Over one year ago i had gone through a very tough and stressful time that was brought about because of a cancer scare, and not having health insurance. During this time i had gone into a deep depression/stress and anxiety which started to bring on serious physical symptoms, impacting my sexual function greatly. I had begun to feel very low in energy, brain fog, lack of libido,weak erections,lack of morning erections,watery semen,testicle pains along with gradual shrinkage of my testicles,loss of muscles and strength,back pains. After it was revealed that i did not have cancer, my symptoms persisted, getting even worse! After sometime i finally relocated and got health insurance through my job, and was finally able to see a doctor and get some blood tests done, testing my testosterone. The Doctor that i had seen put me on an anti-depressant called Cymbalta which i took for about a month until i could not take it anymore. It made all of my symptoms much much worse. I had gotten a girlfriend at that same time and start to become sexual active again, but while i was on the medication,it prevented me from orgasming. I had only taken the medication for a month before stopping cold turkey(which may have been a big no no from my part), but ever since then my sexual function had gotten worse, but i have made some improvements. It has not been one year since i have been off them but i still have symptoms that i cannot shake. I am very aware of sexual exhaustion, which i do not believe i have because i never over masturbated, but i seem to share all the symptoms of it. Whenever i orgasms, i get very very tired and irritated feeling, my eyes feel like they are buring, and my knees feel weak and sore. After researching on the web i feel as those i am suffering from Low Dopamine, and have no idea how to fix myself, hoping i am not permanently damaged, my testicles have decreased in size during all of this and that worries me a lot. I have no been very successful abstaining from sexual activity, but feel an improvement whenever i had tried. I am looking for advice in what i should do to help myself, and i am hoping that there is a chance i can feel normal again. I had tried exercising which helps a little bit but not much. I take a multivitamin daily, along with ginkgo biloba, vitamind D, and every night before bed i take zinc,magnesium, and vitamin B6. On my most recent bloodwork i had done it show that my prolactin was at 16.2ng/ml (range 3.7-17.90), and that was after i had abstained from ejaculation for over a week! These are the full results from that test.

Test Result Reference Range
Testosterone, Total 684 mg/dl 250-1100
SHBG 40 nmol/l 7-49
Testosterone Bioavailable 177.4 mg/dl 110.0-575.0
Albumin, Serum 4.8 g/dl 3.6-5.1
Testosterone, Free 81.1 pg/ml 46.0-224.0
AM Cortisol 17.1 mcg/dl 5.0-22.0
T4 Free 0.94 ng/dl 0.76-1.76
TSH 1.74 uIU/ml 0.350-5.500
Prolactin 16.2 ng/ml 3.7-17.90
Any help or advice would be greatly appreciated, I am lost!

I’m sorry to hear of you problems, especially that they persisted so long, since they could have been addressed properly much earlier.

Most of cases of sexual exhaustion as a result of of excessive sexual activities, however, sexual exhaustion can be a result of anything that may affect certain neurotransmitters, hormones, and bodily reactions.
The stressful times you’ve gone through increased stress and inflammatory response and gradually altered nervous modulation on inflammatory response (highly dependent on proper serotonin, GABA, dopamine, and acetylcholine levels), which resulted in a vicious cycle for excessive epinephrine, norepinephrine, cortisol, histamine, glutamate, and prostaglandin E2. The cycle of inflammation is usually self supporting through:

-Lowered acetylcholine, serotonin, dopamine, and GABA levels which will eventually lead to internal stress and inflammation response.
-Adrenal gland adjustments to chronically create more stress and inflammatory hormones, such as cortisol and epinephrine, and lowered DHEA.
-Artery constriction for less blood flow and thus increased local inflammation.
-The increased levels of cortisol, prostaglandin E2, norepinephrine, epinephrine, and especially prolactin will negatively affect the levels of GnRH, LH and FSH, and together with the arterial inflammation and constriction will burden testicular function as well as hypothalamic-pituitary-adrenal-testicular axis’ proper functioning. Less androgens to modulate inflammatory response, testicular tissue health, insulin resistance, energy levels, tissue and testicular health, proper nts. and hormonal conversions, and neurotransmitter homeostasis will result in even greater cycles of inflammation to suppress them even further through low dopamine levels and chronically high prolactin. The overactive sexual activities will slowly drain the organism of its potential for rejuvenation.

The antidepressant drugs are usually prescribed in similar situations (carrying serious health risks) addressing just some of the symptoms and completely neglecting the root of the problem. It is a good thing you discontinued the usage of the drug.

The blood work presented is indicative of heightened inflammatory response. Usually, one of both manifestations and causes, as you suspected, is weak dopaminergic functioning.

The irritation, weak and stiff joints, as well as eye irritations are mainly a result of excessive sympathethic epinephrine response, as well as inflammatory prostaglandin E2 and cortisol.

One must transform the neuroplasticity to a positive one. The inter neuronal connections have been developed and ordered to process information in a specific manner. You may experience severe difficulties in rewriting their work to induce proper (by what you consider a proper response) responses in certain situations.
Every problem must be addressed simultaneously to avoid negative feedback mechanisms. That is why just a random set of supplements may prove to be ineffective.

For the specific case, a combination of Alpha-Amino, Multi-Alpha, Zeolite-DA, Alpha-AGH, 5HTP-Nettle, and Ultra-Purified-FishOil will better nervous and endocrine functioning, detoxify the liver and restore its P450 system functioning, restore proper acetylcholine, serotonin, dopamine, and GABA levels, better hypothalamic-pituitary-adrenal-testicular functioning, increase androgens, lower inflammatory response and prolactin levels, jump start the CNS, increase prostaglandin E1 E3 and Nitric Oxide, alter numerous gene expressions, and finally rewrite the negative neuroplasticity developed.

Testicle cooling to additionally increase androgens is to be considered as well.

Light exercise, negative ion exposure, massages, positive attitude, sexual abstinence for 2 to 4 weeks, and proper diet may also aid the recovery process.

Glad if I could help!