Source
r/tressless•
underlying_unity

Persistent erectile dysfunction after 7 months of stopping finasteride

Finasteride/Dutasteride

What do i do? Am I completely fucked?

I started having ED just 3 days into this medicine. Once I went for vacation and forgot finasteride and the side effects went away immediately after few days. But then i came back and continued this drug for few more months (total of 6) and after stopping it, i still can't get it up! After a few months i started feeling restless leg syndrome. And started to feel a little depressed and anxious. Now the RLS is fine due to medication by a psychiatrist. But i still don't feel my dick : (

Posted Mar 31, 2020, 12:41 PM UTC · edited

1567
goregego•

Your balls will start shrinking until they're a size of a pea and then you'll grow a huge vagina between your nipples

your comment 10 months ago making fun of someone asking about fin sides

39
underlying_unityOP•

😂😂😂

13
GreenDrake007•

Sorry to hear of your issues. I'm debating taking the plunge with fin and have done quite a bit of reading on it. The other day I read a study of PFS and doctors examined men who had taken fin and those who never had. The conclusion was that they could find no differences in their hormone profile or any other metrics between the groups. The doctors ultimately decided that men with PFS most likely were just suffering the effects of clinical depression, which can cause symptoms such as you describe.

Have you had a full blood workup to check for any deficiencies in your hormones?

12
Rinkmaster1•

This might be the paper you mean:

Basaria S, Jasuja R, Huang G, et al. Characteristics of Men Who Report Persistent Sexual Symptoms After Finasteride Use for Hair Loss. J Clin Endocrinol Metab. 2016;101(12):4669-4680. doi:10.1210/jc.2016-2726

This study compared three groups: 1) former finasteride users with adverse symptoms after stopping; 2) finasteride users without symptoms; and 3) healthy controls. They looked at outcomes including sexual function, cognition, hormone levels, body composition, brain activity and gene sequences.

For people who had adverse symptoms after finasteride, they found impaired sexual function, higher depression scores, more negative affect and more cognitive complaints. Other areas were not significantly different, except the following: brain activity in fMRI scans showed "abnormal function in brain circuitry linked to sexual arousal and major depression."

Later in the paper:

These 2 fMRI experiments suggest that there are underlying neurobiological abnormalities in symptomatic finasteride users, which can be linked to circuitry that has been implicated in both depression and in sexual arousal.

It doesn't mean the group is simply depressed; it means that abnormalities observed in brain activity involved circuits that have previously been linked to depression and sexual arousal. Keep in mind that while fMRI is a powerful tool, it's based on blood flow in the brain, so it's only one view of brain activity. If we see activation in the same circuits, that's worth looking into, but it definitely does not mean the post-finasteride condition can be reduced to depression and "psychogenic" sexual dysfunction (psychogenic meaning due to psychological factors).

The study didn't find differences in gene expression of SRD5A1 and SRD5A2, which are involved in producing 5-alpha reductase (the enzyme which finasteride inhibits, which is involved in metabolism of hormones).

It was a sophisticated study, but not definitive. They acknowledge a limitation:

...we cannot exclude the possibility of variations in other genes or in the gene expression levels in other tissues or specific brain regions involved in regulation of mood and sexual function. It is also possible that finasteride may exert epigenetic effects which may account for persistent symptoms.

Also, while they did not find differences in androgen levels, it is possible that the differences only show up in downstream metabolites of DHT. Roberto Melcangi and colleagues in Italy are looking closely at these downstream metabolites (there are many as the metabolic pathway is complex and not fully understood).

On a forum for post-finasteride users, many find that T levels are in normal range, suggesting that the problem is farther downstream.

While the Basaria et al. study is noteworthy, there are a number of plausible explanations that were not considered. The research continues.

For more research on adverse effects of finasteride, see: finasteride.network

3
GreenDrake007•

Yes thats the study I referenced. Sorry, I wanted to link to it this morning but was at work and didn't have time to search for it.

Are you basically thinking that finasteride's suppression of DHT is causing the brain to be rewired? I suppose it's certainly possible. But it could also be possible that depression is doing the same. Depression is often associated with some sexual dysfunction. This would create a 'chicken or the egg' quandary. However, as mentioned, further study of downstream DHT products is needed, and could go a long way toward settling the matter.

