PSSD windows: when symptoms lift, then return
A PSSD window is a short spell when symptoms ease, then come back. We found no study of why. What people describe, and why to write it down.
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A “window” is a short spell when the symptoms of post-SSRI sexual dysfunction (PSSD) lift, then come back. Some people with PSSD talk about them, but we found no study of why they happen or whether they mean recovery.
PSSD can last after you stop an SSRI or SNRI antidepressant, such as sertraline or citalopram. The main sign is a lasting change in how the genitals feel, often numbness. But it’s more than sex. The checklist doctors and researchers proposed in 2022 to recognise it also lists emotional numbing, problems with memory and concentration, and changes in other senses.
A window can feel like the start of getting better, and its end like a fall. Nobody can yet say what one means for you, but you can keep a record of it.
The story in 3 lines
- A Canadian sexual health charity's guide for patients says some people with PSSD have “windows” when symptoms improve, then “crashes”.
- In a 2026 UK study, people with PSSD described windows that came and went, one man many years after his PSSD began.
- We searched the medical research in October 2026 and found no study of why windows happen or what they predict.
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Researchers in a 2026 UK study talked to 10 people with PSSD. One man, who they call Frank, had a window shortly before his interview. For a short time his sexual function got better. Then he crashed again. He told them:
“It’s terrible [losing that window], I actually- because when I got the window, I was crying. I actually started crying with joy because I thought ‘oh, I’m feeling better!’, but it was just a brief window.”
What is a PSSD window?
The Canadian guide describes “windows” as times when symptoms improve, and “crashes” as times when they get worse again. For other people, it adds, symptoms stay steady.
Victoria was a student when she took escitalopram for about two weeks, then trazodone. In the months after she stopped, she had windows and crashes. In one window she saw her friends and felt happy again. Then it passed. She calls PSSD “unpredictable”.
In this one-minute clip she tells it herself, from going home to her family to going back to university. English isn’t her first language, so her main points are written out above.
You can read more in Victoria’s story.
Does a window mean I’m recovering?
Nobody knows. On 28 October 2026 we searched PubMed, the main library of medical research, for studies of PSSD symptoms that come and go. We found none that measured how often windows happen, why, or what follows them.
So a window doesn’t tell you whether you’re getting better or not. Tony, another man in the UK study, had lived with PSSD for 15 years or more and still had brief windows:
“My sexuality occasionally comes back - not completely to how it was before - but partially returns and then it just vanishes again. And it’s like Heaven.”
Not everyone has clear windows. Rosie, president of the PSSD Network, a patient-led group, remembers some symptoms getting a bit better after she stopped and others a bit worse, “like a whack-a-mole thing”. In this short clip she says she never had “massive windows of recovery”.
The PSSD Network says many people do improve over time, though how it goes for each person is “highly individual”. Our article on whether PSSD goes away covers what’s known about recovery.
Why do windows happen, and can I bring one on?
Nobody knows why they happen, and we found no study of what brings one on. The Canadian guide says a window or a crash sometimes follows a change in dose, and sometimes comes with no clear trigger.
The 2022 checklist mentions reports of PSSD lifting for a few days when someone stopped a different medicine. Then it came back. The authors add that this “has failed to lead to any treatment options”.
After a good week, it’s natural to hunt for whatever caused it. The PSSD Network strongly advises against trying medicines or supplements on your own. Its reason: “the potential risk of causing worsening of your existing symptoms”.
Should I write down my windows?
Yes. A dated note turns a window from a memory into a record your GP and a side-effect report can use.
What to write when a window comes
“Started 14 June 2025. Gone by 18 June.”
“Touch felt almost normal. Music moved me again. Desire no different.”
Sleep, an illness, any medicine or supplement, a hard week. Just note it.
“Faded over a day” or “gone overnight, numb again”.
The Canadian guide suggests bringing a symptom log to appointments, because some doctors may not know about PSSD. Our journal guide has a simple daily and weekly template.
Taking it to your GP
You could start with: “Since stopping sertraline in March 2024, touch has felt numb. Twice, feeling came back for a few days. I’ve written down when.”
Bring the leaflet’s own words too. For example, the UK leaflet for Cipralex (escitalopram) says that in some cases sexual problems have “continued after stopping treatment”.
