Androgen Deprivation Can Cause Penis Shrinkage

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IdealForehead

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I have read for years concerns from finasteride/dutasteride users that reducing their DHT may deprive their penises of androgen stimulation and lead to penile shrinkage over time. I have seen the animal studies showing this does in fact happen in rats. I have also read some claims from long term finasteride/dutasteride users that their penises have noticeably shrunken over the years.

This is especially pertinent to me now as I am on darolutamide, which is the most powerful androgen receptor antagonist (and completely experimental), so I looked to see what I could find. I found this study, showing that yes, in fact, androgen deprivation can definitely lead to penile shrinkage over time:

"The effects of long-term androgen deprivation therapy on penile length in patients with prostate cancer: a single-center, prospective, open-label, observational study."

Before therapy, the mean stretched penile length was 10.76 cm. After 24 months of ADT, mean penile length had decreased to 8.05 cm. However, these changes plateaued after 15 months.

https://www.ncbi.nlm.nih.gov/pubmed/21699669​

So, in other words, with very aggressive androgen deprivation (much more aggressive than anyone here is considering), considerable penis shrinkage did occur. It was a fair amount. Penises shrunk from 10.76 cm stretched to 8.05 cm stretched after 24 months of treatment.

Fortunately, the effect plateaued over time, leveling off after 15 months, which suggests that no matter what, your dick won't shrivel away indefinitely until there's nothing left at all. But the amount of penis atrophy was considerable and should probably be taken seriously.

Is this relevant?
Before we go any further, it must be clarified that things like finasteride/dutasteride/RU do not block or reduce androgens to nearly even a fraction of the extent as the agents used in the study quoted above. So probably this is not even something to worry about for standard med users.

But I do think it is important to be aware of, given that we all have different androgen sensitivities throughout our bodies, and most of us are aiming to treat our hair loss for 40-50+ years, over which time even subtle effects could become more obvious.

Solutions
The first solution to avoiding this problem over time (besides just not worrying about it) would then obviously be to limit your anti-androgens (finasteride/dutasteride/RU/whatever) to the lowest dose possible.

The second solution, which I am debating employing for myself, would be to add a bit of topical androgen back to your penis, in the form of testosterone or DHT gel applied directly to the penis. DHT gel (Adractim) is commonly used in the penis enlargement community to help maximize androgen stimulation of the penis. Testosterone gel should work similarly.

The first trouble with this approach is DHT/test gels/creams fall under "anabolic steroids" and may be highly illegal depending on where you live. (Don't blame me if you get arrested trying to procure some.)

The second trouble is that adding extra androgens to your system may undo any benefits you are getting from your hair loss treatment. The hope would be that the test/DHT gel/cream would stay "local" to the penis, but the penis is so incredibly vascular, this is almost certainly completely unrealistic.

In my case as I am using daro topically to my scalp, I would not be worried about a little extra DHT/test circulating from penile application. It would never overwhelm my topical daro. But if you are on a more conventional/safe regimen, then the extra DHT/test could be problematic. You'd probably have to monitor carefully if you were trying anything like this.
 
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Obsessive

Obsessive

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IdealForehead said:
I have read for years concerns from finasteride/dutasteride users that reducing their DHT may deprive their penises of androgen stimulation and lead to penile shrinkage over time. I have seen the animal studies showing this does in fact happen in rats. I have also read some claims from long term finasteride/dutasteride users that their penises have noticeably shrunken over the years.

This is especially pertinent to me now as I am on darolutamide, which is the most powerful androgen receptor antagonist (and completely experimental), so I looked to see what I could find. I found this study, showing that yes, in fact, androgen deprivation can definitely lead to penile shrinkage over time:

"The effects of long-term androgen deprivation therapy on penile length in patients with prostate cancer: a single-center, prospective, open-label, observational study."

Before therapy, the mean stretched penile length was 10.76 cm. After 24 months of ADT, mean penile length had decreased to 8.05 cm. However, these changes plateaued after 15 months.

https://www.ncbi.nlm.nih.gov/pubmed/21699669​

So, in other words, with very aggressive androgen deprivation (much more aggressive than anyone here is considering), considerable penis shrinkage did occur. It was a fair amount. Penises shrunk from 10.76 cm stretched to 8.05 cm stretched after 24 months of treatment.

Fortunately, the effect plateaued over time, leveling off after 15 months, which suggests that no matter what, your dick won't shrivel away indefinitely until there's nothing left at all. But the amount of penis atrophy was considerable and should probably be taken seriously.

Is this relevant?
Before we go any further, it must be clarified that things like finasteride/dutasteride/RU do not block or reduce androgens to nearly even a fraction of the extent as the agents used in the study quoted above. So probably this is not even something to worry about for standard med users.

