I seem to have been burned by long-term finasteride use and wondering what you might do in my shoes. I’m thinking to either try a restart, hold tight and wait, or maybe try TRT (which has a bad track record for a lot of people, perhaps due to 5AR / 3a-diol g issues). Some have clearly benefited. Above all, don’t want to make things even worse (hoping to try something intelligent and not turn myself into an experimental lab rat). I read this PCT finasteride recovery story (and similar stuff) which was interesting and had me thinking to post at T Nation. Here’s what I read: https://forum.propeciahelp.com/t/i-think-im-healed-after-six-year-nightmare/35477/2
Right now, I’ve got all the symptoms of hypogonadism (lack of motivation, very patchy beard, lack of libido, watery sperm, depression, anxiety, brain fog, et al). Really, I could live with all that shit, though it sucks. But the one that bothers me above all is very severe ED. Can only get erections under perfect conditions and they go away pretty fast (zero spontaneous erections, no nocturnals, max does Cialis doesn’t really work?). I’m wondering if long term DHT deprivation has degraded things to a point of no return where I’m totally fucked. The details of this recovery story is similar to my situation (he kept on the drug after problems arose, not making the connection), and he recovered naturally after 4/5 years. Many or maybe most don’t recover though: https://forum.propeciahelp.com/t/fully-recovered/3714
Timeline of Notable Events
Almost 9 years ago: Started Propecia and took it continuously for about 7 years.
Noticed watery semen almost immediately. Read online it was “normal” and “reversible” upon quitting and so soon forgot about it. Perceptible sex drive increase noticed, probably from the extra free T and much lower DHT.
About 5 years ago: Had a failed double jaw surgery that added a lot of stress. Pretty clear bone loss for lower jaw to support soft tissues. Would like to eventually sort that out.
About 4 years ago: Unexplainable and noticeable decline in motivation / ambition in life. Major “burnout” that remains today, probably increased over time.
About 2 years and 3 months ago: Noticed slightly weaker erections, thought might be stress related.
About 2 years ago: Losing erections during sex and very high anxiety.
Early September 2018 (About 1.5 years ago): Decided to get off finasteride completely.
To date: Symptoms remain (including watery sperm, severe ED (but not totally impotent), penile rotation on axis, curvature when erect (which isn’t often), maybe some thinning/low temperature. But it’s not typical peyronie’s. Multiple doctors believe I’m “normal”).
Available Labs (as mentioned, completely off Finasteride since early September 2018)
*Elevated IgA - 346 mg/dL; 47 - 310 mg/dL (think it suggests an auto immune which runs in family).
The following lab results aren’t pasting all that great, but some of the issues below are LH - dropped on last test to 2.8. Total testosterone dropped on last test to 355 (150+ point decline in just months), low free t percentage despite normal SHBG / Albumin. Possible elevated thyroid issues, though in range.
||May 2019|August 2019|February 2020|Ranges|
|SA (Prostate?)||1.16 ng/mL||0.00 - 4.00 ng/mL|
|Estradiol||23 pg/mL|21 pg/mL|< OR = 39 pg/mL|
|FSH||4.7 mIU/mL|4.3 mIU/mL|1.6 - 8.0 mIU/mL|
|LH||3.9 mIU/mL|2.8 mIU/mL|1.5 - 9.3 mIU/mL|
|Prolactin||11.0 ng/mL|10.4 ng/mL|2.0 - 18.0 ng/mL|
|Testosterone|444 ng/dL|512 ng/dL|355 ng/dL|250 - 1,100 ng/dL|
|Testosterone, Free|81.7 / pg/mL|66.1 pg/mL|Result Pending|46.0 - 224.0 pg/mL|
|Testosterone Bioavailable||135.9 ng/dL||110.0 - 575.0 ng/dL|
|Sex Hormone BG||35 nmol/L|Result Pending|10 - 50 nmol/L|
|Albumin||4.5 g/dL|Result Pending|3.6 - 5.1 g/dL|
|TSH||2.55 mIU/L|2.59 mIU/L|0.40 - 4.50 mIU/L|
|Free T3|||3.0 pg/mL|2.3 - 4.2 pg/mL|
|Free T4||1.1 ng/dL||0.8 - 1.8 ng/dL|
|Dihydrotestosterone||32 ng/dL|Result Pending|16 - 79 ng/dL|
|Vitamin D||60 ng/mL|64 ng/mL|30 - 100 ng/mL|
|3 Alpha Diol G|||Need to go test||
All CBC / annual physical labs. Nothing notable there.
I take Cialis at night, doubt it’s doing much though.