Measuring numbness: PSSD sensation studies

Yes, genital numbness in post-SSRI sexual dysfunction (PSSD) can now be measured. In a small 2026 London study, simple touch tests found numbness in every patient with PSSD, while nerve tests were normal in almost all of them.

PSSD can last after stopping an antidepressant, and it is more than sexual problems. The 2022 criteria put a lasting change in genital sensation at its core, and also describe emotional numbing, problems with thinking and changes in other senses. There is no test for PSSD, so numbness a doctor finds on examination can matter for your record.

The UK leaflet for Cipralex (escitalopram) says sexual problems have, in some cases, “continued after stopping treatment”.

Benjamin took Cymbalta (duloxetine), an SNRI antidepressant. He has lived with PSSD for 14 years. Watch this extract if you’ve struggled to be believed: in his interview with Moral Medicine, he talks about how hard it was to get doctors to take it seriously.

Play video: Benjamin on living with PSSD (extract)

A measurement could one day give patients like Benjamin evidence a doctor can see. That’s what the new research is trying to do.

What did the London doctors measure?

They measured what patients feel on the skin. The team works at the National Hospital for Neurology and Neurosurgery in Queen Square, London. Patients are referred there when their genital feeling has changed. Jalesh Panicker, of the hospital’s uro-neurology department, presented the work at the International Continence Society’s meeting on 9 October 2026.

They went back through the records of patients referred with genital numbness between 2019 and 2024. Nine met the 2022 criteria for PSSD.

Every one of the nine had numbness a doctor could find. The tests are simple. A fine nylon filament checks light touch, and a sharp but safe pin checks whether a prick still registers.

The loss was strongest over the head of the penis and the shaft just below it, the same on both sides, and worse on the underside. That pattern matches the most sexually sensitive skin, the team notes.

Why were their nerve tests normal?

In eight of the nine, the nerve tests were normal. These tests send a small electrical signal from the skin and time how it travels up to the brain. A normal result makes damage to the main nerves unlikely, the team says.

So the numbness was there on examination, but the wiring seemed to work. The team suggests the problem lies in the brain, in how touch is turned into sexual feeling. That process involves pleasure and reward systems, they write, and long exposure to an SSRI may unsettle them. That’s their reading of the results, and it’s still a hypothesis.

The 2022 criteria already treat these as two different things: ordinary touch, and sexual feeling. For sexual feeling, they say, “there are no available tests”.

Doctors elsewhere hear the same complaint. In this extract, Dr Kenneth Peters, a urologist in Michigan, describes four young patients who came to him within two weeks with almost the same symptoms, numbness among them. It’s context from a clinic, not evidence from the London study.

Play video: Dr Kenneth Peters on four young patients (extract)

Can a sensation test prove PSSD?

Not yet. A test can show that feeling is reduced. It can’t show what caused it.

In the London study, patients whose numbness had other causes failed the touch tests about as often as those with PSSD. So the test confirms numbness, and the history still has to point to the medicine.

A second team, at San Diego Sexual Medicine, went back through 15 years of records of men with PSSD. They had used quantitative sensory testing, which measures the smallest vibration, warmth and cold a person can detect. About 9 in 10 of the men tested had abnormal results, they reported in 2025.

Both studies are short conference abstracts from clinics that see people already looking for answers. Neither compared its patients with healthy people, or with people who took SSRIs without problems. So neither can say how often PSSD happens, and no reliable figure exists for that.

Sensory testing isn’t widely available either, two of the researchers behind the criteria note.

What can I do?

These medicines help many people. If you have side effects, that’s a decision for you and your prescriber. Don’t stop suddenly.

If your genital feeling has changed, say “numb” to your GP, and say where. Mention changes beyond sex too, such as feeling emotionally flat. A doctor can check feeling by examination. A normal nerve test doesn’t rule PSSD out, the London findings suggest.

Our page on how PSSD is diagnosed explains the criteria, and genital numbness and medicines covers the other causes a GP will want to rule out.

Many people say it took time to be taken seriously. Bring the leaflet line. You can report it without a doctor agreeing.

Report it: it helps everyone

A doctor’s note helps you. A report to the medicines regulator helps everyone else: it is how patterns get noticed.

• No proof needed. A suspicion is enough, even years after stopping.
• Where: the Yellow Card scheme in the UK, MedWatch in the US.
• Use the right words. If symptoms continued after stopping, write Post-SSRI sexual dysfunction (MedDRA 10086208).

Our reporting guide walks you through it

What else do people ask?

Is there anything that sets PSSD apart from other numbness? Possibly. In the London study, about 3 in 4 people with PSSD also had ejaculation problems, against 1 in 5 with numbness from other causes. The team suggests this could help doctors spot PSSD. With nine patients, that needs checking in a bigger group.

Does numbness mean my nerves are damaged? Not necessarily. In the London study, the main nerve pathways tested normal in almost everyone with PSSD. Depression doesn’t numb the genitals, two researchers write. Nobody yet knows exactly what causes it.