These medicines help many people. If you have side effects, that’s a decision for you and your prescriber. Don’t stop suddenly.
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. Our Yellow Card guide for PSSD shows each step.
- Use the right words. If symptoms continued after stopping, write Post-SSRI sexual dysfunction (MedDRA 10086208). In the description, say how it has changed over time, windows included.
Our reporting guide walks you through it
What else do people ask?
What is a crash in PSSD? In the Canadian guide, a crash is when symptoms get worse again, for example after a window. People also use the word for when symptoms first start, or get much worse, after stopping the medicine. Our guide to the PSSD crash covers that.
Why do I feel worse when a window ends? Losing one can hurt. The researchers who spoke to Frank called his window bittersweet: a reminder of what he’d lost and what he could still have. If it’s hard, tell someone you trust. Our WhatsApp peer support groups are for people who’ve lived it.
Is a window only about sex? No, and neither is PSSD. For Frank and Tony, sexual function improved for a while. Victoria describes windows where she felt “more myself”. The Canadian guide talks about symptoms in general, not only sexual ones. Note whatever lifts, including feelings, concentration and memory.
Frank’s window didn’t last, but a window you write down stays on record. If you have one, note the date and what lifted, and add it to your report.
Sources
- SIECCAN (Sex Information and Education Council of Canada). Post-SSRI Sexual Dysfunction (PSSD): Key Information for Patients, patient guide, PDF dated September 2025. “Symptom patterns”: some people have “windows” when symptoms improve and “crashes” when they get worse again. This “can follow a dose change or happen without a clear trigger”. “Others have steady symptoms.” “Medical care”: bring a symptom log, as some providers may not be familiar with PSSD. A patient guide, not a study.
- Brugi S, Budd B, Mackie C, Fish S. “It’s taken away the most fundamental things about being human”: the lived experience and impact of post-SSRI sexual dysfunction. Int J Qual Stud Health Well-being 2026;21(1):2717470. University of East Anglia. Interviews with 10 people in the UK, recruited through a PSSD patient network; names are pseudonyms; participants gave written consent to publication. Theme “what helps me to cope”: Frank (PSSD under 5 years) and Tony (15 to 19 years since PSSD began) on windows, quoted as published. A small qualitative study: it describes experiences, not how often they happen.
- Our search, 28 October 2026: PubMed, (“post-SSRI sexual dysfunction” OR PSSD) AND (fluctuat* OR window* OR waxing OR intermittent OR “temporary improvement” OR remission*). Two results, neither about PSSD windows; titles of all PSSD records also checked.
- 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. Proposed criteria. Section 3: “An enduring change in somatic (tactile) or erogenous (sexual) genital sensation after treatment stops.” Ancillary non-sexual symptoms “may include” emotional numbing, depersonalization, other sensory problems and “cognitive impairment”. Also in section 3: reports of “a brief improvement in their PSSD linked to stopping another drug where their condition lifts for a few days only to return afterwards”. This “has failed to lead to any treatment options”.
- PSSD Network. Frequently asked questions. Patient-led organisation, not a study. “Many people do improve over time.” “The course of this condition is highly individual.” It advises against self-experimentation “due to the potential risk of causing worsening of your existing symptoms”. The FAQ does not mention windows.
- Lundbeck Limited. Cipralex (escitalopram) patient information leaflet, electronic Medicines Compendium, UK, revised May 2025. Section 2: sexual symptoms “have continued after stopping treatment” in some cases.
- GOV.UK. Report a problem with a medicine or medical device.
- Moral Medicine, She Took Lexapro for 3 Months. Then Everything Changed, interview with Victoria, 10 August 2026. Extract 13:26 to 14:25 (windows and crashes, a window with friends, “unpredictable”); 11:11 to 11:21 (windows where she felt “more myself”). From the YouTube auto-captions. The title is the channel’s; on our story page she took escitalopram for about two weeks, then trazodone.
- Moral Medicine, Interview with PSSD Network President Rosie, 9 July 2024. Extract 10:39 to 10:57. From the YouTube auto-captions.
Sources checked on 28 October 2026. AI-assisted writing and review, not clinical review.
This information does not replace medical advice. Talk to your doctor before you make any decision about your treatment.
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