But I do think it is important to be aware of, given that we all have different androgen sensitivities throughout our bodies, and most of us are aiming to treat our hair loss for 40-50+ years, over which time even subtle effects could become more obvious.

Solutions
The first solution to avoiding this problem over time (besides just not worrying about it) would then obviously be to limit your anti-androgens (finasteride/dutasteride/RU/whatever) to the lowest dose possible.

The second solution, which I am debating employing for myself, would be to add a bit of topical androgen back to your penis, in the form of testosterone or DHT gel applied directly to the penis. DHT gel (Adractim) is commonly used in the penis enlargement community to help maximize androgen stimulation of the penis. Testosterone gel should work similarly.

The first trouble with this approach is DHT/test gels/creams fall under "anabolic steroids" and may be highly illegal depending on where you live. (Don't blame me if you get arrested trying to procure some.)

The second trouble is that adding extra androgens to your system may undo any benefits you are getting from your hair loss treatment. The hope would be that the test/DHT gel/cream would stay "local" to the penis, but the penis is so incredibly vascular, this is almost certainly completely unrealistic.

In my case as I am using daro topically to my scalp, I would not be worried about a little extra DHT/test circulating from penile application. It would never overwhelm my topical daro. But if you are on a more conventional/safe regimen, then the extra DHT/test could be problematic. You'd probably have to monitor carefully if you were trying anything like this.
Click to expand...
I can't access the article. Do you know what anti-androgen(s) were used in study?
 
Maave

Maave

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Obsessive said:
I can't access the article. Do you know what anti-androgen(s) were used in study?
Click to expand...
LHRH agonists aka GnRH agonists like lupron. So LH was completely suppressed and the testes didn't receive any signal to produce T. This is quite a bit different from finasteride or even NSAAs.

I can't find the full text but I'll copy the summary for you:
INTRODUCTION: The adverse effects of long-term drug therapy for prostate cancer (PCa) can dramatically impact patient quality of life and are considered to be important factors when selecting treatment. AIM: To assess stretched penile length before and after long-term androgen deprivation therapy (ADT) for treatment of PCa.

METHODS: From January 2008 to June 2010 at a single institution, 39 consecutive patients without distant metastases who were elected to receive ADT as initial therapy for PCa were prospectively enrolled. Exclusion criteria were history of penile anomalies and/or trauma, and prior radical prostate surgery or radiation therapy. Erectile functions were evaluated at baseline according to the International Index of Erectile Function (IIEF). Vertically stretched penile length was measured every 3 months from the pubopenile junction to the meatus with a spring scale.

MAIN OUTCOME MEASURE: After ADT, significant 3-month interval changes in stretched penile length were noted for up to 15 months (P < 0.001). The relationship between potency and penile shortening was not significant (P = 0.45). RESULTS: The mean patient age was 67.1 years. Before therapy, the mean stretched penile length was 10.76 cm. After 24 months of ADT, mean penile length had decreased to 8.05 cm. However, these changes plateaued after 15 months. Normal erectile function (EF) was reported by 41% of patients before therapy, while 10.5% reported normal EF at the 24-month follow-up. The relationship between potency and penile shortening was not significant. However, patients who preserved their potency tended to experience less penile shortening.

CONCLUSIONS: The administration of luteinizing hormone-releasing hormone (LHRH) agonists induced significant decreases in penile length for only up to 15 months in the absence of the confounding effects of surgery and radiation.
 
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Vinc2097

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but i think men in the studies with prostate cancer were taking 5 mg proscar every day (this is the dose for prostate disorder)

So with the 1mg for hair loss you have 5x less chance to get this side !. but it is still there, esspacially if you tike it for a long period of time (decade +)
 
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Ryko

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Vinc2097 said:
but i think men in the studies with prostate cancer were taking 5 mg proscar every day (this is the dose for prostate disorder)

So with the 1mg for hair loss you have 5x less chance to get this side !. but it is still there, esspacially if you tike it for a long period of time (decade +)
Click to expand...

That's not necessarily true, finasteride is accumulated over time in the body, the lowest dose I think is 0.05mg which still reaches the end result of 60-70% DHT reduction in the body. 0.04mg and lower reaches lower DHT reduction, around 48% if I'm correct. However, those doses are not as effective obviously.
 
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Vinc2097

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Ryko said:
That's not necessarily true, finasteride is accumulated over time in the body, the lowest dose I think is 0.05mg which still reaches the end result of 60-70% DHT reduction in the body. 0.04mg and lower reaches lower DHT reduction, around 48% if I'm correct. However, those doses are not as effective obviously.
Click to expand...

how is it possible to take 0.08 mg or less...

i thought about 0.25 mg every other day
 
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