Were women included? Barely. One of the nine London patients was a woman, and the San Diego study included only men. Women’s genital feeling in PSSD hasn’t been measured in any study we could find. PSSD in women covers what women describe.

Benjamin has lived with PSSD for 14 years. If your genital feeling has changed too, write down what changed and when, and report it. Every report about PSSD adds to the record.

Sources

1. Valnarov-Boulter I, Noronha A, Malladi P, Simeoni S, Wright S, Panicker J. Genital sensory loss in persistent sexual dysfunction following SSRI exposure. International Continence Society 2026, abstract 302, short oral session 32, 9 October 2026, presented by Jalesh Panicker. Continence 19S (2026) 102779, doi 10.1016/j.cont.2026.102779. University College London Medical School, and the Department of Uro-Neurology, National Hospital for Neurology and Neurosurgery, Queen Square, and UCL Queen Square Institute of Neurology. Cross-sectional study of consecutive patients referred to a tertiary unit for genital sensory impairment, May 2019 to May 2024. 9 of 55 met the 2022 PSSD criteria (mean age 35, range 20 to 47, eight men). All nine abnormal on examination with von Frey hairs (touch) or Neurotip (pinprick); loss most marked over the glans and distal and mid-shaft, symmetrical, more on the ventral than the dorsal surface. No significant difference from non-PSSD patients in Neurotip (55.5% vs 56.5%, p=1.00) or von Frey (66.6% vs 43.5%, p=0.281) abnormality. Ejaculatory dysfunction 75% vs 20% (p=0.0055; the abstract gives percentages, not counts); sexual dysfunction 100% vs 65.2% (p=0.046). Pelvic neurophysiology (tibial, S2 and S3 dermatomal and pudendal somatosensory evoked potentials) normal in 8 of 9. The authors interpret this as a central disturbance of erogenous sensation processing rather than peripheral nerve damage, and suggest sustained serotonergic activity may dysregulate dopaminergic reward pathways; this is their hypothesis. Conference abstract, not a full peer-reviewed paper. Funding: none.
2. Goldstein A, Goldstein S, Drian A, Bajwa A, Kim N, Goldstein I. Sexual symptoms and biologic pathophysiologies of post-SSRI sexual dysfunction: a 15 year review. J Sex Med 2025;22(Suppl 4): abstract 313, doi 10.1093/jsxmed/qdaf320.309, published online 9 December 2025. San Diego Sexual Medicine. Retrospective chart review, 2009 to 2024: 43 men, mean age 27.6 (16 to 43). Quantitative sensory testing of vibration, heat and cold perception abnormal in 89% (n=37, as the abstract gives it; no separate figure per test); reduced genital sensation reported by 92% (n=39). The authors’ proposed mechanisms are hypotheses. Read as the abstract only (the full text is a subscriber PDF). Comparison groups were older men with vascular erection problems and men with erection problems after penile or perineal trauma; no healthy or symptom-free SSRI-exposed controls. Conference abstract, not a full peer-reviewed paper.
3. Cipralex (escitalopram) patient information leaflet, electronic medicines compendium (UK): sexual problems have, in some cases, “continued after stopping treatment”.
4. Healy D, Bahrick A, Bak M and colleagues. Diagnostic criteria for enduring sexual dysfunction after treatment with antidepressants, finasteride and isotretinoin. Int J Risk Saf Med 2022;33(1):65-76. Necessary criterion: “an enduring change in somatic (tactile) or erogenous (sexual) genital sensation after treatment stops”. “If available, quantitative sensory testing (QST) of the penis (vibration, warm and cold temperatures)” may help assess somatic sensation. “Erogenous sensation is poorly understood and there are no available tests.” Section 3: ancillary non-sexual symptoms “may include” “emotional numbing”, “other sensory problems involving skin, smell, taste or vision” and “cognitive impairment”.
5. Healy D, Mangin D. Post-SSRI sexual dysfunction: barriers to quantifying incidence and prevalence. Epidemiol Psychiatr Sci 2024;33:e40. Quantitative sensory testing of the genitals “may be helpful in elucidating tactile insensitivity” but “is not widely available”. “no mental health disorder causes anaesthesia of the genitals”.
6. Moral Medicine, Benjamin’s 14-Year Battle with PSSD, interview with Benjamin, July 2024 (30 minutes), embedded here as an extract from 5:35 to 7:50 (the same extract as on Genital numbness: could a medicine be why?). The details in this article (Cymbalta, 14 years, finding medical validation) are from Moral Medicine’s description of the film and from his story on our site: Benjamin’s 14-Year Battle with PSSD.
7. SIDEfxHUB, Interview with Dr. Kenneth Peters, PFS / PAS / PSSD Summit 2026, April 2026 (15 minutes), embedded here as an extract from 2:56 to 5:06. Dr Peters is chair of urology at Corewell Health William Beaumont University Hospital, Michigan. Paraphrased, not quoted: four young patients, men and women, within less than two weeks, with almost identical complaints including numbness; one after finasteride, one with PSSD, two after isotretinoin. The interview on our site: Dr. Kenneth Peters on the First PFS/PSSD/PAS Summit.