Do Not Worry About Testing Your Hormone Levels. If There Was Damage Done, It's Done For Good

[leprous]

According to this study, the famous rat studies were right and Finasteride will have a negative impact in your penile tissue, replacing muscles with fibrotic tissue: https://www.jsm.jsexmed.org/article/S1743-6095(17)31817-9/abstract

How many of us will develop enough fibrosis to have significant erectile dysfunction? Nobody knows, but nothing cures fibrosis, as far as I know (please, prove me wrong, there's nothing I would like more that being wrong about all this).

So once you're off the drug, I don't think is very important to check your hormone levels since they will go back to normal 99.9 out of 100 times. The issue here is the damage done while on the drug. Urologists don't seem to believe fibrosis can be cured although I have read some old interviews that pointed on the other direction.

I'm considering quitting and I don't think it is going to cause me much trouble after being on it for less than three months.

It would be interesting to know what happens to the prostate after you stop taking finasteride. Does it go back to were it was before, with the same kind of tissues, or does it grow in an abnormal way? I tried to find studies on it but I haven't found anything. If it grows back perfectly normal then there's some hope, I would assume.

TL;DR: Your hormones should return to normal weeks after going off finasteride. If you have taken the drug for a long time and you still experience erectile dysfunction weeks after quitting is probably because the morphology of your penis has changed even if it looks the same outside. DHT creams, TRT and those kind of things could help to a degree. It's not about permanent changes in hormones, it's about permanent changes on tissue.

 

[barfacan]

tissue requires a specific stimulus threshold to induce change, fibrosis is reversible, it's all about the proper intervention...it varies across different tissues.

 

[leprous]

tissue requires a specific stimulus threshold to induce change, fibrosis is reversible, it's all about the proper intervention...it varies across different tissues.

Please, could you elaborate more on the threshold?

All studies I've read sate that penile fibrosis is not reversible, with connective tissue taken the place of smooth muscle. Please, could you link me to any study that states that penile fibrosis is reversible? That would ease my mind.

 

[Ollie]

As someone who has just started finasteride this is a particularly distressing side effect.

I dont understand how a mere 60% reduction in DHT could have an effect on penile tissue, especially to the extent of causing scar tissue ?

EDIT: Just found these which appear very interesting.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4149188/

https://en.wikipedia.org/wiki/PDE5_inhibitor

Looks like the use of a PDE5 Inhibitor could reverse fibrosis or at least be a great piece of preventative medicine to safeguard the male genitalia during the use of 5AR-I's. (presumably there are ones that aren't as extreme as v****)

 

[leprous]

As someone who has just started finasteride this is a particularly distressing side effect.

I dont understand how a mere 60% reduction in DHT could have an effect on penile tissue, especially to the extent of causing scar tissue ?

EDIT: Just found these which appear very interesting.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4149188/

https://en.wikipedia.org/wiki/PDE5_inhibitor

Looks like the use of a PDE5 Inhibitor could reverse fibrosis or at least be a great piece of preventative medicine to safeguard the male genitalia during the use of 5AR-I's. (presumably there are ones that aren't as extreme as v****)

Thank you, Ollie. That's a very interesting paper regarding this issue. They say it could at least partially help, so that's something since most people don't appear to suffer significant side effects. My hypotheses is that probably everyone has its penile tissues damaged from long term finasteride use but in most cases it's just not enough damage to cause significant erectile dysfunction. Chronic heavy drinking also damages penile tissues, for example, but not everyone gets major erectile dysfunction.

The 65% reduction in DHT refers to serum DHT, which accounts for all DHT going through the blood vessels. DHT is a peripheral paracrine hormone, therefore it works binding to the receptors of the tissues in the body, unlike Testosterone, which also "runs free", so to speak. For example, 1mg of finasteride reduces DHT in the prostate by around 80 to 90%, while in most areas of the brain where 5-AR type 1 is predominant it doesn't reduce much. 5-AR type II is predominant in the genitalia.

 

[Grasshüpfer]

It really would be interesting to know the mechanism here.

We know that Finasteride reduces nightly erections and morning wood, as those are regulated by androgens.
This can cause fibrosis as the nightly erections are a means of keeping the tissue flexible.

So it goes the other way round. Not fibrosis leads to ed but nightly ed leads to fibrosis.
I don't have any proof tho, it's just a theory.

 

[Ollie]

Thank you, Ollie. That's a very interesting paper regarding this issue. They say it could at least partially help, so that's something since most people don't appear to suffer significant side effects. My hypotheses is that probably everyone has its penile tissues damaged from long term finasteride use but in most cases it's just not enough damage to cause significant erectile dysfunction. Chronic heavy drinking also damages penile tissues, for example, but not everyone gets major erectile dysfunction.

The 65% reduction in DHT refers to serum DHT, which accounts for all DHT going through the blood vessels. DHT is a peripheral paracrine hormone, therefore it works binding to the receptors of the tissues in the body, unlike Testosterone, which also "runs free", so to speak. For example, 1mg of finasteride reduces DHT in the prostate by around 80 to 90%, while in most areas of the brain where 5-AR type 1 is predominant it doesn't reduce much. 5-AR type II is predominant in the genitalia.

Thank you for the reply Leprous.

Building on what you said about DHT in localised areas, can we assume the effect of 5-AR inhibition reduces DHT in the genitalia as much as it does in the prostate ? And if so do you believe this could be a reason why a small population have reported a decrease in penis size ?