1
Rinkmaster1•

I wouldn't use the term "rewired," and I couldn't pinpoint it to a particular point in the metabolic process such as DHT. I would call it a disruption in the metabolic pathway that (in normal conditions) looks like this—and I know this is crude:

T [via 5-alpha reductase enzyme] -> DHT -> androgen receptors -> neuroactive metabolites -> sexual organs and functions

When working correctly, it's a complex cascade of reactions and substances that regulates itself through waking hours, sleep, sexual arousal, stress and so on. My hypothesis is that in PFS, this system is disrupted. It can no longer function and no longer regulate itself. So the body just does the best it can amid disruption to the various functions governed by this neuroendocrine system.

The best knowledge on this would be in recent papers by Traish and Melcangi which you'll find here: finasteride.network

We still lack a good understanding of the whole pathway, and only have hypotheses about what goes wrong in PFS. It could be many different things including levels of hormones/metabolites, receptor functioning, epigenetic modifications or something else.

My hypothesis about the cause is that the cumulative effect of finasteride over the long-term, or stopping the drug after taking it for a long period, disrupt the equilibrium so that it can no longer regulate itself. (There is another class of cases who develop severe and complex symptoms after taking one pill or a few—this group has high and immediate susceptibility for some reason.)

Let me step back and talk about how medicine tends to look at sexual dysfunction. It is often considered "psychogenic" as you are suggesting: someone gets depressed or worried, or has low self-esteem, or has been through a lot of stress lately, and can't get an erection or perform sexually as well as normal.

This is one reason someone might develop ED.

There can also be non-psychological causes of erectile dysfunction, for example prostate surgery. There might be still other reasons for ED such as a neuroendocrine system that is not functioning properly. Neuroendocrine disruption could conceivably cause both erectile dysfunction and depression. In this scenario, it's not ED causing depression, or depression causing ED; rather, there is a prior cause for both conditions. In my opinion this is the most promising hypothesis for what's happening in PFS patients.

One reason I think so, is the common report of numbness in the penis, a symptom which I have. A second is persistent low libido. I have been very depressed before ever taking finasteride, but it never curtailed my libido or sensitivity of the genitals. By now I've had numbness in the penis and no libido continuously for the last seven years. Have I been depressed? For a while I was when I realized what had happened, but I haven't been for years.

So if someone wants to explain sexual symptoms after finasteride as a function of depression, they need to explain why there are people with PFS symptoms who are not depressed or anxious and have no mental health history. They would also need to explain the loss of feeling in the genitals (Melcangi's group measured abnormal responses of the pudendal nerve to stimulation).

Numbness in the genitals is not, to me, a plausible result of depression. And by the way animal studies have indicated that finasteride can cause changes to penile tissue (see Traish 2020 in bibliography).

Medicine tends to have crude categories where phenomena must be either "psychogenic" or physiological. I believe Melcangi and Traish are onto something by looking at this as a neuroendocrine phenomenon. Neuroendocrinology affects the brain, sexuality and physical systems. So it is plausible that a disruption to the neuroendocrine system would have the constellation of cognitive, sexual and physical side effects that we see after discontinuing finasteride.

2
[deleted]•

[removed]

1
underlying_unityOP•

No. But if you're loosing hair you should definitely hop on finasteride it stopped my hair loss and even after 7 months of stopping it my hairline is still the same! (hasn't receded further!)

Just see if you get the side effects and if you do get, stop taking it or reduce the dosage to 1mg every other day best of luck

2
GreenDrake007•

Yeah I've been taking topical fin and min for 4 1/2 months and it has stopped my hair loss completely. But I'm thinking maybe if I take the pill too I can get better regrowth. Then maybe eventually quitting the oral and just stick with topical for maintenance. I'll start at a low dose and will drop it quick if I see any sides.

2
underlying_unityOP•

Regrowth is usually very low, just get a hair transplant. I'm from Asia and in my country hair transplants are cheap. I'll get one to get a NW0 hairline 😎 my mom agreed im just NW2

2
GreenDrake007•

I don't need much regrowth, but I want some. I think since I'm using the formula 82f already, and have seen my hair fall completely stop, maybe the added oral fin will allow the minoxidil in the formula to regrow me some hair. If I add the oral pill and don't see any difference at 6 months use, I'll consider the surgical route. My cousin, with 1mg fin taken every other day and no minoxidil has regrown a substantial amount of hair.

1
CherryNoUta•

Really cool that you don't say stuff like "jesus christ this pill ruined my lyfe!!!!!111" and stuff. There were people here who got stuff 100 times worse than you from 1 pill lmao (and it was permanent too!)

Overall, your health will almost definitely go back to where it was before and you can say that at least you tried to take fin, instead of saying "this stuff kills dick" and that's it

2
wannaachievemygoals•

If your hairline is still tthe same that means fin has killed 5ar enzyy permanently. Get your dht levels checked.

