5-AR Inhibitor Drugs Like Finasteride Cause Persistent ED And Lower Testosterone

haidut

Member
Forum Supporter
Joined
Mar 18, 2013
Messages
19,798
Location
USA / Europe
The FDA has denied for decades that the mainstream drugs for hair loss (MPB) and benign prostate enlargement (BPH) cause any persistent problems. It was in the minds of the users, the FDA said. Upon discontinuation, the problems were said to disappear within 2-4 weeks. But the reports on long term effects continued, and now this study finally adds some weight to the claim of long term dysregulation damage done by drugs like finasteride, dutasteride and other 5-AR inhibitors. The study found that the long term side effects can last for years and some people never fully recover, exactly as people kept reporting over the last 2 decades. What's worse, the negative side effects are most pronounced in younger males and was not alleviated by using drugs like Viagra. The study did not address mood disorders, but given the important role of DHT (and allopregnanolone) in mental health I do not see how the mood will be exempted. So, it would be very nice to also see an official confirmation of the depression, anxiety and cognitive dysfunction that drug users have reported as well, often saying they are much more profound than the sexual ones.

https://peerj.com/articles/3020/
Hair loss and prostate drugs linked to persistent erectile dysfunction in men - Northwestern Now
"...Men with longer exposure to the drugs finasteride and dutasteride had a higher risk of getting persistent erectile dysfunction than men with less exposure, reports a new Northwestern Medicine study. The persistent erectile dysfunction continued despite stopping these drugs, in some cases for months or years. Among young men, prolonged exposure to the drugs posed a greater risk of persistent erectile dysfunction (PED) than all other assessed risk factors. This means there is a stronger relationship between taking these drugs and having PED than having diabetes, hypertension or smoking, which are other risk factors. Erectile dysfunction is difficulty achieving and maintaining a sufficient erection to have sex. Persistent erectile dysfunction continued despite stopping the drug and continued despite taking sildenafil (Viagra) or similar drug. Prior to the new study, there was no strong evidence that finasteride and dutasteride cause sexual problems that continue after men stop taking them. There also was no strong evidence that taking these drugs for a longer time increases the chance of experiencing sexual problems.
Our study shows men who take finasteride or dutasteride can get persistent erectile dysfunction, in which they will not be able to have normal erections for months or years after stopping finasteride or dutasteride,” said lead study author Dr. Steven Belknap, a research assistant professor of dermatology at Northwestern University Feinberg School of Medicine. Finasteride and dutasteride are drugs that are male hormone blockers. These drugs block the conversion of testosterone to its more active form, 5 alpha dihydrotestosterone. Finasteride is prescribed to some men with prostate enlargement or baldness. Dutasteride is prescribed to some men with prostate enlargement. Propecia and Proscar are brand names for finasteride. Avodart is a brand name for dutasteride. Jalyn is a combination drug containing dutasteride and tamsulosin."

Now, here is the even worse news. FDA and many bodybuilding forums claim that finasteride and other 5-AR inhibitors can actually help increasing muscle mass because they increase testosterone. This is a simplistic conclusion based on the assumption that by blocking 5-AR more testosterone will be left to affect muscle mass. Unfortunately, as I posted in another thread, finasteride and company also block several other steroidogenic enzymes so they reduce entire androgenic steroidogenic output, while at the same time increasing cortisol synthesis.
https://raypeatforum.com/community/...drugs-increase-cortisol-and-cause-nafld.8370/
And now there is a study that supports the earlier findings (@TubZy you may want to post this on the other forums).

Finasteride, not tamsulosin, increases severity of erectile dysfunction and decreases testosterone levels in men with benign prostatic hyperplasia. - PubMed - NCBI
https://www.statnews.com/2017/03/09/finasteride-erectile-dysfunction/
"...But others have published related research with similar findings. A 2015 paper, for instance, found that men with enlarged prostates who took finasteride experienced a decrease in erectile function as well as a decrease in testosterone levels over four years."
 

TubZy

Member
Joined
Sep 30, 2016
Messages
1,649
Location
USA
Good find. It seems like the "longer" used, the more the body adapts hence making it harder to return to normal/homestasis. What is your theory behind it? That the body just adapted to downregulated steroid levels and enzymes and once ceasing usage, doesn't return to normal?

We already know pregnenolone and progesterone levels are depleted during and post fin use. I think they get depleted due to trying to fill in the missing hormones (i.e. allopreg etc.) that fin is inhibiting so they both get drained quick. Backfilling those hormones should be no brainer.
 

