Propecia Impotence Temporary?

[johnfelt82]

Hello all,

Well as many of you can relate, the last month or so after really discovering my hair loss has a been a crazy ride. Anyway I got on the solid regimen of propecia, rogaine and nizoral and was feeling good.

Today, after one week of being on propecia, I woke up with a limp member. This is completely unusual for me. Id like to attribute it to something else-general stress, having a cold, but come on, lets be real,

Anyway, I see a lot of people say that the sdie effect goes away after a little bit after your body gets used tot he propecia. Has this been anyone's experience.

I don't want to stop the propecia. I am grateful for the hair I have and at least want to keep that. Should I hold out hope that I can stay on propecia and the ED will go away?

Thank you all; I appreciate it very much.

John

 

[Mew]

Should I hold out hope that I can stay on propecia and the ED will go away?

It's russian roulette and there are no guarantees, despite what Merck might claim. You MAY find your body adapts to the medication and things get better, or you may not.

Choice is up to you if you want to risk it, especially considering this recent bit of info:



Granted there are many men who do not have issues with the drug, but there are also others who do, as you are finding out. Merck claims all side effects will go away upon discontinuation in men who experience them, and possibly reduce with continued use. If you want to believe that story and take that chance, keep taking it. Otherwise, make a decision about what's more important to you, your health and sexual abilities, or your hair.

 

[el_duterino]

Mew, do you have any scientific information or reasons to believe that libido side effects might subsist forever after stopping finasteride ?

 

[Mew]

Reasons: it's happened to me personally, and tons of other guys out there.

As for scientific info, I posted a link to new labelling changes in Sweden for the drug in my initial response but it was censored by the mods here. If you want to review studies, check the Finasteride Studies section of the "other" website that nobody's allowed to talk about here.

 

[el_duterino]

Reasons: it's happened to me personally, and tons of other guys out there.

As for scientific info, I posted a link to new labelling changes in Sweden for the drug in my initial response but it was censored by the mods here. If you want to review studies, check the Finasteride Studies section of the "other" website that nobody's allowed to talk about here.

I mean what is the scientific background for that. Has the body ability to produce 5ar being permanently affected by long term 5ar inhibition ? are the testes producing less testosterone in a permanant manner due to finasteride etc.. these are the kinds of answers we are looking for.

 

[Mew]

I mean what is the scientific background for that. Has the body ability to produce 5ar being permanently affected by long term 5ar inhibition ? are the testes producing less testosterone in a permanant manner due to finasteride etc.. these are the kinds of answers we are looking for.

First, who is "we"? I thought you're still taking dutasteride and doing just fine?

Second, if anyone had the true answer to that question, none of us with ongoing permanent problems from the drug would be in the situation we're currently in, because we'd hopefully be cured, if there is even an available treatment to fix whatever is causing these problems -- IF the source of these problems can be found.

But yes, many guys that crash and have these ongoing issues seem to end up with near hypogonadal levels of Testosterone, LH, FSH, often elevated Estradiol, Prolactin, TSH... and various other imbalances. The drop in Testosterone levels, and their bloodwork showing this, seems to be a consistent pattern for those men with problems continuing after quitting.


That said -- various theories abound:

Is it at the genetic level? Has gene silencing, genetic or epigenetic changes occured?

Have we become insensitive to our own androgens (androgen insensitivity) due to Androgen Receptor mutation or extreme downregulation/desensitization?

Has the liver's P450 Cytochrome system, CYP19/CYP21 metabolizing enzymes, and sites of 5AR1/5AR2 synthesis been damaged thanks to a drug that is extensively metabolized in the liver, preventing proper 5AR or androgen metabolism?

Has our brain's hypothalamus and pituitary 5AR2 tissues been permanently desensitized to the effects of DHT due to 5AR inhibition and lack of androgen while on the medication?

Has the drug's inhibition of neurosteroid production, including Allopregnanolone, THDOC etc. and resultant interference with proper GABA-A function in the brain, caused permanent neurochemical changes in our brains to cause these ongoing side effects?


