Finasteride/Dutasteride Sexual Side Effects Help

[Restoration87]

Hello All,

 

 

I am 24 years old and I have a slightly receding hairline and a bit of miniaturization in the crown.

 

I have been on generic proscar since Mid-March, and started noticing sexual side effects in September after that whole possibility was brought to my attention. I have noticed watery semen, weaker erections, and quite possibly testicular shrinkage/strange testicular sensations. I think some of this is real and some is psychological but it is hard to determine what is what.

I stopped the finasteride for a couple weeks, things seemed to get back to normal, and then resumed it again for about the past weak and I think I have noticed side effects.

My plan is to lay off the finasteride (generic proscar) until things get back to normal, and then get blood work done to check my testosterone/DHT levels. After that point, assuming my levels are fine and my sexual situation is 100% good, I plan on taking 1 MG Propecia every other day, and stopping the generic proscar.

If that all works out I am going to consider Avodart/Dutasteride because it is supposed to be more effective as a hair loss treatment, though the side effects have the potential to be worse.

I just wanted to see what everyone thinks about this situation and see if anyone has advice. Thanks for you time.

 

 

 

- Restoration87

[TakingThePlunge]

Restoration87,

 

When I started generic Proscar, I was taking 1/4 tablet daily. I also experienced testicular pain, watery semen and softer and less frequent erections. I began experimenting with my dosage and ultimately settles on 1/4 tablet MWF. I have found that this dose has maintained my results and lessened but not eliminated the side effects.

 

I no longer have pain but the watery semen and less frequent erections persist but I've not found them to be intolerable.

 

I'm no doctor but I would venture to guess that you may experience more severe sides on dutasteride.

[Restoration87]

Thanks David, After speaking with a hair surgeon about it, I am probably going to lay off it for a bit to get baseline blood work done and then start taking brand name Propecia every other day and go from there.

 

The doctor recommended normal Propecia so as to eliminate differing dosages and to guarantee effectiveness and reliability. Though it's about 3 times the price I am willing to give it a try.

[Gish]

If you look at the merck data you will see that finasteride has a very flat dose-response rate.

 

iirc .2mg worked inhibited ~5% less 5AR II compared to the full 1 mg.

 

In the rat prostate studies the inhibition for 72mg/kg/day was nearly the same as 7.2mg/kg/day. Goes to show, the difference between either a very little or a lot can be quite marginal.

 

Also consider that finasteride binds with the 5AR type 2 enzyme so strongly that even though it has a half life of only 8 hours it takes the metabolic synthesis of new 5AR type 2 much longer to restore normal activity. I remember reading it can take anywhere from a single to several days.

 

In regards to your thoughts about using Dut instead of fin, I think you should do a bit of your own research. We have no long term models of 5AR type 1 inhibition to observe so it can be more difficult to say exactly what the long term implications of inhibiting the enzyme may be. It have often read forum posters say that 5AR I is found in the brain, and that it serves as a precursor, or a part of a metabolic pathway, for a certain neurosteroid. Of course, the question is does 5AR type 1 actually matter in terms of hair loss? I have always felt that the added bennefit some people see from Dut is due to the higher rate in inhibition of 5AR type 2 and not 1.

 

I have heard stories about a topical 5AR 1 anti androgen developed by merck in the early days of testing 5AR inhibition, and that it did nothing for MPB.

 

You may want to look into topical spironolactone if you are wanting to strengthen your regimen. Such a product has been studied quite a bit for the application of acne and has shown to be quite safe.

[Restoration87]

Gish,

 

 

 

This is very interesting data that I have not been presented before. It obviously is very eye-opening and makes me realize that there may not be much need to take much more than .2mg of finasteride per day for hair loss.

Do you personally have any comments on taking 1mg of propecia every two or three days and how that may be effective, as opposed to .2 mg every day? I would like to avoid cutting up pills is possible, so as to get the same dosage every time.

Also, dutasteride probably isn't a route that I'm going to go any time soon or at all. If I'm having side effects with finasteride right now there is no need to go to a stronger drug of the same kind.

Lastly, I checked out a couple websites on spironolactone, and they implied that it's effects on MPB are minimal. I would still consider that though, along with topical ketoconazole. Do you have any thoughts on topical ketconazole versus spironolactone? I currently use rogaine foam and I have just starting using the shampoo Regenepure, which has 1% ketoconazole and some saw palmetto as well, along with many other ingredients.

Thanks for your help and advice.

 

 

- HairRestoration87

[Gish]

Hey restoration 87,

 

Merck found that, although the dose response rate for fin was very flat once you reached dosages of .2 mg, they decided that 1 mg was the most beneficial dose. This likely translates to something along the lines of "1mg of finasteride inhibits 5% more 5AR type 2 then .2mg".

