure. It doesn't even matter what the source of stimulation is -- if I'm "ready to go", absolutely everything is arousing. So, it's not a "find something that really turns you on" issue, either.

It's literally that my brain is producing something so slowly that it takes weeks upon weeks for it to build up to a level that supports sexuality.

Testosterone doesn't help, either. This problem has been with me since age 13.

What are the neurotransmitters that are necessary to experience sexual pleasure?

I gather there are three areas of interest:
1. A generally low libido - i.e. sex drive, desire for sex, an intense pleasurable sensation from desiring sex.
2. A libido which cyclicly builds up slowly until it is at a level to support sexual behavior.
3. Orgasm which lacks an intense pleasurable sensation.

As far as I know:
Dopamine increases libido - it is the most important neurotransmitter for determining libido.
Norepinephrine can increase libido (when not excessive), and triggers the orgasm
Orgasm triggers the release of oxytocin in the brain, which provides the intense pleasure of orgasm

Even if dopamine was optimal and oxytocin release were optimal, there are many neurotransmitters/hormones which can suppress the intense pleasure of libido and orgasm. They are often related to the stress reponse (remember that under stress, resting functions such as libido and digestion, are turned off).

For example:
1. Adrenal fatigue - reduces the energy available to have intense pleasure, impairs focus on sex. When libido is cyclic and builds up, I would wonder if adrenal fatigue is present and libido builds up as adrenal fatigue is reduced with time, relaxation, rest, and reduction of stress.
2. Norepinephrine is a stress signal that turns off libido, when stress is high
3. Serotonin helps reduce stress but also reduces dopamine and blunts the pleasure of libido and orgasm
4. Low thyroid can reduce libido
5. Insulin resistance can reduce libido (by impairing nerve signal transmission) and testosterone levels.
6. High progesterone levels can reduce libido

[marianco]

7. High or low estrogen activity can reduce the pleasure of libido and orgasm.

[chap]

thank you for the information

I am intrigued by the: "2. A libido which cyclicly builds up slowly until it is at a level to support sexual behavior."

This is EXACTLY what I always missed when on any kind of trt protocal. What are some theories on this concept?

Testosterone could be good and estrogen in control (I think) and yet there would be no cyclic build up and never that sense of urgency that I took for granted when natural.