Thank you for sharing the details of your problem. Fluvoxamine
is probably helping you by suppressing the obsessive nature of the thoughts. But the fact is that you may still need to work on your thoughts.
The best addition you can make to the current treatment regime is that of Psychotherapy
. Cognitive Therapy
is immense potential in treating Body Dysmorphic Disorder
. The disorder is eventually nothing but your thoughts about self. And there are probably a lot of irrational beliefs hidden under the surface thoughts of "looking feminine". Going in for Psychotherapy can help you explore those core beliefs and thoughts, modify them so that they do not create the emotional disturbances, and lead a much happier life. It might take care of the other problems such as the ED.
Hope this helps.
Abhijeet Deshmukh, MD