Finasteride sides - Doctor appointment log & help request

[philippe]

hey chrisis,

i just posted pretty much the same thing--although i was on propecia for over a year and cut down my dosage to .05 mg at the half year mark, i too, am suffering from sides.

i am in the process of tapering off the drug as i've heard going cold turkey could be problematic.

my problems have been lowered libido (pretty much no desire for sex)--it's like i have to remind myself that it's enjoyable.

i can still get an erection but it is pretty lackluster and softer than it used to be and makes sex with my girlfriend difficult. i am writing this because i am curious to know the extent of your sides? can you still get an erection? is it softer, etc, etc?

[UK_]

I heard it that Fin will turn you transgender. Is this true? I hope not.

There's a tipping balance with the endocrine system, on the one hand you have it tipping toward the test > estradiol pathway and on the other you have the test > DHT pathway, tipping in favor of the former will create more feminine characteristics such as breast growth etc, and the latter, male characteristics. In seeking either of the extremes through the use of exogenous substances can lead to some serious unwanted side effects.

Penis sensitivity through androgen deprivation is partially understood when viewing the penile nerve framework of castrated rats:

"Androgens are essential for the expression of normal libido in the male, but their role in the maintenance of the erectile response in humans is controversial. It has been shown previously in the rat that castration induces 1) loss of penile reflexes; and 2) considerable reduction in the erectile response to electric field stimulation (EFS) of the cavernosal nerve."

http://endo.endojournals.org/content/136/4/1495.short"

[UK_]

If you are experience sexual sides there is hope with hormone replacement therapy. It is likely that your androgen receptors at your - you know what - have become under sensitive and will only respond to a high amount of testosterone or DHT.

I think DHT can repair the nerve damage caused by finasteride, testosterone is unable to do so, but DHT can, please read the following article and let me know what you think (btw it is in RAT model).

http://endo.endojournals.org/content/136/4/1495.short

Five-month-old rats were either castrated or left intact. The orchiectomized rats were implanted with SILASTIC brand silicon tubing (Dow Corning) containing testosterone or DHT with or without daily injections of the 5 alpha-reductase inhibitor finasteride. After 7 days, rats were submitted to EFS and the intracavernosal pressure was recorded. Castration reduced the EFS-induced erectile response by 50% in comparison with intact rats and testosterone restored this decrease to normal. When finasteride was given to these testosterone-treated castrate rats, erectile response was not restored. DHT was as effective as testosterone in restoring response to EFS in castrates and this effect was not decreased by finasteride.

When androgens are restored using testosterone it seems to bring the EFS score back to baseline however when finasteride is used it does not work, it can only work in this instance with the direct use of DHT itself, probably because the test is being programmed by the estrogen dominated endocrine system to favor the conversion of test to estradiol and reject DHT. The only problem here is how long do the benefits last, are they permanent?

[nikemata]

There's a tipping balance with the endocrine system, on the one hand you have it tipping toward the test > estradiol pathway and on the other you have the test > DHT pathway, tipping in favor of the former will create more feminine characteristics such as breast growth etc, and the latter, male characteristics. In seeking either of the extremes through the use of exogenous substances can lead to some serious unwanted side effects.

Penis sensitivity through androgen deprivation is partially understood when viewing the penile nerve framework of castrated rats:

Where does Fin go?

[UK_]

Where does Fin go?

Finasteride inhibits the formation of DHT by blocking the enzyme 5AR. 5AR convert testosterone, progesterone, deoxycorticosterone, aldosterone and corticosterone into their respective 5A -dihydro-derivatives, which serve as substrates for 3A - hydroxysteroid dehydrogenase (3α-HSD) enzymes. The latter transforms these 5A-reduced metabolites into a subclass of neuro-active steroid hormones with distinct physiological function. The neuro-active steroid hormones modulate multitude of functions in human physiology encompassing regulation of sexual differentiation, neuro-protection, memory enhancement, anxiety, sleep and stress, among others. In addition, 5α -reductase type 3 is also implicated in the N-glycosylation of proteins via formation of dolichol phosphate.

This explains the side effects, why this continues upon discontinuation of the drug is what medical science needs to figure out.

[UK_]

Some thoughts on TRT, please feel free to weigh in:

I personally feel testosterone therapy will not have the desired impact as finasteride has created some sort of intracellular down-regulation of 5AR activity. In this sense, your body has been endocrinologically moved toward converting more test into estradiol, if estradiol is excessive your body simply reduces its 'baseline' production of testosterone. So individuals are now left with the symptoms of low testosterone, but remember that testosterone production is something the body has no problem with, it's the down-regulated activity of 5AR that is pushing estradiol up and reducing the activity of neurosteroids throughout the nervous system. Doctors simply look at the low testosterone levels and put the patient on TRT, so now they have created two problems from one, not only has the body gained an intracellular down-regulation of 5AR, but it is now with the belief that it does not need to naturally produce any more testosterone due to the new exogenous supply. The problems may seem resolved, as the return of increased testosterone alleviates some symptoms, but the root of the problem is still there, and what is all that excess testosterone being converted to? That's right, ESTRADIOL.

