T Nation

TRT and BPH/Finasteride

So I was on TRT through a shitty clinic in Bali (where I live), They did very basic and incompetent blood work and whacked me on 250mg of Sustanon every 2 weeks.
A few months in I start getting trouble reaching orgasm, followed by severe ED and prostate issues.
I stopped the TRT, and had complete ED and loss of libido so I went on Nolvadex for 4 weeks and got some libido back and ability to get an erection on Viagra

The uroligist I went to for the prostate issues put me on Finsasteride which I’m still on.

So currently I have a slightly enlarged prostate which I’m on finasteride for and also I have some sex life, but it’s pretty ordinary and dependent on Viagra,

The thing is, I want to go back on TRT, I felt amazing on it, my sex life was unbelievable and being off it feels like half a life.

As far as I can tell you can be on both finasteride and TRT:
https://www.endocrine-abstracts.org/ea/0021/ea0021p43

And also my understanding is that my prostate growth was most likely triggered by high estrogen levels, so in theory after I’ve done my bloodwork I could possibly be on TRT as long as I control my estrogen levels carefully, perhaps by doing small doses more frequently, or possibly by using an estrogen inhibitor when i dose.

So my questions are, does this sound like a horrible plan and what part of the picture am I missing?

Btw I’m 48 years old, so enlarged prostate is the sort of thing u often get at this age or slightly older anyway.

Thank you for any replies!

The only horrible plan is not trying at all, men with lower testosterone have more aggressive prostate cancer than those with higher testosterone, there are many disease where low testosterone is the cause.

Smaller doses more frequently is key, the smaller the dosage, the lower the estrogen is the majority of cases.

Watch out for Post Finasteride Syndrome, once you have it there is no cure.

Atypical post-finasteride syndrome: A pharmacological riddle

Post finasteride syndrome (PFS) is a symptom complex which occurs in patients taking finasteride. This symptom complex can be physical, sexual, as well as neurological. The United States Food and Drug Administration approved the use of finasteride for benign prostatic hypertrophy (BPH) as well as androgenic alopecia (AGA) while dutasteride is approved only for BPH.[2] The exact prevalence of PFS is not documented so far. We describe a case of PFS with an atypical presentation in a patient treated with finasteride for AGA. The present case illustrates the atypical as well as so far irreversible nature of PFS in the patient as well as challenges in its management.

Post-Finasteride Syndrome

The Post-Finasteride Syndrome is a serious state of permanent sexual, mental, and physical side effects which do not resolve after quitting the drug. Most often, it is accompanied by an acquired form of secondary hypogonadism and post-drug loss of androgenic action, which remains highly resistant to hormonal PFS treatment. This is aimed at restoring Testosterone/DHT’s effects in the male body to pre-drug virility levels.

It is also surmised by the few specialists in the medical field that a type of receptor or “brain damage” has occurred. As often seen with such damage, recovery is very slow or now questioned whether possible at all. Needless to say, men suffering from PFS are plagued with any physical, mental, and emotional symptoms that have led to long term depression, marital problems and divorce, and now several reports cases of suicide.

I would be careful with finasteride, as in don’t take it if you can help it…

Yeah I’m aware and also there’s a pretty strong body of people who think Finasteride has caused penis shrinkage. I have tried coming off it but symptoms returned within a month and the constant need to urinate can pretty much ruin your life.
I have read that you can get the same effects with much lower dosages than 5mg, so thinking that might reduce the chances of complications down the road.

Cialis was approved by the FDA for treatment of benign prostatic hyperplasia, you could try this instead and see if it works.

I hadn’t seen that, I’ll research it and strongly consider switching, Obv I’m uncomfortable on finasteride. I’ve used alpha blockers but they don’t really do the job.

Get off finasteride, get on trt, either way you’ll be fine. There isn’t a cure for PFS but plenty of people respond well to proper TRT and avoiding overthinking things.

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