Sexual Dysfunction following MDMA
I may be able to help with this one, guys.
I was a 'moderate user', but I still got fucked up bad. I was taking 3 tabs two weekends in a row that got me. I've only done 30 tabs lifetime, all in the last two years.
Now I am four months post roll, and like you, wondering if I will ever be the same. I have read quite a bit of research, and spent a LOT of time analyzing my own symptoms.
Based on what I have read, the seretonin network exists for one primary purpose, digestion. Intestinal motility. Had any issues there? Lots of us do. I know I have. If I eat the wrong things, I feel like the shit takes way too long to move through me. In the beginning, I thought my intestines and liver were going to fucking burst. At the same time, I could feel swelling around my brain. You could say I was an acute case.
Sure, seretonin does lots of other things in the body....like immune system response, mood, sleep cycles, and yes, sexual appetite. But you have to understand that 95% of your seretonin is in your intestines, and exists primarily to cause muscle contractions there. By the way, the body makes seretonin out of the same ingredient that bile is made from, tryptophan. Think about that...the body makes extremely acidic digestive juice AND involuntary muscle stimulating neurotransmitter from the same thing!
How does the body do this? Your brain.
Imagine a dense network of nerve fibers surrounding your gut, traveling up your spinal cord, and connected to every region of your brain. The gut actually injects seretonin into the brain tissue via a network of impossibly dense connections. How the brain responds to this network is the subject of great amounts of study.
That means no one knows exactly what we are doing when we take this wonderful drug. But they are figuring out a few things. Just remember, your digestion and your ejaculation are both controlled by smooth involuntary muscle, which require seretonin for some reason.
I want to focus on your frontal lobes, the part of your brain right behind your eyes. Despite being farther away from the brainstem than any other brain region, it has a lot of connections running between the two. The seretonin cells are quite long and tree like, more so than other cell types.
According to research, these distant connections in the frontal lobes have two factors running against them here. First, they are the most likely connections to be damaged from neurotoxic doses of MDMA. They are the first to go. Second, they are also the least likely to show signs of recovery during future investigation. Yes, some recovery does occur, but not complete. In one study, they found that the recovery seen in this area has a gradient to it, which shows more intensive recovery near the rear of the frontal lobes, with less occurring as you move towards the face. Still with me?
The frontal lobes are responsible for most of our higher thinking capabilities. In humans, the pre-frontal cortex is responsible for our higher intelligence compared to other animals, like language. It is ironic, that the same region of the brain responsible for real thought, is also involved in the perception of sexual desire and physical pleasure. People that have damage to specifically the dorsolateral prefrontal cortex are shown to have reduced sex drives. You don't even have to fuck up the entire frontal lobe, just this one part of it.
Want some good news? In research, former heavy MDMA users describe their 'depression' as lasting up to a year, maybe two. There are extreme cases that go longer, but most fall into this timeline. I would assume that their sexual functions have returned to normal if they are no longer depressed, but 'ejaculatory anehdonia' is not included in the abstracts I have read. That, by the way, is the term for not feeling your orgasm. And yes, in post SSRI patients, it can last months, years, and sometimes forever. This is also reported in former meth users, by the way.
So you have burned these pathways, kids. It really sucks, doesn't it? It does for me.
Want some more reassurance?
Go back and look at Dr. Riccaurte's famous study showing complete devastation of the frontal cortex in the primate. Seven years later, the recovery is far from complete. But consider how much he gave these monkeys. Go back and look again, from absolute devastation, I see some valuable recovery. For me, this study is both evidence of potent nerotoxicity, AND evidence of eventual partial recovery.
Given enough time (years), you will start to feel normal again. Will you ever have the same sensation in your cock? Maybe not. But I'm willing to bet it gets better with time.
From my personal experience, piracetam makes a huge difference. The first thing it does is smooth out my digestive process. Without the medication I feel a lump all the time. When I take it, the lump goes away, and my shit is much darker....evidence of increased bile production. It also brings positive emotions to my mind, sometimes quite powerful. Then, after the rest has occurred, I feel increased tactile sensation all over my body. My testicles get tingly, and my dick feels more natural. I also respond to visual arousal quite a bit more.