DHT therapy might help, but will it last? That's the main concern, some people suffering from PFS have had some success with Proviron - but nothing amazing which tells me something serious has gone wrong with the function of 5AR. The fact that some individuals feel as if they have entered some prepubertal state also indicates that finasteride may have destroyed a large proportion of androgen receptors, if something in your body is not in use, the body will simply remove it.

[UK_]

I have managed to grow a long white beard with the time I have spent researching this, but I personally believe that the impact of finasteride has a domino effect on the endocrine system which then knocks back neurosteroids which then knocks back issues to do with dopamine receptors in the brain.

I say this because I have always strongly believed the side effects experienced by some SSRI users (genital numbness and sexual sexual anhedonia in particular) are similar to PFS sufferers in that the penis feels numb and disconnected, that when an orgasm takes place nothing at all is felt, it is simply 'mechanistic'.

I dont believe there is localised nerve damage because the actual function of the penis still works, rather it may be a dopamine issue:

A strong case can be made that many of the side effect of SSRIs, both sexual and otherwise, are dopamine dependent [13]. Data suggest that SSRIs can inhibit dopaminergic neurotransmission, not only by their effects on dopamine secretion or recapture, or on dopaminergic receptors, but also indirectly through serotonergic mediation [14]. Complex changes of dopaminergic neurotransmission (mostly antidopaminergic effects) have been described with SSRIs [10]. The partial reversal of symptoms with dopamine agonists or reuptake inhibitors in Case #3 strengthens the case for a role of downregulation of dopaminergic neurotransmission as a cause of persistent SSRI sexual side effects

Besides central nervous system (CNS) alterations,it is also possible that peripheral changes are caused by SSRIs. For example, 95% of the serotonin receptors in the body are outside the brain, many in the peripheral nerves [16], and only 1–2% of serotonin is located in the CNS [17]. Thus, it has been postulated that SSRIs, in part, cause sexual problems because of the inhibition of the serotonin receptors in the peripheral nerves [16,17]. While any or all of these changes may be responsible for SSRI sexual side effects, no studies have been performed to validate that these changes are normalized after discontinuation of therapy. It is therefore possible that sometimes, these parameters remain persistently altered. However, at least
two of these biomarkers––serum testosterone and prolactin––were normal in the cases reported here. Second, although rare, many publications point
to a role of SSRIs in the occurrence of extrapyrimidal effects such as bradykinesia, rigidity, akathisia, and acute dystonia [18]. These effects can sometimes be persistent even after drug discontinuance [19], an example of other longerlasting side effects caused by SSRIs. Perhaps, persistent sexual side effects are caused by a similar mechanism to extrapyramidal effects, namely, adverse but unclearly defined neurological alterations in areas of the nervous system responsible for sexual arousal and functioning..

[Maradona]

Some thoughts on TRT, please feel free to weigh in:

I personally feel testosterone therapy will not have the desired impact as finasteride has created some sort of intracellular down-regulation of 5AR activity. In this sense, your body has been endocrinologically moved toward converting more test into estradiol, if estradiol is excessive your body simply reduces its 'baseline' production of testosterone. So individuals are now left with the symptoms of low testosterone, but remember that testosterone production is something the body has no problem with, it's the down-regulated activity of 5AR that is pushing estradiol up and reducing the activity of neurosteroids throughout the nervous system. Doctors simply look at the low testosterone levels and put the patient on TRT, so now they have created two problems from one, not only has the body gained an intracellular down-regulation of 5AR, but it is now with the belief that it does not need to naturally produce any more testosterone due to the new exogenous supply. The problems may seem resolved, as the return of increased testosterone alleviates some symptoms, but the root of the problem is still there, and what is all that excess testosterone being converted to? That's right, ESTRADIOL.

DHT therapy might help, but will it last? That's the main concern, some people suffering from PFS have had some success with Proviron - but nothing amazing which tells me something serious has gone wrong with the function of 5AR. The fact that some individuals feel as if they have entered some prepubertal state also indicates that finasteride may have destroyed a large proportion of androgen receptors, if something in your body is not in use, the body will simply remove it.

fukin scary shit. One of the reasons I for good quit was because it's effect on neurosteroids. Some guy in ************ posted a study 6 months ago and they were srsly fuked up.

Do you have an account in propeciahelp? Are your sides better man? You seem to know this stuff very much.

