Therapist for PSSD, PFS or PAS: how to find one

A therapist can’t reverse post-SSRI sexual dysfunction (PSSD), post-finasteride syndrome (PFS) or post-Accutane syndrome (PAS), where a medicine’s side effects can last after stopping. One who accepts that your symptoms began with a medicine can help with what they do to your life.

These conditions are more than sexual problems. The checklist doctors and researchers proposed in 2022 puts a lasting change in genital sensation at the heart of PSSD. It adds emotional numbing and problems with concentration and memory. For PFS and PAS, it lists depression and suicidal thoughts, which can happen even without sexual changes. If you have thoughts of suicide, call Samaritans free on 116 123, day or night.

That’s a lot to carry, and it can change how you see yourself. You might worry that seeing a therapist means agreeing it’s all in your head. It doesn’t. The same checklist says a current mental health diagnosis doesn’t rule these conditions out.

Katie was prescribed fluoxetine (Prozac) at 21. When her problems carried on after she stopped, doctors put them down to low self-esteem, trauma and depression, she says. Here she explains why that didn’t fit.

Play video: Katie on being told it was psychological (extract)

“I remember what it’s like to have sexual feelings and desires,” she says, “but I can’t actually access these functions anymore.”

What can a therapist help with?

A therapist can help with how you live with it: low mood, anxiety, grief and the strain on relationships. They can’t treat the condition, diagnose it or change your prescription. In October 2026 we found no study that had tested talking therapy for PSSD, PFS or PAS.

What we have is therapists’ experience. Amanda Hall, a sex and relationship therapist, wrote about PSSD in May 2025 for the College of Sexual and Relationship Therapists (COSRT), a UK body for sex therapists. She suggests helping people grieve what they’ve lost, as therapists do for people who lose sexual function through illness, such as cancer.

In England, the NHS says you can refer yourself to NHS talking therapies for “coping with a long-term health condition”.

Will a therapist think it’s all in my head?

Some might, because not every therapist has heard of these conditions. Amanda Hall hadn’t:

“I was unaware of PSSD until a client came into my therapy room with an article that resonated with their experience.”

She tried to learn fast but couldn’t keep supporting that client. She writes that people with PSSD find it distressing to have to “educate, and even convince” the professionals around them. Her advice to other therapists: believe the client. In sex therapy, she adds, therapists should stress that the difficulties “are not psychological”.

She has since learnt more, partly in a group of therapists from the UK, Canada and the US who talk through how they support people with PSSD. Yassie Pirani, a therapist for people with PSSD and PFS, is its contact.

In a Moral Medicine interview, she told people who are struggling that what they feel is real, and that it isn’t their fault or a sign of weakness.

How do I find a therapist in the UK?

Start with the route that fits your budget and where you live.

• NHS, England only: refer yourself to NHS talking therapies without seeing a GP. You need to be 18 or over (16 in some areas) and registered with a GP.
• Scotland, Wales or Northern Ireland: ask your GP what’s available near you.
• Other free options: some employers, universities and local charities offer counselling.
• Private counselling: the British Association for Counselling and Psychotherapy (BACP) has a therapist directory that lists only members on its register. More than half of its listings charge £40 to £60 a session.
• Sex therapy: it’s talking only, with no touch and no examination. Some NHS sexual health clinics offer it. Ask your GP about a referral, as our page on who to see about PSSD explains. The COSRT therapist search lists members on its register.

Anyone can call themselves a counsellor, BACP warns. The NHS says a private counsellor should be on a register that the Professional Standards Authority has checked and accredited, such as BACP’s. For sex therapists, it names COSRT and the Institute of Psychosexual Medicine.

Before you book, ask:

If the first one doesn’t feel right, keep looking. BACP says your relationship with your therapist is usually what matters most in whether therapy works.

What can I do?

These medicines help many people. If you have side effects, that’s a decision for you and your prescriber. If you take an antidepressant, don’t stop suddenly. Amanda Hall tells therapists the same: unless they prescribe, it isn’t their role to say whether you should take a medicine.

Talking to people who have it is different from therapy. Elliot took Roaccutane at 17. Years later he told Moral Medicine he’d “never be able to communicate” how it had changed him. What he wanted was “a friend who’s going through this”.

Play video: Elliot on feeling alone with PAS (extract)

People with all three conditions talk in our WhatsApp groups, and our guides to PFS support groups and PAS support list other places.

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) for an antidepressant, or Post 5-alpha-reductase inhibitor syndrome (MedDRA 10082430) for finasteride or dutasteride. PAS has no term yet, so write that the symptoms continued after stopping isotretinoin.

Our reporting guide walks you through it

What else do people ask?

Can therapy help if I feel emotionally numb? We found no study. Katie was in therapy while she took fluoxetine. She says she couldn’t “process my issues in therapy properly” because the medicine had dulled her emotions. If feelings are hard to reach, tell your therapist in the first session.

Should my partner come too? They can. Amanda Hall writes that relationship counselling may help a couple understand the condition and grieve together. Our page on relationships after PSSD may help you both.

Do I need a diagnosis first? No. In England, the NHS says you don’t need a diagnosed mental health condition to refer yourself to talking therapies. You don’t need a diagnosis to report your symptoms either.