TubZy

Member
Joined
Sep 30, 2016
Messages
1,649
Location
USA
No.. it increases preg and decreases prog

Wrong
SiSYuod.jpg
 

TubZy

Member
Joined
Sep 30, 2016
Messages
1,649
Location
USA
I can see preg levels being somewhat higher post treatment only because if the 5AR is still down regulated, the preg doesn't really have many other areas to go (or the cortisol, estrogen, stress route). It was a very small study, but at the same time many PFS people have thyroid issues and high cortisol and how can preg be high if in a hypothyroid type state? Many people PMed me saying that had low preg levels along with prog levels.

What I did find interesting from the study is in bold though:

  • levels neuroactive steroids CSF and plasma seven post-finasteride patients compared with twelve male, age-matched healthy controls.
  • comparison healthy controls, post-finasteride patients presented different neuroactive steroid pattern both in CSF and plasma.
  • - 1 shows the levels PREG, its metabolite PROG, levels of the further metabolites, DHP, THP and isopregnanolone.
  • reported, levels PREG significantly increased CSF and plasma of post-finasteride patients.
  • On the contrary, PROG was significantly decreased in CSF but unchanged in plasma.
  • DHP, THP and isopregnanolone were significantly decreased in CSF post-finasteride patients with levels under detection limit.
  • DHP and THP significantly decreased plasma, levels of THP under detection limit.
  • - 2 shows the levels DHEA, its metabolite T, levels of the further metabolites, DHT, 3 -diol, 3 -diol and 17 -E.
  • reported, DHEA levels both in CSF and plasma; on the contrary, CSF and plasma of post-finasteride patients levels T significantly increased.
  • levels of the first metabolite T, DHT, were significantly decreased in CSF but unchanged in plasma; levels of the further metabolites, 3 -diol and 3 -diol were significantly increased in plasma.
  • plasma, levels of 3 -diol CSF significantly increased.
  • Levels 17 -E were significantly increased in plasma CSF

So isopregnanolone decreased, but pregnenolone increased? Any idea why? They also mention significantly lower DHT levels, but many people have normal DHT levels still with sides. Also the study you posted shows higher levels of T PFS, when haiduts study above shows lower T? And I guess the best way to increase THP would be progesterone.
 
Last edited:

sladerunner69

Member
Joined
May 24, 2013
Messages
3,307
Age
31
Location
Los Angeles
That is very irritating what was mentionned about guys claiming that the mental side effects were much worse than the sexual side effects. People don't seem to understand that the two are inexorably linked, through the enrves and the hormones they are both being influenced so much by the other that they are essentially the same thing. In fact I believe that erections could be used as a barometer for the state of ones mental health, in one sense. But as Peat has often pointed out, the current paradigm is rationalism which is falls short on so often an occasion- you can't seperate sexual health from mental health from physical health, and the drug companies and researchers are clearly doing that. They do so for liability issues Im assuming because any flaw in their precise rationalist logic will be used to deny the credibility of their study as a whole by Big Pharma suits.

But yes the first thing I noticed a couple weeks after taking proscar was how terrible and lifeless I felt, like life was an inescapable void and everything was so fake and saddening. I was actually on a very nice cruise to see the glaciers in alaska, an idea I had always loved prior. I had begun to take proscar and was cutting the pills uy myself, and taking probably 2 or 3 times the 5mg recommended dosages because I thought ti would help fully block the "useless" dht that was causing my hair to shed. After a few days I noticed my erections were really bad and I was unable to experience pleasure, and everything we were seeing on the vacation was so boring it was making me sad, and I did not want to talk to anyone. I started drinking tons of rum and the last night i ended up in the brig below deck because I was picking fights, which is completely out of character for me but Iw as feeling desperate and morbid.

Of course I got back home and realized something was seriously off when I couldn't get even a small erection and everything down there was a fraction of the size and turning bright blue. That part was bad enough, but I ahd trouble caring because hoenstly I was much mroe cocnerned with my mental state which had completely gone on the lamb. Everything made me unspeakably sad, I couldnt hang out with friends or family because no one wanted to talk to me. I could not laugh at movies and was tired all the time, I couldnt get any rest, I couldnt eat, etc etc. Im sure youve all hear the horror stories.

problem is, I took high dose finasteride when I was not even 19 years old yet, and Im sure that's why I got hit so bad. I have an abnormally sensitive system as it is, but finasteride really jsut annhilitated my health and tore down my whole life. I am thankful to have found authentic scientific based health through Ray Peat and Danny Roddy, which is really the sivler lining here, but still I will never get those 3 or 4 miserable years of my life back.