[25 going on 65]

What cascade might fin cause to affect neurosteroids? I ask because 5-ar type I is involved in neurosteroid synthesis, but type II is not, and fin inhibits type II but not type I.
I'm not denying it could somehow be possible, just looking for anyone's best explanation as to how this indirect relationship might work?

[UK_]

fukin scary shit. One of the reasons I for good quit was because it's effect on neurosteroids. Some guy in ************ posted a study 6 months ago and they were srsly fuked up.

Do you have an account in propeciahelp? Are your sides better man? You seem to know this stuff very much.

Well the more I look into this problem the more I realise that Finasteride has caused some kind of domino effect that travels through issues regarding the endocrine system (neurosteroids) and leading to issues impacting dopamine/serotonin etc. The reason I say this is because 95% of serotonin receptor/activity occurs outside the brain, but dopamine is also playing a part here.

All of this madness is happening because of the downregulated/damaged intracellular activity of 5AR - that's where the first domino falls.

I dont have a propeciahelp account.

Maradona if you look at what is known as "post SSRI sexual dysfunction" - the comparison in descriptions of sexual side effects (i.e. no feeling, totally numb, no orgasm) is almost exactly similar to the complaints as PFS sufferers.

[Dan26]

Geeze! reading all this is making me really not want to start propecia. I'm 19. There must be a way to determine if you chances of getting PFS are high or low...is there? Hormone level test maybe?? I mean some guys genetics are just so strong, maybe their DHT isn't all that high, so propecia would not be a good idea. I dunno, what are your thoughts???

[UK_]

Geeze! reading all this is making me really not want to start propecia. I'm 19. There must be a way to determine if you chances of getting PFS are high or low...is there? Hormone level test maybe?? I mean some guys genetics are just so strong, maybe their DHT isn't all that high, so propecia would not be a good idea. I dunno, what are your thoughts???

Keep away from it - and especially keep away from anti-depressants - finasteride sexual sides are nothing compared to SSRI sides.... those forums are just horrid places.

The human body has had 3 billion years of field testing data to go by lol - we are so arrogant to think we know the effects of substances that block 5AR.... of course there is a genetic aspect to all this... plz go on propeciahelp.com an read the posts by member called "awor", he knows this shit inside out 1000x better than I do.

I was raised all my life taught to fear and avoid cannabis, society teaches you that, but as I grew older... I realised the most dangerous drugs are those that are sitting behind the shelf of a smiling doctor writing you a prescription with a corporate logo on. You cant monopolize cannabis which is why it remains illegal.

Question to Maradona: have you tried the herb "Yohimbine"?

[chrisis]

Thanks for all the feedback!

Just wanted to raise the point that I do sometimes have good days. Doesn't this suggest that whatever has been affected could potentially be fixed? Maybe it's a matter of resolving a hormonal imbalance, rather than a permanent lack of sensitivity/libido.

[Maradona]

Keep away from it - and especially keep away from anti-depressants - finasteride sexual sides are nothing compared to SSRI sides.... those forums are just horrid places.

The human body has had 3 billion years of field testing data to go by lol - we are so arrogant to think we know the effects of substances that block 5AR.... of course there is a genetic aspect to all this... plz go on propeciahelp.com an read the posts by member called "awor", he knows this shit inside out 1000x better than I do.

I was raised all my life taught to fear and avoid cannabis, society teaches you that, but as I grew older... I realised the most dangerous drugs are those that are sitting behind the shelf of a smiling doctor writing you a prescription with a corporate logo on. You cant monopolize cannabis which is why it remains illegal.

Question to Maradona: have you tried the herb "Yohimbine"?

I have to agree with you on cannabis. I wasn't forbidden to cannabis I just thought it was bad because people said that etc.

But the world is different. Not everything they say it's true, even if it has a safety label on it.

Cannabis is the best drug ever. I get the same effects with alcohol. I just don't give a damn about MPB when I'm drunk but it is true alcohol is very bad for your body. I haven't had cannabis in 2 years though!

No man. I haven't tried anything to combat PFS. I'll just keep waiting out because I seem to be getting better. My erections are ok when I need them now. My sides are other parts of the body. My prostate is ****ed from finasteride for example.

I don't want to mess with my body anymore either unless it's something you rub yourself with or it becomes ultra necessary.

I'll keep waiting .

[Maradona]

Thanks for all the feedback!

Just wanted to raise the point that I do sometimes have good days. Doesn't this suggest that whatever has been affected could potentially be fixed? Maybe it's a matter of resolving a hormonal imbalance, rather than a permanent lack of sensitivity/libido.

Yes it could mean you will get better. If you check propeciahelp.com those guys who had up and downs get better eventually.

Lucky you. Some guys at propeciahelp are like at 0% progress despite everything they've used.

You feel better somedays with no treatment right?