Amanda Hall learnt about PSSD because one client brought an article into the room. You can do the same: send your therapist our page on PSSD, PFS or PAS before you meet.

Sources

1. 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 agreed by expert consensus. Section 3, PSSD: “An enduring change in somatic (tactile) or erogenous (sexual) genital sensation after treatment stops”. Its non-sexual symptoms include “emotional numbing” and “cognitive impairment”. Section 5: finasteride effects that “can occur independently of any sexual difficulties” include cognitive impairment, depression and suicidality. Section 6 lists the same for isotretinoin. Section 9: “A current diagnosis of a mental health disorder does not prevent a diagnosis of these enduring conditions”. Read 28 October 2026.
2. Propecia 1 mg film-coated tablets, patient leaflet, Electronic Medicines Compendium (EMC 2194), last revised May 2026. Section 2: “Impaired sexual function that may contribute to mood alterations, including suicidal thoughts, has been reported in some patients”. Section 4 lists sexual problems that persist “after discontinuation of treatment”. Read 28 October 2026.
3. Lustral (sertraline), patient leaflet, EMC 2835, last revised December 2025: “In some cases, these symptoms have continued after stopping treatment”. Roaccutane, patient leaflet, EMC 100633, last revised April 2026: sexual symptoms “have continued despite stopping treatment with isotretinoin”. Both read 28 October 2026.
4. Amanda Hall, AccCOSRT, Post SSRI Sexual Dysfunction (PSSD), College of Sexual and Relationship Therapists news, 22 May 2025, read 28 October 2026. Written for therapists; the views are the author’s. “I was unaware of PSSD until a client came into my therapy room with an article that resonated with their experience”, and “I tried to learn fast, but ultimately I was not able to offer ongoing support for that client”. She has since joined “a clinical supervision group for therapists supporting PSSD patients with members located in the UK, Canada, and the US”. People with PSSD find it distressing “to educate, and even convince” professionals. Therapists should be “validating their experience and believing their perspective”. Support like that “after a loss of sexual function for medical reasons (e.g. cancer) may be helpful”. In psychosexual therapy, therapists should stress that “difficulties are not psychological”. Relationship counselling may help couples “grieve together”. Therapists who cannot prescribe should not tell clients whether to take medication. Yassie Pirani is the contact for a clinical supervision group for therapists.
5. NHS, Find NHS talking therapies for anxiety and depression, last reviewed 14 February 2025: for people who “live in England”, aged 18 or over (16 or 17 in some areas). “You do not need to have a diagnosed mental health condition”. NHS, Talking therapies, last reviewed 5 November 2025: self-referral covers “coping with a long-term health condition”. You need to be registered with a GP. Therapy is sometimes free “through your employer, university or local charities”. Both read 28 October 2026.
6. NHS, Counselling, last reviewed 9 October 2025: check a private counsellor is “on a register accredited by the Professional Standards Authority, such as the British Association of Counselling and Psychotherapy (BACP)”. NHS, Erection problems, last reviewed 28 July 2023: sex therapists should be members of COSRT or the Institute of Psychosexual Medicine. Both read 28 October 2026.
7. British Association for Counselling and Psychotherapy, How to find a therapist and How to get therapy, read 28 October 2026. “Only registered or accredited BACP members can advertise on our directory”. “Anyone can call themselves a counsellor and set up in private practice”. “More than half of the therapist listings on our directory advertise costs of between £40 to £60 per session”. For NHS options, your GP “will know what is available locally”. “Your relationship with your therapist is usually the most important factor in the success of your therapy”. The BACP Register is accredited by the Professional Standards Authority.
8. College of Sexual and Relationship Therapists, Find a Therapist: “All profiles are for Registered COSRT Members”. Registers: these therapies “do not involve physical touch and do not entail any medical procedures or examinations”. Both read 28 October 2026.
9. PubMed search, 28 October 2026: psychotherapy, cognitive behavioural therapy, counselling, psychological intervention or sex therapy, with PSSD, post-finasteride syndrome or post-Accutane syndrome: 6, 3 and 1 results. None tested a therapy for any of the three.
10. Moral Medicine, I Lost My Sexual Identity After Prozac, interview with Katie, May 2026. Embedded as an extract from 4:40 to 6:21. Doctors’ explanations at 4:50; “I remember what it’s like…” at 6:04; therapy at 3:14 to 3:23. Quotes from YouTube’s automatic captions. Her story on our site: Katie’s story.
11. Moral Medicine, He Took Accutane at 17. His Life Never Returned to Normal., interview with Elliot, 28 January 2025. Embedded as an extract from 1:24:00 to 1:26:23. “never be able to communicate” at 1:24:17; “you want a friend who’s going through this” at 1:25:15. Quotes from YouTube’s automatic captions.
12. Moral Medicine, interview with Yassie Pirani, YouTube, 28 July 2025, 52 minutes. Her work with people with PSSD and PFS at 1:26 to 1:57; her words to people who are struggling near the end (50:20 to 52:12), paraphrased here. Cited without a link and not embedded. Picture: Moral Medicine.

Sources checked on 28 October 2026. AI-assisted writing and review, not clinical review.