I thought that I'd bring this discussion over to the Surgical forum. I've been living chemically castrated now since at least early 2007. Prior to that I've lived with a very low T count since around Spring 2005. The reason for me being chemically castrated is due to the psychiatric meds that I've been taking since 2005 for Bi-polar (Manic-Depressive) disorder, depression, & OCD (Obsessive-Compulsive disorder). Since that time I've been taking SSRI's (Selective Serotonin Reuptake Inhibitors) to treat my OCD & depression.

The SSRI's have worked wonders in treating my problems however one of the very well documented side effects of SSRI's is that they block T production in men. The higher the dose the more effective SSRI's are at blocking T production. I should add here that YMMV and apparently I've received outstanding mileage from my SSRI's in blocking my T production. I guess I should FYI here that when I had my T tested about 4 months ago it was well under 100. I had it checked again this past Thursday and I should know the results Monday. When I get the results I'll pass them on here.

Getting on to why I moved my conversation to the surgical forum. It was suggested to me that I might consider transitioning to surgical castration rather than keep fighting the battle that's raging inside of me right now. The poster who is a surgical eunuch thought that I would have much less trouble with my sexual desires, thoughts, and dreams that are really bothering me if I went the surgical route.

I posted back that the thought has crossed my mind on occasion. If I decided to go that route some very decisive things would have to happen.

1: I would have to have the blessings of at least one or two of my docs such as my endocrinologist and my psychiatrist.

2: Somehow my insurance (I have both private through my wife's job & Medicare) would have to buy off on it because there is no way I can pay cash.

3: I'd want my wife to be in full agreement. This one would probably be the easy one.

Just curious... Has anyone been down this road before? I'm really interested in finding out if anyone has convinced their private insurance OR Medicare to finance the surgery. Without there being an underlying confirmed medical reason such as the possibility of cancer or other medically reason to have a bi-lateral orch done.

Thanks!

It may depend on the SSRI, but most modern ones don't lower testosterone (at least not to castrate levels). They do lower libido, but they do it by changing your obsessive tendencies (which horniess is closely related to). In fact they reduce your drive to make any sort of indulgent decisions (like overeating, drug addiction, cigarettes, alcoholism, etc.)

To be "chemically castrated" you have to either stop the production of testosterone, or you have to block the action of testosterone. SSRIs don't do either. The only thing they possibly do is affect the rate of testosterone metabolism in the liver. But SSRIs like Celexa (my preference) don't affect that pathway either.

I suspect if you did get a med-induced lowered test, it was due to something like the tri-cyclic type of antidepressants or various anti-psychotics that tough cases of depression are sometimes prescribed.

Also, keep in mind that coorelation doesn't mean causation -- just because you started a med and then your testosterone went down doesn't mean that the med caused it.

By the way, I do think SSRI is a very good choice for some people with castration fetish, especially those who don't have any gender dysphoria because it helps control the general obsession as well as the libido-related urges specifically