Post-finasteride syndrome, post-Accutane syndrome, post-SSRI sufferers

[tobenormalagain]

Sadly, I have taken both; SSRI and Finasteride; SSRIs (many different Rxs and for quite a few years), Finasteride (sporadically and for a year or so). What makes me soooooooo frustrated is that I am very healthy (I exercise consistently 4 X/week) 55yo, fit/athletic body, normal testosterone, normal lipids, no hypertension, no diabetes, no smoking. However, I have suffered ED since my 30s and I am absolutely convinced that it is not an organic problem (equipment works...er, sometimes). What's maddening is that there is just no rhyme or reason to my ED. I can have a rock hard erection 15 minutes before sex and when it's show time...nothing, zip, nada??? No amount of stimulation or imagery can get it back. PT-141 has had only minimal results, the same for Viagra/Cialis. Trimix, although effective, gave me a curvature and scared me away from ever trying again. I have consulted a urologist and been approved for an implant but man, I just really, really don't want to go that route:(

[Simbarn]

Sadly, I have taken both; SSRI and Finasteride; SSRIs (many different Rxs and for quite a few years), Finasteride (sporadically and for a year or so). What makes me soooooooo frustrated is that I am very healthy (I exercise consistently 4 X/week) 55yo, fit/athletic body, normal testosterone, normal lipids, no hypertension, no diabetes, no smoking. However, I have suffered ED since my 30s and I am absolutely convinced that it is not an organic problem (equipment works...er, sometimes). What's maddening is that there is just no rhyme or reason to my ED. I can have a rock hard erection 15 minutes before sex and when it's show time...nothing, zip, nada??? No amount of stimulation or imagery can get it back. PT-141 has had only minimal results, the same for Viagra/Cialis. Trimix, although effective, gave me a curvature and scared me away from ever trying again. I have consulted a urologist and been approved for an implant but man, I just really, really don't want to go that route:(

Finasteride is a horrible drug. It should be taken off the market for cosmetic use. DHT is so important for all men of all ages. Many of the actions of testosterone in the body are actually mediated by DHT. Playing with hormones in the body for cosmetic use is IMO irresponsible medicine. There is now scientific evidence in the animal model that Finasteride does damage the erectile tissues over time. What this means is that even for the men taking the drug who do not fall prey to its sudden sexual dysfunction side effect will most probably slowly suffer with weakening erectile function earlier on in life than what they would have without using the drug. This will first manifest with the need to take PDE5i and then the use of these will stop being effective. The bad effects of oxidative stress will occur earlier in life in the erectile tissues.

Did your ED problems predate the use of Finasteride? Are you experiencing the same problems with masturbation?

[steamfitter]

I believe Finasteride, Isotretinoin (accutane), and SSRI should all be banned. It just goes to show how completely corrupt big pharma is that these things are still on the market and handed out like candy by so many doctors.

[1380anthony]

I have PfS and the problem relies more on the erectile tissue and probably the limbic system. It is horrible!!! I think the only thing the cire erectile tissue is shockwave.

[Flavio]

[...] Finasteride is a horrible drug. It should be taken off the market for cosmetic use. DHT is so important for all men of all ages. Many of the actions of testosterone in the body are actually mediated by DHT. Playing with hormones in the body for cosmetic use is IMO irresponsible medicine. [...]

I agree with Simbarn and steamfitter, finasteride is a dangerous drug and may impact your sexual performance.

The big question is how important is DHT? Many users claim that DHT is 'useless' and a trash hormone but every doctor I've spoken to said the exact opposite.

Same thing with SSRIs: lots of side effects, incl. ED. I remember an episode of The Sopranos about Prozac and the effect it had on Tony Soprano's sex life.

[Simbarn]

[...] Finasteride is a horrible drug. It should be taken off the market for cosmetic use. DHT is so important for all men of all ages. Many of the actions of testosterone in the body are actually mediated by DHT. Playing with hormones in the body for cosmetic use is IMO irresponsible medicine. [...]

I agree with Simbarn and steamfitter, finasteride is a dangerous drug and may impact your sexual performance.

The big question is how important is DHT? Many users claim that DHT is 'useless' and a trash hormone but every doctor I've spoken to said the exact opposite.

Same thing with SSRIs: lots of side effects, incl. ED. I remember an episode of The Sopranos about Prozac and the effect it had on Tony Soprano's sex life.