Life moves on, however, I am not gonna be the one to wait around for it to come back.
 

REOSIRENS

Member
Joined
Jan 4, 2017
Messages
339
Location
Europe
That is very irritating what was mentionned about guys claiming that the mental side effects were much worse than the sexual side effects. People don't seem to understand that the two are inexorably linked, through the enrves and the hormones they are both being influenced so much by the other that they are essentially the same thing. In fact I believe that erections could be used as a barometer for the state of ones mental health, in one sense. But as Peat has often pointed out, the current paradigm is rationalism which is falls short on so often an occasion- you can't seperate sexual health from mental health from physical health, and the drug companies and researchers are clearly doing that. They do so for liability issues Im assuming because any flaw in their precise rationalist logic will be used to deny the credibility of their study as a whole by Big Pharma suits.

But yes the first thing I noticed a couple weeks after taking proscar was how terrible and lifeless I felt, like life was an inescapable void and everything was so fake and saddening. I was actually on a very nice cruise to see the glaciers in alaska, an idea I had always loved prior. I had begun to take proscar and was cutting the pills uy myself, and taking probably 2 or 3 times the 5mg recommended dosages because I thought ti would help fully block the "useless" dht that was causing my hair to shed. After a few days I noticed my erections were really bad and I was unable to experience pleasure, and everything we were seeing on the vacation was so boring it was making me sad, and I did not want to talk to anyone. I started drinking tons of rum and the last night i ended up in the brig below deck because I was picking fights, which is completely out of character for me but Iw as feeling desperate and morbid.

Of course I got back home and realized something was seriously off when I couldn't get even a small erection and everything down there was a fraction of the size and turning bright blue. That part was bad enough, but I ahd trouble caring because hoenstly I was much mroe cocnerned with my mental state which had completely gone on the lamb. Everything made me unspeakably sad, I couldnt hang out with friends or family because no one wanted to talk to me. I could not laugh at movies and was tired all the time, I couldnt get any rest, I couldnt eat, etc etc. Im sure youve all hear the horror stories.

problem is, I took high dose finasteride when I was not even 19 years old yet, and Im sure that's why I got hit so bad. I have an abnormally sensitive system as it is, but finasteride really jsut annhilitated my health and tore down my whole life. I am thankful to have found authentic scientific based health through Ray Peat and Danny Roddy, which is really the sivler lining here, but still I will never get those 3 or 4 miserable years of my life back.

Life moves on, however, I am not gonna be the one to wait around for it to come back.
I do understand you my friend but people in propeciahelp forum were crazy only about erections... Sex is important but I think mental state is much important because you need to interact with people around you and you have to take care emotionally your partner or family... Mental mayhem can kill you on spot and lack of erections is only frustrating at some degree(don't deny sexual well being is important)... But I think pfs guys(some) should first look for psychological and neurological solutions than simple measuring their success in recovery by the moments they have erections...
 

sladerunner69

Member
Joined
May 24, 2013
Messages
3,307
Age
31
Location
Los Angeles
I do understand you my friend but people in propeciahelp forum were crazy only about erections... Sex is important but I think mental state is much important because you need to interact with people around you and you have to take care emotionally your partner or family... Mental mayhem can kill you on spot and lack of erections is only frustrating at some degree(don't deny sexual well being is important)... But I think pfs guys(some) should first look for psychological and neurological solutions than simple measuring their success in recovery by the moments they have erections...

The hormonal insufficiencies that cause erectile disfunction also cause the cognnitive problems and the depression so yes
 

REOSIRENS

Member
Joined
Jan 4, 2017
Messages
339
Location
Europe
I can see preg levels being somewhat higher post treatment only because if the 5AR is still down regulated, the preg doesn't really have many other areas to go (or the cortisol, estrogen, stress route). It was a very small study, but at the same time many PFS people have thyroid issues and high cortisol and how can preg be high if in a hypothyroid type state? Many people PMed me saying that had low preg levels along with prog levels.