1
underlying_unityOP•

Ohh fuck

1
wannaachievemygoals•

You can't fuck now, sorry. Start taking cialis and horny goat weed 😅

1
Low_Singer•

bro fin only kills one type of 5ar which produces around 70% of your blood dht. For sure his remaining 5ar should still be shooting good and strong hair killing dht molecules unless his destined pattern has been reached.

1
Rinkmaster1•

Am I reading this right? Finasteride gave you all these side effects, and they aren't going away, and you're advising other people to take it?

There are plenty of reports that people start to get side effects, then stop, but the side effects don't go away. For some, like me, they persist indefinitely. As I mentioned elsewhere, there is no known treatment to fix it.

1
potatoptats•

I have always struggled with depression and when i started taking fin and underwent a depressive episode i would instantly blame it on the fin but then i'd be like bitch u've always been like that and continued taking it hehe nocebo's a bitch and the whole mass hysteria around corona is bespeaking why people are bound to experience psychosomatic symptoms on it like just take it and shut up live la vie and forget about it pffs

1
z0mbielol•

Mine got better over time (took me around 9 months), but yeah. Drug is poison. My sides came on after about 1.5years, to all the people who say "I take it and I am fine." after taking it for a couple of months

Just wait...

Remember the earlier the quit generally the better before it gets too late.

11
Rinkmaster1•

Remember the earlier the quit generally the better before it gets too late.

This is right. The longer you take finasteride, the higher the risk of getting sexual and other symptoms, either while taking it or after stopping. These symptoms can be persistent (i.e. they don't go away).

Here's the paper that found this:

Kiguradze T, Temps WH, Yarnold PR, Cashy J, Brannigan RE, Nardone B, Micali G, West DP, Belknap SM. Persistent erectile dysfunction in men exposed to the 5α-reductase inhibitors, finasteride, or dutasteride. PeerJ. 2017;5:e3020. doi:10.7717/peerj.3020 | PeerJ site

5
underlying_unityOP•

You took the drug for how many months? And did you experience ED side effects while taking the drug?

1
z0mbielol•

18 months, and yes worsened the longer I was on it until it was unbearable.

2
underlying_unityOP•

Hooh i just took it for 6 months that means i can recover :)

My sides came on after about 1.5years

What does this mean? You took it for 1.5yrs and?

1
z0mbielol•

It means my sides came on later on, didn't get them early.

​

You can recover for sure.

2
proactivelad•

Also not to mention that people usually have libido spikes, ups and downs without finastiride. But its so easy to pin it to the drug when that happens. Drug might enhance the libido drop too since you have less androgens in your body.

1
Low_Singer•

I kinda experienced that. started taking fin in October 2019 and my libido was already pretty dead due to University stress. But like over the course of the past 6 months my libido just got progressively stronger. I now literally feel almost the same way I did when I was 15 and have strong boners.

why

1
proactivelad•

If you maintain healthy lifestyle and was already side effect free once you started taking the drug, you shouldnt have long term sides (my opinion). ED can come if you have a bad diet over time and increase your body fat % which will increase your estrogen. Also cycling this drug is not a bad idea either, every 10 months get off for 1-3 months

0†
z0mbielol•

I am a marathon runner, but yeah thanks for your input. My Vo2 Max is over 55.. in the top 5% for my age, fitness health is not the issue.

Pretty sure my diet also didn't turn my semen into water.

2
proactivelad•

I see. The only thing that i can think of would be overtraining to the point where your T drops too low. If i were you i would ve done a bloodwork for all the sex hormones. Most of the times you can find the answer there and correct it with the help of your endocrinologist

1
mintylove•

Your VO2max means fuck all about your (neuro)endrocrine system though. You can be the best marathon runner and have a shit hormonal profile.

1
Rinkmaster1•

I took finasteride from about 2008–2013 when I started noticing some sexual side effects such as numbness in the penis and delayed ejaculation. Like you, I went off it for a while, then back on. When I went back on the adverse effects got worse.

Then I stopped taking it. Some weird stuff started happening like night sweats, occasional vertigo, total loss of sexual desire and numbness of my penis.

That was seven years ago. Unfortunately, the sexual side effects have not improved since and are still present today. My hair has also become dry, like straw. Before this, I had always had very high libido and zero sexual problems for my entire life to that point.

