I was asked in a PM: "What is your view on DHT blockers like Propecia?"
Propecia is but one drug classified as 5-alpha reductase inhibitors.
I have something controversial to say. Bring on the debate.
These drugs are xeno-testosterones [I coined that], look at molecular structure. Transported as a steroid chemical to every cell nuclei in the body where gene expression is altered [well documented]. For a few, this created permanent epigenetic changes to DNA or to processes that transcribe the DNA, which might be secondary to other DNA expression changes. How can we trust that? One doc called out an alarm that these drugs can, even with a single dose, sexually cripple men. We have had a few young guys here who had hair loss who had their lives ruined. As they loose LH/FSH levels, it would seem that the hypothalamus is broken. But one would want to administer a trial of a SERM to better understand that. As steroid drugs can affect different genes, there may be changes beyond the obvious or expected. What other important steroid metabolism processes are shutdown? When these guys go on TRT, is there any effect that prevents TRT from working properly in terms of a response to restored T levels?
Why are some guys vulnerable to this damage? Probably from the natural variations in DNA methalization that expose some DNA for transcription and hiding many other genes in the DNA. This creates traits that go well beyond DNA code changes. These methalization changes can be trans-generational, responsible for some of the things that we inherit from our parents. It is well documented that women who were subjected to starvation during WW-II pass on effects that can be seen in their children and grandchildren. So a susceptible methalization trait can make one vulnerable to epigenetic changes that most would seem to avoid.
The 5-alpha reductase problem is probably a result of changes to DNA methalization. For some, this is DNA [expression] poisoning.
When you read about how some body builders can't recover after a cycle with what seems to be a permanent HPTA shutdown; consider that the high steroid doses can really accelerate hair loss. The use of 5-alpha reductase inhibitors in this group is wide spread. It is easy to connect the dots. Some of these HPTA disasters for body builders are from the 5-alpha reductase inhibitors, not from poor post cycle therapy [PCT].
Also consider a man who has an enlarged prostate. He is probably suffering from elevated E2 and declining T levels at his age and condition. That is a double hit on the E2:T ratio. If he is prescribed a 5-alpha reductase drug, if he is normal, the resulting drop in DHT levels can kill his already waning libido. If libido is dead, ED drugs will not work. DHT is essential for the development and maintenance of the sex organs and mission critical for libido. Some men will drop the drug in an effort to recover their libido and sense of being a male. A few of these will not recover to any degree. With a dead HPTA, their DHT levels will also remain low - what a benefit! With a known prostate condition, his doctor will probably then refuse TRT. There are effective prostate supplements that are safe and effective. It is a doctors job, it seems, to prescribe drugs, not supplements. And there is no way to get insurance or Medicaid to pay for the supplements. Only FDA approved [poisons] are allowed. Many who stop the drug, can recover and then manage their condition with a supplement type product.
For some 5-alpha reductase inhibitors are permanent chemical castration. They cannot make their wives pregnant unless they are on TRT. And if they are not using hCG [or a SERM - which has issues] fertility is then also in doubt or time limited.
We sometimes also see cases of permanent HPTA damage with deca only steroid cycles. I also regard deca as a dangerous xeno-testosterone for some. One can then regard all synthetically structured steroids as suspect. Many will use deca at it does not metabolize into DHT. Sounds hair friendly enough.
There is no way to know in advance who will be effected. The risks are not widely known, but even if they were, many young men are disposed to ignore risks.
5-alpha reductase inhibitor: http://en.wikipedia.org/wiki/5-alpha-reductase_inhibitor
5-alpha reductase: http://en.wikipedia.org/wiki/5-alpha_reductase
Also effect the nervous system: "Another function of the enzyme is participation in the creation of such neurosteroids as allopregnanolone and THDOC."