You might also be interested to read this https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4386768/

Having read this: Nitric oxide (NO) is a non-adrenergic neurotransmitter that converts guanosine triphosphate into cyclic guanosine monophosphate (cGMP).14 cGMP initiates calcium efflux from smooth muscle cells, with resulting relaxation in cavernosal and arterial smooth muscle tone. Type 5 phosphodiesterase (PDE5) converts cGMP to 5-GMP, thereby resulting in smooth muscle contraction and degradation of the erection. Inhibition of PDE5 effectively maintains cGMP activity in the penis, resulting in improved erections. The PDE5 isoenzyme is highly prevalent in the penis, as well as in the prostate, bladder, and urethra, and their supporting vasculature.

Can we assume that by maintaining cGMP (through daily Tadalafil) , and therefor not allowing penile dysfunction to occur in the first place we can prevent the onset of fibrosis ? My understanding of why fibrosis actually occurs there due to Finasteride is essentially zero.

As for these sorts of side effects how often do you believe they actually occur ? It seems you talk to most Doctors and they say 90% have had no problems at all and of those that do it is fully reversed through stopping the drug. Its hard to draw conclusions from reading online when of course you get a concentration of horror stories.

 

[Ollie]

Also:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3075874/

Conclusion:

Sildenafil treatment after BCNR activates genes related to SM preservation and down regulates genes related to fibrosis in the corpora cavernosa. These results provide a mechanistic justification for the use of sildenafil and other PDE5 inhibitors as protective therapy against corporal SM loss and fibrosis after radical prostatectomy.

For the sake of safeguarding myself i think i might start taking 5mg of taladafil a day.

 

[leprous]

Thank you for the reply Leprous.

Building on what you said about DHT in localised areas, can we assume the effect of 5-AR inhibition reduces DHT in the genitalia as much as it does in the prostate ? And if so do you believe this could be a reason why a small population have reported a decrease in penis size ?

You might also be interested to read this https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4386768/

Having read this: Nitric oxide (NO) is a non-adrenergic neurotransmitter that converts guanosine triphosphate into cyclic guanosine monophosphate (cGMP).14 cGMP initiates calcium efflux from smooth muscle cells, with resulting relaxation in cavernosal and arterial smooth muscle tone. Type 5 phosphodiesterase (PDE5) converts cGMP to 5-GMP, thereby resulting in smooth muscle contraction and degradation of the erection. Inhibition of PDE5 effectively maintains cGMP activity in the penis, resulting in improved erections. The PDE5 isoenzyme is highly prevalent in the penis, as well as in the prostate, bladder, and urethra, and their supporting vasculature.

Can we assume that by maintaining cGMP (through daily Tadalafil) , and therefor not allowing penile dysfunction to occur in the first place we can prevent the onset of fibrosis ? My understanding of why fibrosis actually occurs there due to Finasteride is essentially zero.

As for these sorts of side effects how often do you believe they actually occur ? It seems you talk to most Doctors and they say 90% have had no problems at all and of those that do it is fully reversed through stopping the drug. Its hard to draw conclusions from reading online when of course you get a concentration of horror stories.

Another interesting study right there. I think using a PDE5 inhibitor PDE5 inhibitor would definitely help to maintain penile tissues healthy. I do not know how to get it without prescription though and I don't know what side effect could come when used daily for years or when one decides to get off it after chronic usage.

I think penile tissue smooth muscle deterioration and fibrosis may have to do with decreased nitric oxide synthase activity but there could be more causes. As Grasshüpfer points out, nocturnal erections are essential to maintain a healthy penis and the decreased NO synthase activity could lead to fewer and less stronger nocturnal erections and the less blood enters the penis every day the less healthy its tissue will be.

I'm not sure how much DHT finasteride reduces in penile tissues but I assume it's a high percentage since 5-AR type II is as essential in the development of the penis as it is in the development of the prostate. I assume shrinkage could occur in some cases as it did in rats penises and as it does in human prostate but it's just an assumption.

 

[Ollie]

Another interesting study right there. I think using a PDE5 inhibitor PDE5 inhibitor would definitely help to maintain penile tissues healthy. I do not know how to get it without prescription though and I don't know what side effect could come when used daily for years or when one decides to get off it after chronic usage.

I think penile tissue smooth muscle deterioration and fibrosis may have to do with decreased nitric oxide synthase activity but there could be more causes. As Grasshüpfer points out, nocturnal erections are essential to maintain a healthy penis and the decreased NO synthase activity could lead to fewer and less stronger nocturnal erections and the less blood enters the penis every day the less healthy its tissue will be.

I'm not sure how much DHT finasteride reduces in penile tissues but I assume it's a high percentage since 5-AR type II is as essential in the development of the penis as it is in the development of the prostate. I assume shrinkage could occur in some cases as it did in rats penises and as it does in human prostate but it's just an assumption.

From what i've seen there have been some long term studies done that show its daily use is safe and well tolerated. I really dont intend to stay on finasteride forever as i'd love to just keep as much as possible for the sake of getting a stem cell treatment like shiseido for maintenance in the future.

I suppose my only other worry would be then coming off of Tadalafil after x years.

What country are you from ?

 

[g.i joey]

I think finasteride users overlook the fact that they should be getting erections daily, whether its spontaneous or self stimulated or through other means.

 

[ckp4eva]

If what you’re saying is true, then how is it possible that drugs such as; v****, Cialsis etc can restore the penis to a fully functioning state? Even if it’s for a short period of time?