I have reluctantly delved into the science and medical background, and here's what I can report:

  • Finasteride inhibits an enzyme (called 5-alpha reductase or 5-AR) that converts T into DHT. By reducing available DHT, it is supposed to slow hair loss (supposedly). I'll come back to hormonal changes below.
  • Some people have an immediate adverse reaction to even 1 to 5 pills, and get side effects that don't go away after they stop.
  • Some other people initially tolerate it, then get some side effects, then they stop and the side effects persist (like me).
  • The core side effects come up over and over again in reports from people who take finasteride: loss of libido (sexual desire), loss of sensitivity in the penis, reduced volume of semen, watery consistency of semen.
  • Some get a wide range of other side effects including insomnia, skin issues, muscle atrophy, receding gums, tinnitus, vertigo, dry hair, dry eyes and cognitive difficulties.

You might be thinking, whoa that is really weird stuff, how can one pill, taken by so many men, cause all those symptoms? Maybe they're making it up; they're just depressed and blame it on finasteride.

But the case reports have been flowing in for over ten years. And the scientific research is starting to zero in on what's going on. Not all doctors and researchers have accepted this, but some have (see bibliography here).

We don't know exactly what's going on, but at a high level, in some men, finasteride seems to disrupt the way the body metabolizes hormones. We know that DHT and its metabolites are key for sexual development and maintaining sexual function. There are a few hypotheses about what's changed: maybe the 5-AR enzyme can't be made any more so that DHT can't be produced. Maybe the androgen receptors don't work anymore. Maybe the metabolism is broken farther downstream, disrupting normal brain, emotional and sexual function.

There is no known treatment for this condition. It is a lot like accelerated aging, where the body of a young man starts to function like that of a 70-year-old man.

There are treatments that aging men take for losing their sex drive, and post-finasteride patients try the same things. These include HCG (a hormone), DHT cream or a DHT analogue called mesterolone. But none of these treatments work reliably. People have also tried many supplements, exercise, fasting, diets—hundreds and hundreds of things. There have been some recovery stories but my impression is that if symptoms are still there after 6–12 months, recovery is less common.

What does this mean for you now? Having been through this myself, I'd advise to see how you can adapt to your current situation without letting anxiety and depression set in. Exercise, eat well, maintain relationships, direct your life energy to other things. I would be thrilled if you recover, and it could happen. But symptoms may not get better over time, and again, there is no known treatment.

​

Research

It might not be helpful to you to look at the scientific research right now, but I do want to provide references to show that the above is based on published literature. The literature is not all in agreement about the details, but the evidence is piling up. The literature on sexual side effects of finasteride goes back almost 30 years.

Bibliography: finasteride.network

Papers to look at: Traish (2020) and Kiguradze et al (2017).

Traish: "...use of these drugs is associated with development of sexual dysfunction, which may persist in a subset of men, irrespective of age, drug dose or duration of study..."

Kiguradze et al.: "Risk of PED [persistent erectile dysfunction] was higher in men with longer exposure to 5α-RIs. Among young men, longer exposure to finasteride posed a greater risk of PED than all other assessed risk factors."

See also page 2 of the patient information sheet for Propecia:

https://www.merck.com/product/usa/pi_circulars/p/propecia/propecia_ppi.pdf

3†
underlying_unityOP•

WTF 7YEARS!!! Im scared af now

2
personwquestions•

Did ur sides go away after stopping the first time? Do you think ppl who try taking fin again are more at risk of long term problems?

1
Rinkmaster1•

Did ur sides go away after stopping the first time?

I don't remember. Probably not. It is actually the *discontinuing* that seems to disrupt the system. (One hypothesis: when the 5-AR inhibition of finasteride stops, DHT levels increase and the receptors get disrupted by this rapid change. After that they can no longer function.)

​

Do you think ppl who try taking fin again are more at risk of long term problems?

Yes. Although this specific on/off/on pattern hasn't been studied, people who go on and off are probably greatly increasing the risk because these can be shocks to androgen metabolism. It seems some have metabolism that is particularly sensitive to these shocks. Because young men with high libido sometimes report the strongest adverse reactions, perhaps higher hormone levels make one more sensitive to finasteride.

So yes, I do think going off and back on would increase the risk of persistent sexual dysfunction.

2
[deleted]•

[deleted]

3
bigmistake_138•

I'm going to chime in here and say yes i've been dealing with PFS sides for about 5 months now. Debilitating insomnia and pretty drastic ED. Never had one sexual problem previously. Sure PFS is likely rare but we still don't know the risk and there is no way to tell if you're at risk. The juice ain't worth the squeeze in this case folks, please reconsider finasteride.