The truth is, nobody knows because no research scientists have looked into this problem yet. This is further compounded by the fact most in the medical community are unaware of the possibilities the drug can potentially cause these problems in a certain subset of users, and dismiss such things as "psychological" in nature (not true, especially when physical changes to genitalia, loss of nocturnal/morning/spontaneous erections, penile fibrosis etc are involved). But the more men that experience these issues, the more attention this issue will get. Granted those who have these ongoing problems are in the minority of users who get side effects in the first place, but they are a minority nonetheless.

Finally, for those with permanent issues, nobody has been tested for 5AR2 enzyme activity post-finasteride so we don't know if in fact 5AR is functioning or even present anymore in those tissues (ie, penis) where it was inhibited. However, there are guys who have taken TRT and DHT gel post-finasteride and have no changes in libido, ED, shrinkage etc -- leading me to believe the problem lies at the receptor/genetic level.

Only researchers in a lab can unlock this mystery.

 

[el_duterino]

ok got it. I am taking dutasteride and was using finasteride for 7 years too. I observed that finasteride decreased my quality of orgasms, but i had no changes in libido.
dutasteride did decrease the libido but not all the time. I never stopped taking 5ar inhibitor since 1998 so i don't know if sides are permanent.
If is there is such risk I still woould like to be aware of it..and understand more the mechanisms hence the WE...

 

[Mew]

I never stopped taking 5ar inhibitor since 1998 so i don't know if sides are permanent.

Nobody knows unless they actually quit to see if they go back to normal. That's the crappy part: you either do or you don't.

Statistics generally say most men will go back to normal, and if you believe Merck, everyone should. But that is not reality for a small minority of users out there who found out otherwise.

If is there is such risk I still woould like to be aware of it

The problem is there is no study on these permanent issues, thus a true risk cannot be given. However, I'd say if you are experiencing ongoing side effects while on the medication, take it as a message from your body that it doesn't agree with what you are doing to it hormonally. The ultimate consequences of that, should you quit, will be determined by your body's response to a (hopeful) return of DHT and is completely out of your control.

 

[el_duterino]

if those sides become permanentt, at least the good thing would be that the benefits on hair will also become permanent since DHT will be reduced forever..that would be the real "cure" for hairloss.

 

[el_duterino]

Mew, can you confirm that since you seem the most knowledgeable on those permanent side effecst

Permanent low DHT = Permanent halt of hairloss

 

[Mew]

Permanent low DHT = Permanent halt of hairloss

I wouldn't say "permanent" halt of hairloss, because you'll always have some residual DHT from 5AR1 (~30%) when taking Finasteride, unless of course you took dutasteride and inhibited both 5AR I and II, thus inhibitng ~99% of DHT.

Furthermore, many guys have high serum DHT levels post-finasteride (self included), although such tests are not necessarily reliable as 5AR is an intracelluar enzyme and DHT conversion take places locally in those tissues where it is present, such as the prostate and genital tissues.

While the hair follicle is sensitive to the effects of DHT, post-finasteride many men with "permanent issues" continue to go bald, despite not having their sexual function come back... and I'm not clear on why exactly that would be. Perhaps 5AR1 is providing residual DHT which is affecting the hair follicles, but the 5AR2 tissues have been irreversibly inhibited from finasteride and thus no T-->DHT conversion is happening in those local tissues anymore post-finasteride.

Theoretically, if you had no DHT in your body then yes, you'd theoretically have a halting of the balding process, in my opinion... but maybe Bryan can speak more to that point.

However, even in 5AR2 deficient pseudohermaphrodites (which is what they based the drug's design on -- instilling a hormonal profile in normal men similar to that of a 5AR2-deficient pseudohermaphrodite), again -- 5AR1 provides residual DHT so it's possible this may allow the balding process to continue. Again, this is all conjecture and I could be completely wrong.