When I have sex, the orgasms are showing improvement month by month. At first, I felt almost nothing during climax. Now, it is enough to make me happy. No, it is far from the intense pleasure I am used to, but I am going to be patient. When I discontinue the piracetam, things are much worse.
Another suggestion....don't stop jerking off! Remember, the brain is trying to re-establish the innervation you so carelessly abused. I bet you didn't want to eat anything for a while, right? Did you just stop eating? No. In fact, by eating, I can feel my intestines are driving the entire process of re-wiring. Remember, the intestines inject the seretonin back into the brain. It is your gut that is in control, not your brain. So I strongly suggest that you masturbate, or have sex, as often as you can manage.
Yes, I have had awkward, anesthetized sex with my wife, that ends with a blunted and disappointing orgasm. I have discovered, however, that the next day is better for me. In fact, when we have sex 5 days a week, it gets better each day! One factor may be the length of time spent. If I delay my orgasm as long as possible, especially if I am jerkin off after she is worn out, I have been shocked at how good it felt. Almost like normal, guys.
So work at it. Make it last as long as possible. Then try again the next day. If your brain is re-wiring itself, it makes sense that you want to continually re-activate that prefrontal cortex as often as possible. That's what brain injury rehabilitation experts force their patients to do! You have to force your body to do what your brain cannot! Eventually, you may guide the brain to heal the regions that are being used the most. For me, that means vocabulary lists and lots of orgasms, good and bad.
By the way, I need very little piracetam to have an effect. I take less than 500 mg most days. Taking it several days in a row seems to open the sexual floodgates for me. Yes, I have been to the stripclub and been sadly unaroused (with the wife). After a few days of sex and piracetam, it was well worth a return visit! I also find that this medication has exponentially increased my semen volume. Whoah.
Final advice, be flexible with your time. I find that there are windows of opportunity when I can tell my sexual responsiveness is much higher. Often in the morning or early afternoon. If I take piracetam, within an hour or two. I tell my wife, "Right now." Also of importance, try it after you take a shit... Yes, I'm serious. After a good dump, I feel like my prostate is suddenly reconnected to the brain. It makes sense since the prostate runs on the gastric nerve. When your intestines are empty, there is a lot more seretonin to go around down there. Even when I used to roll, I wanted to shit before sex. Once I did, watch out!
If you try all of this and still find yourself sadly bereft of pleasure, please come back and tell all of us. The best research we have on this aspect of it is community responsiveness. Share what you know....God knows I just did.
One last suggestion. There is a belief that the seretonin issue is not the direct cause of the problem here. When seretonin floods the frontal cortex of the brain, they think it also releases dopamine down the mesolimbic reward pathway. This may be what actually makes rolling great. Since your seretonin is sadly lacking in the frontal cortex, there is little dopamine release despite your pounding the pud. We hope that the reinnervation of seretonin will eventually be great enough to reestablish this link in the frontal cortex. But another approach, especially for the long-term people, would be to increase dopamine availability.
No, I am not suggesting to use meth, a much more potent dopamine releaser. Bad idea. I recommend seeing a doctor and considering wellbutrin, an antidepressant shown to help post SSRI patients. It blocks the re-uptake of both dopamine and norepinephrine. Also, check out yohimbine. It has also shown promise in this are, but BE CAREFUL - the overdose doesn't lie far from the therapeutic dose. Use with caution.
There are a couple other anti-depressants that can be used to increase dopamine, but I recommend waiting until you have passed the 2 year mark before fucking around with these too much. We don't understand the re-wiring process well enough to know what the long term effects of these dopamine agents will be. I'm sticking to my fucking piracetam for now.
Good luck, guys.
I hope it gets better for all of us.
Anyone out there that has been where we are and gotten better? Please tell us about it...
vegetables) and eliminating fatty protein sources (red meat too often, pork, dark meat chicken) can help a lot. That all may seem silly and inconsequential, but it can change a lot.