3
DonJuan_69•

Avoid porn and masturbation. Talk to ur doctor about daily cialis. I take 2.5mg

2
underlying_unityOP•

I can't get it up and I dont feel any desire for porn and masturbation at all. I'm really worried how will I make kids. You say cialis can bring back my libido? Ok i'll research cialis thnx

3
proactivelad•

In order for Cialis to work you need to have libido first. Cialis doenst give you libido in any way, just helps you have rock hard errection when you are already horny. Actually, in my case, masturbation brings me much more libido. If i dont masturbate for a long time i dont feel like masturbating at all.

Actually my advice would be the opposite, try watching porn and getting it off. Once you get into it you will feel more need to masturbate. Buy Zinc picolinate or gluconate and vitamin D3. Zinc picolinate 100mg - 200mg depending how much you have zinc in your body. Vitamin D3 5000units every day. Good luck my friend, i hope you get your shit back in no time

4
DonJuan_69•

Steroids took my libido away. And i quit masturbating and started taking cialis daily.

2
MrBaldThrowAway•

I seem to suffer from low-grade ED too and I have very low libido and I haven't even taken Finasteride, and I really want to try Cialis Daily but it's not available in my country so they just prescribed me four 10 mg pills and it's not AT ALL what I want. The high dosage is too much for me because I don't like taking pills that give a clear physical effect (you can get bad migraines, feel congested, etcetc), and 4 pills for $65? That would probably lead to more planning around sex which is hard when you actually want to date people etc. The doctors clearly didn't believe that my issue is real as well, or well, they didn't take me seriously I should say.

I'm 28 and I'm too scared to even date because of this. Like I used to have anxiety relating to sex before (like performance anxiety) but it was fine whenever I was by myself which meant that yeah, If I couldn't keep it up or get it up it was mental, but now I rarely even get a full erection when I try to jerk off. If i'm with someone else I usually get it up properly but lose erection mid-intercourse, and if I somehow manage to maintain an erection I usually can't cum anyway.I don't feel much in the form of sex drive and it's hard for me to even feel attracted to anyone more than "yeah she looks good", but it's less like "yeah I want her" and more like "yeah I see the appeal" and I don't want to live like that.I had terrible self-esteem even BEFORE this and now it's just... too much.Annoying as hell. Have taken a bunch of blood samples and testosterone is fine (actually twice as high now compared to two years ago), prostate is fine, i don't have diabetes, and they tested for... blood fats? or whatever it's called, and it was perfect. I have a bunch of mental health issues though so I mean it could be somewhat related to that, but I doubt it's the whole truth. I watch porn but not that much and it's mostly because I have zero visual imagination and I still need to cum to get that dopamine release.

3
CherryNoUta•

forgot finasteride and the side effects went away immediately after few days

Maybe you still can't get it up and stuff because you're worried? Earlier it took only few days because you weren't using it for a long time and you simply didn't care (forgot). After 6 months, it will take a bit longer but that should be it. That is, unless you were constanlty worrying about that. I'm not a doc tho

2
underlying_unityOP•

I'm not worrying. It's nothing to do with my anxiety. It's just as you said that

After 6 months, it will take a bit longer but that should be it.

👍

2
potatoptats•

I take fin and i even got hornier tbh

2
msu_mdriskill•

Same fucking thing - a little annoying to tbh.

2
Low_Singer•

right here, people say it's an initial increase in test but like I'm 6 months in and want to fuck everything so bad.

1
Robearito•

You need to talk to a doctor if you want your dick back.

2
Ansonm64•

Welcome to the club buddy. There’s lots of sources for cialis on line and it’s actually pretty affordable.

2
PoopyPie1234•

I’ve had persistent sides for 3 years now. It’s definitely possible and known as “post Finasteride syndrome.”

2
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1
rfb44•

How much were you taking and what was the frequency?

1
underlying_unityOP•

1mg everyday

1
Vtron89•

It took hurt a few days for nipple sensitivity to occur for me... On a dose of 0.01mg per day. It's a powerful drug man. I hope it brings our hair back... Lol

1
Sufficient-Assistant👹BEASTGAINS👹•

Idk what's your situation but resting animal products can give your ED as it limits the blood flow to the body.

1
[deleted]•

[deleted]

1
TraditionalCoffee•

I’m going to put my money on porn addiction.

0
impel203•

Porn addiction has no relation to ED

1
TraditionalCoffee•

Read a book mate.

1
impel203•

What book is this? 😂

1
Englishface•

Yes, yes it does.

1
impel203•

No it doesn’t 😂 in what way?

1
Englishface•

Google is your best friend, try it.

1