I don't think its such a big question anymore Flavio. Its quite evident that DHT is important, but also, 5 alpha reductase is very important too, which Finasteride and its evil brother Duasteride strongly inhibit.

Do you think those “users” claim this just to make themselves feel better about taking the drug? I wonder where they get their information from? DHT is a very potent androgen, far more potent than testosterone. Testosterone is converted into DHT by the enzyme 5 alpha reductase in particular cells so that particular required actions of testosterone are carried out by DHT. Some of these actions are in the penis, keeping it healthy and thus maintaining erectile function. It is one of the hormones that masculinizes us. Doesn’t sound like a “trash hormone” to me.
It is quite possible that our body adapts when levels of this hormone are drastically reduced and perhaps some of the actions are taken over by testosterone to compensate. But this will most likely cause some adverse effects.
One of the very concerning effects is also the loss of particular neurosteroids in the brain that depend on 5 alpha reductase, most importantly Allopregnanolone. Finasteride and to a greater extent Duasteride stops the enzymatic conversion of progesterone into Allopregnanolone. This could have serious implications with depression and anxiety and may also be responsible in part for the sexual side effects seen in some men. It has been shown that post finasteride users show altered levels of neurosteriods in cerebrospinal fluid.
https://pubmed.ncbi.nlm.nih.gov/24717976/

I quote from: https://www.sciencedirect.com/topics/bi ... egnanolone
“Allopregnanolone is a neuroactive metabolite of progesterone. Allopregnanolone is synthesized from progesterone by the sequential actions of two enzymes, 5α-reductase type I (5α-RI), which transforms progesterone into 5α-dihydroprogesterone, and 3α-hydroxysteroid dehydrogenase (3α-HSD), which converts 5α-dihydroprogesterone into allopregnanolone. Allopregnanolone is a potent positive allosteric modulator of GABA action on the GABAA receptor. Allopregnanolone slows the rate of recovery of the GABAA receptor from desensitization and possibly increases the rate of entry into fast desensitized states. Allopregnanolone exerts neurogenetic, neuroprotective, antidepressant, and anxiolytic effects. Reduced levels of allopregnanolone are found to be associated with major depression, anxiety disorders, premenstrual dysphoric disorder, and Alzheimer's disease.”

Another good paper on the topic:
https://www.icurology.org/DOIx.php?id=1 ... 4.55.6.367

It could be that 5 alpha reductase inhibitors may change certain enzymatic conversions of progesterone and its metabolites in the brain long-term, causing depression and other mental health disorders. This could also explain some of the permanent sexual side effects such as the inability to feel any sexual pleasure, which may affect erectile function with regard to compromised erectile stimulation from the brain.

5 alpha reductase inhibitors appear to affect much more than just DHT.

[slipnslider]

My ED problems started after I took finasteride. My dick has very little sensation now.
I was also circumcised around that time (late 20's) which caused a great loss of sensation so it's hard for me to determine exactly what killed my erections.

I still get erections naturally sometimes. But not easily or frequently. And they dont stay hard enough long enough for sex.

Pills gave me bad side effects and were becoming less effective, so I've become reliant on trimix injections as the only way to have reliable, stress free sex. But the total inconvenience sucks. Having to travel with it sucks. And how long the erection lasts after sex is annoying and embarrassing. But it's better than not having sex.

I'd love to have an implant and just not worry anymore, but the recovery process seems like absolute hell. As does the frequency of problems and revisions. And the cost.

I had a nightmare last night that a hot girl invited me to a spontaneous orgy but I couldnt go because I didn't have my trimix with me. I'm 45 years old. Unmarried. I've spent almost 20 years fighting with my dick. Just wish I could be normal.

[Markc2008]

You pretty much hit the nail on the head with my experiences. Low sensation and the only way to have a reliable erection is pge-1 shot but it is embarrassing when two hours later I’m stressing whether my dick will go down.. not to mention my libido sucks.

[sogwap]

I have taken Paroxetine (Paxil) 10 mg daily to help with PE (Premature Ejaculation).

Would Paroxetine cause these problems that you are describing here? If so I will give my experience in using Paroxetine and its other side effects.

[Flavio]

[...] I can have a rock hard erection 15 minutes before sex and when it's show time...nothing, zip, nada??? No amount of stimulation or imagery can get it back. [...]

This sounds a lot like coital anxiety. I also battled this curse for many years.

Oral meds, a natural anxiolytic (Seredyn) and lots of patience worked well for me.