What I did find interesting from the study is in bold though:

  • levels neuroactive steroids CSF and plasma seven post-finasteride patients compared with twelve male, age-matched healthy controls.
  • comparison healthy controls, post-finasteride patients presented different neuroactive steroid pattern both in CSF and plasma.
  • - 1 shows the levels PREG, its metabolite PROG, levels of the further metabolites, DHP, THP and isopregnanolone.
  • reported, levels PREG significantly increased CSF and plasma of post-finasteride patients.
  • On the contrary, PROG was significantly decreased in CSF but unchanged in plasma.
  • DHP, THP and isopregnanolone were significantly decreased in CSF post-finasteride patients with levels under detection limit.
  • DHP and THP significantly decreased plasma, levels of THP under detection limit.
  • - 2 shows the levels DHEA, its metabolite T, levels of the further metabolites, DHT, 3 -diol, 3 -diol and 17 -E.
  • reported, DHEA levels both in CSF and plasma; on the contrary, CSF and plasma of post-finasteride patients levels T significantly increased.
  • levels of the first metabolite T, DHT, were significantly decreased in CSF but unchanged in plasma; levels of the further metabolites, 3 -diol and 3 -diol were significantly increased in plasma.
  • plasma, levels of 3 -diol CSF significantly increased.
  • Levels 17 -E were significantly increased in plasma CSF

So isopregnanolone decreased, but pregnenolone increased? Any idea why? They also mention significantly lower DHT levels, but many people have normal DHT levels still with sides. Also the study you posted shows higher levels of T PFS, when haiduts study above shows lower T? And I guess the best way to increase THP would be progesterone.
Sometimes pregnenolone is high in people under intense stress it is body mechanism in dealing with stress or stressors... Ssri rise allopregnenolone increasing physiological stress by overloading your system with serotonin excitation... even dhea is high sometimes in people with massive depression...Body try to bring up all nutrients that are necessary to fight stress
 

REOSIRENS

Member
Joined
Jan 4, 2017
Messages
339
Location
Europe
The hormonal insufficiencies that cause erectile disfunction also cause the cognnitive problems and the depression so yes
Yes my friend... But I wanted to say is that your system after propecia or ssri will run on surviving mode because of physiological damage... So it will first try to have cellular energy ATP for most essential things on daily basis life and not canalize to sex or erections... It will try to provide first brain a muscle and some other important organs with raw materials to help you survive day by day and then when you are healed specially neurologically it will start to share some of nutrients with other systems to provide you a wholesome well being... But it happens one step at time... Not sexually first and then emotionally/neurologically later... Some pfs guys want to be sex machines straight away and most of time just to masturbate to fight anxiety
 

TubZy

Member
Joined
Sep 30, 2016
Messages
1,649
Location
USA

Why did you delete, I thought that was a good hypothesis. Funny you mention T3 and progesterone ppl recovered from. I have been getting the same positive effects from prog+DHEA compared to high dose oral preg which leads me to believe the benefits from oral preg were from the prog increase. DHEA alone I get zero benefits from and progesterone alone helps but after a few days get anti androgenic symptoms, but when taken together feel much better.

When you said T3 and prog were they taken at the same time? i.e. like spaced out throughout the day?
 
Joined
Aug 18, 2015
Messages
1,817
Why did you delete, I thought that was a good hypothesis. Funny you mention T3 and progesterone ppl recovered from. I have been getting the same positive effects from prog+DHEA compared to high dose oral preg which leads me to believe the benefits from oral preg were from the prog increase. DHEA alone I get zero benefits from and progesterone alone helps but after a few days get anti androgenic symptoms, but when taken together feel much better.

When you said T3 and prog were they taken at the same time? i.e. like spaced out throughout the day?

i'm not sure what they did. i just know there has been at least 1, maybe 2 recoveries from people taking that route. i'd imagine the half life of progesterone is longer so it probably wouldn't matter. i'm thinking maybe the t3 would boost the DHEA side of hormones, the progesterone would save you from the increased stress.

i'm not really sure what is going on exactly... all 3 seem like a double edged sword in PFS and i still haven't figured out exactly what is going on. sometimes they will help, other times not so much. i think too much progesterone would not be good if you don't have good levels of things like DHT or T, and then thyroid in general can be a double edged sword if other areas arent taken care of. then pregnenlone is either helpful or hurtful, depending on how much stress is being generated and how much progeserone there is.

i dont think enough progesterone is being made, but just progesterone in general doesn't always make it work, it doesn't dock right or something, i'm not sure.

i don't know really, it is very confusing, i'm still trying to work through some stuff.
 

