Dihydrotestosterone (DHT) and its role in sexual health

[chrisis]

I'm trying to get to the root cause of some sexual side effects as a direct consequence of taking finasteride for 2 months and quitting 3 months ago.

So far I've discovered that dihydrotestosterone plays a key role in sexual development, but is also integral to male health into adult life.

According to the following study, "differences in concentrations of circulating dihydrotestosterone within the normal range may represent a major predictor of sexual activity in healthy young men

http://www.bmj.com/content/310/6990/1289

If it is true that by blocking 5-alpha reductase, finasteride blocks the conversion of testosterone into DHT, then surely we have identified the cause of sexual side effects. It's because, as the study concludes, difference in concentrations of DHT appear to predict sexual activity in healthy young men. Doesn't this mean that to overcome sexual side effects, we must simply address the levels of DHT? Or is something else going on?

Is it possible to ask a doctor to measure DHT when getting hormone levels checked? And then is it possible to increase levels of DHT?

[bob13]

wasn't there a huge thread with this already?
Why start another one?

Chris you ought to go to medical school.

[chrisis]

Awesome feedback as ever bob.

[bob13]

Awesome feedback as ever bob.

I guess that means Im right.

[chrisis]

My question evolved from another discussion, yes. But I wanted to ask it directly.

I'm confused a bit here: is there some sort of limit on how many posts we can post in a day?

Is there a rule about which topics are appropriate?

Are there members here in an appointed position to dictate which topics are suitable and which aren't?

I'd really prefer to stick to the topic at hand. In future please don't get involved in my topics unless you have something constructive to say. This is just another useless distraction from substantial issues I'm concerned about.

[CurlyBird]

Results: Serum dihydrotestosterone concentration was the only independent hormonal predictor of the frequency of orgasms; an increase in concentration of 1.36 nmol/l (about 2 SD) corresponded to an average increase of one orgasm a week.

Two standard deviations = +1 orgasm per week. Two standard deviations on either side of the mean includes something like 96% of all people. I don't count my weekly orgasms but +/- 1 doesn't bother me.

[SoothSayer]

If you are interested in hypothesizing about the causes of the persistent sexual side effects from taking finasteride, I suggest you visit other forums that are more responsive to this type of thing. Many of the guys on this forum taking finasteride are doing so without facing any problems and it greatly upsets their sense of security to consider this unfortunate outcome.

Additionally, the majority of these guys are not really educated on the physiology of taking finasteride or the endocrine system. Even those that are really do not have a clear understanding of the mechanism of action involved in how finasteride causes side effects since little of it is truly disclosed in Merck's safety literature. There are medical professionals and scientists that have been studying this issue for probably half a decade, with increasing focus designated to the problem every year, but the rate at which they are deriving insights is progressing slowly.

I suggest you get a work-up from a proper doctor (endocrinologist/urologist) ASAP in hope that your problem stems from an issue other than your finasteride use and may be something that is treatable. Otherwise, you will struggle to find answers or even open-minded people on forums like "the Bald Truth".

[bob13]

Well said best answer Ive seen in these forums.

[the_charger]

yes Soothsayer thank you for your post. as you maybe saw, chrisis and I were debating the role of DHT in adult men and its impact on normal sexual functioning.

If you are interested in hypothesizing about the causes of the persistent sexual side effects from taking finasteride, I suggest you visit other forums that are more responsive to this type of thing. Many of the guys on this forum taking finasteride are doing so without facing any problems and it greatly upsets their sense of security to consider this unfortunate outcome.

I think I know what forum you are referring to. from what I can see, there isnt much talk there that DHT is responsible for sexual issues. this is especially the case because after guys quit finasteride, it looks like their hormones come back to normal, but still have sexual problems. im curious what is your take on the role DHT has in adult sexuality? from what I have seen, its testosterone that seems to be key in erections and libido. but even then, most of the theories are that the persistent problems dont have much to do with hormones at all, and more to do with other chemicals like neurosteroids?

[SoothSayer]

yes Soothsayer thank you for your post. as you maybe saw, chrisis and I were debating the role of DHT in adult men and its impact on normal sexual functioning.



I think I know what forum you are referring to. from what I can see, there isnt much talk there that DHT is responsible for sexual issues. this is especially the case because after guys quit finasteride, it looks like their hormones come back to normal, but still have sexual problems. im curious what is your take on the role DHT has in adult sexuality? from what I have seen, its testosterone that seems to be key in erections and libido. but even then, most of the theories are that the persistent problems dont have much to do with hormones at all, and more to do with other chemicals like neurosteroids?

Many of the men who face persistent side effects after quitting Propecia/Proscar do actually show abnormal hormone levels. However, it is not a requirement to have a hormone profile taken before patients start treatment with finasteride so it isn't possible to compare before/after snapshots but it does seem that they commonly have very low levels of DHT and sometimes free testosterone relative to their healthy male cohorts.

There are other forums other than PropeciaHelp which are more interested in exploring these issues, but TBT is not one of them. I think it is valuable for him to report his study, but it makes sense to be diplomatic in doing so. As I mentioned, men who are on the drug become very defensive when pushed on the subject and it may drive stubborn individuals to engage riskier decisions than they would have otherwise. It is unfortunate, but people don't always make the most rational choices when it comes to potentially emotional issues like hairloss.

I do think that DHT does play a role in adult human sexuality. It is a more potent androgen that testosterone and found in many sexual male organs such as the prostate, epididymis, and seminal vesicles. DHT has been a neglected hormone and it usually coexists at similar levels to T in men so it is difficult to separate out the function of T and DHT.

Nobody currently knows why Propecia causes persisting side effects in a minority of men but there are so many case reports detailing the same symptoms that it is very unlikely to be explained by random chance.

People have theorized that Propecia persistently alters neurosteroids, which are crucial hormones for cognitive functioning but they are difficult to measure. They have also speculated that introduction of the drug has silenced genes that code for the androgen receptor which prevents existing androgens from working in the bottom. Starving the body of DHT could lead to some specific tissue/nerve damage. All of these explanations are very possible we really need more studies to test each scenario to determine which one explains the connection and offer potential treatments if they even exist. It is even possible that a combination of some or all of these are true. However, medical research is extremely expensive and time consuming and those who have demonstrated these symptoms have largely been orphaned by the medical community due to the confusing nature of their problem, their small population size, and hesitation to offend the pharmaceutical industry which often directly or indirectly plays a role in medical research.