 

Given the cost of proscar, I have always just cut it up into fourths. There would be no reason to mess around with doses other then to save cost, in my opinion.

 

Granted, I have read posts from people on other forums saying that when they decreased their dose from say 1,g to .5mg their side effects went away. Its always hard to evaluate these sorts of claims, but take it for what it is. If it is true, your bodies response to 5AR 2 inhibition must be very fine tuned to the point where flucuations of single percents of inhibiton could be the breaker for side effects vs no side effects.

 

in regards to your question about 1mg every 2nd day vs .2 mg every day I am not sure. If I was to guess, I would say to take 1mg every other day. Waiting two days you might see your 5AR levels start winding up. I haven't looked into alternative dosages much as I have been quit happy with cutting my proscr into quarters. 1mg every day has been shown to work time and time again, I see little reason to not go that route. Out of curiosity, why is it so important to you that you get the exact same dose every time.

 

Spironolactone is not a big guns treatment for sure, but is a good adjacent treatment to be used along with an internal AA. It has a different mode of action then fin so you are saving the follicles in two different aspects. Please note thought that I am talking about topical spironolactone. Oral spiro would be quite a heavy duty hairloss treatment, one which some people I know have gone on (with surprisingly few side effects mind you). Topical keto is good as well, but I don't think you need to use a cream, just use nizoral 2% shampoo every other day or so. Should be about as effective as applying a cream.

 

How bad is your hair.

[Restoration87]

I'd say I'm a norwood 2 or 3, with more of a problem with a receding hairline than in the crown. I just received Regenepure shampooo in the mail yesterday. It has 1% ketoconazole as well as other ingredients like saw palmetto, and I must say that even after one use I like how it made my hair feel thicker. Do you know anything about regenepure?

 

Also, as far as the finasteride goes, the doctor I've been speaking with said that in the interests of playing everything as cautiously as possible, it couldn't hurt to take the real brand name propecia and not deal with 1. cutting up the pill and trying to get it perfect (plus not knowing if the medicine is actually evenly distributed through the pill) and 2. the uncertainty of what is in a generic drug as opposed to the real thing.

 

Will taking 1mg propecia make a big difference? Probably not. But given that I am trying to combat these side effects it seems like a good plan.

 

Lastly, just so you know, I am planning on getting a hair transplant in the winter time to lower my hairline a bit, especially at the temples, and thickening my hairline as well. This will most likely be in the area of 2000 grafts.

 

Thanks for your help.

Edited October 16, 2011 by Restoration87

[Restoration87]

There is no conclusive evidence to show that uneven doses can present unwanted effects. The decision to take 1mg brand name propecia is more in the interest of giving myself the best possible shot at making the drug work for me.

[Gish]

Good luck restoration87. You sound like you are in a similar position to me in regards to thinking about a HT. Perhaps my hairline isn't quite a NW3 yet. Pictures are in this link if interested. http://www.hairrestorationnetwork.com/eve/163258-comments-advice.html.

 

I still feel you may be unnecessarily paying much more for Propecia, but the choice is yours and I respect that.

 

Please keep me updated on future developments, and consider topical spiro lotion to apply on the hairline.

 

Good luck man.

Edited October 16, 2011 by Gish

[Restoration87]

Gish, after looking at your pictures I would say that we are in extremely similar levels of hair loss. The type is a bit different, but overall I would say our statuses are quite similar.

 

I am pretty sure I am going to get a transplant, and the only thing that is worrying me is whether I will look strange a month later when I go back to school! I certainly don't want that and as long as I let my hair grow I don't think it will be an issue.

 

Also, Gish, I am very impressed by the information that you spoke about earlier in regards to finasteride and dutasteride studies. Do you have a science background or have you just been following the testing of the drugs more than I have? Either way, it's great to hear your advice and good luck in all hair restoration endeavors.

 

 

-87

[Gish]

87, I'm studying biotechnology at school so my course work is heavy in biochem and genetics material...the perfect stuff for understanding hair loss!

 

Also, I volunteer in a lab that looks at some of the molecular aspects of prostate cancer. you may be surprised to find out just how much overlap there is between the important aspect of both prostate cancer and MPB.

 

I sometimes think it is somewhat strange, but the more I learn about hair loss the more it becomes interesting to me, perhaps because I care about the material beyond a purely theoretical level...hair loss matters to me.

 

I am still considering a transplant as well, and have the same concern as you do, returning to work/school and looking funny. I am not looking for much though, just a reduction in the angle of my temporal loss.

 

Which doctors have you been looking at/considering?

[Restoration87]

I am considering Dr. Konior in Chicago. He has a great reputation and is very conservative and meticulous. He is there for your entire procedure and only has one main office in the suburbs of Chicago where he works. His website is PremiereHairDoc.com if you want to check out some of his work.