A tilt down of 1 degree might help. But you may just be someone that needs a cutout. Somewhere on the board is a cutout test (sit on a hard surface, lean forward like you're biking and if you have soft tissue contact with the surface, you probably need a cutout or depression).

I actually have had my Brooks B68 "chopped and channeled" by Selle Anatomica. My sitbones were happy, but the sensitive parts were very unhappy. Selle Anatomica cut a slot into the saddle and reinforced the leather. It was hard to send that pretty saddle away to be mutilated (eeks, what if it didn't work?!?!?!), but, for me, it was the right thing to do.