TubZy

Member
Joined
Sep 30, 2016
Messages
1,649
Location
USA
i'm not sure what they did. i just know there has been at least 1, maybe 2 recoveries from people taking that route. i'd imagine the half life of progesterone is longer so it probably wouldn't matter. i'm thinking maybe the t3 would boost the DHEA side of hormones, the progesterone would save you from the increased stress.

i'm not really sure what is going on exactly... all 3 seem like a double edged sword in PFS and i still haven't figured out exactly what is going on. sometimes they will help, other times not so much. i think too much progesterone would not be good if you don't have good levels of things like DHT or T, and then thyroid in general can be a double edged sword if other areas arent taken care of. then pregnenlone is either helpful or hurtful, depending on how much stress is being generated and how much progeserone there is.

i dont think enough progesterone is being made, but just progesterone in general doesn't always make it work, it doesn't dock right or something, i'm not sure.

i don't know really, it is very confusing, i'm still trying to work through some stuff.

Same, I know people that recovered from progesterone only as well. Only reason I didn't pursue it way back then was due to the anti androgenic effects. DHEA eliminates that for me though when I take it with the progesterone. Peat actually suggests the same thing actually. Progesterone takes care of the estrogen and the DHEA will convert to DHT. Thyroid in general would just be supportive and anti stress too. Peat mentioned that 10mcg of T3 per day isn't supprssive and could help reduce stress to return to homeostasis.. I never tried T3 in combo with progesterone though. Probably just keep supplementing progesterone allowing endogenous levels to slowly bounce back since it stimulates its own synthesis. I actually found prog+dhea to work better than 5a-DHP.

I have been doing oral prog based on that study that showed increase T, DHT and prostate size.
 
Joined
Aug 18, 2015
Messages
1,817
Same, I know people that recovered from progesterone only as well. Only reason I didn't pursue it way back then was due to the anti androgenic effects. DHEA eliminates that for me though when I take it with the progesterone. Peat actually suggests the same thing actually. Progesterone takes care of the estrogen and the DHEA will convert to DHT. Thyroid in general would just be supportive and anti stress too. Peat mentioned that 10mcg of T3 per day isn't supprssive and could help reduce stress to return to homeostasis.. I never tried T3 in combo with progesterone though. Probably just keep supplementing progesterone allowing endogenous levels to slowly bounce back since it stimulates its own synthesis. I actually found prog+dhea to work better than 5a-DHP.

I have been doing oral prog based on that study that showed increase T, DHT and prostate size.

how is it anti androgen? if it is anti cortisol and anti estogen, and that is it's main job, wouldn't it be pro androgenic? maybe just in very large doses? peat told me progesterone will increase libido.
 

LukeL

Member
Joined
Apr 4, 2016
Messages
217
Same, I know people that recovered from progesterone only as well. Only reason I didn't pursue it way back then was due to the anti androgenic effects. DHEA eliminates that for me though when I take it with the progesterone. Peat actually suggests the same thing actually. Progesterone takes care of the estrogen and the DHEA will convert to DHT. Thyroid in general would just be supportive and anti stress too. Peat mentioned that 10mcg of T3 per day isn't supprssive and could help reduce stress to return to homeostasis.. I never tried T3 in combo with progesterone though. Probably just keep supplementing progesterone allowing endogenous levels to slowly bounce back since it stimulates its own synthesis. I actually found prog+dhea to work better than 5a-DHP.

I have been doing oral prog based on that study that showed increase T, DHT and prostate size.
Are you taking the DHEA orally as well?
 

johnwester130

Member
Joined
Aug 6, 2015
Messages
3,563
Would progesterone and

androsterone be a good combo ?

To avoid the anti-androgenic effect of progesterone ?
 

REOSIRENS

Member
Joined
Jan 4, 2017
Messages
339
Location
Europe
Why did you delete, I thought that was a good hypothesis. Funny you mention T3 and progesterone ppl recovered from. I have been getting the same positive effects from prog+DHEA compared to high dose oral preg which leads me to believe the benefits from oral preg were from the prog increase. DHEA alone I get zero benefits from and progesterone alone helps but after a few days get anti androgenic symptoms, but when taken together feel much better.

When you said T3 and prog were they taken at the same time? i.e. like spaced out throughout the day?
Pregnenolone works with dhea...You have to check what is suitable for you... I do recommend 5mg dhea with 30mg pregnenolone... Pregnenolone alone only works in very low doses like 5mg or 10mg.... Pregnenolone works as well with thiamine combo to unlock memory
 

Similar threads

Back
Top Bottom