There’s a large body of evidence, many thousands of case studies if you will, that you’re unaware of, so being flippantly dismissive of it I think is silly. I’m stating things that are very well known in the performance world. Not all steroids have the same effects. They operate very differently and are used for different reasons. All of the effects that I have mentioned are known to be very real and obvious when these compounds are used correctly and in the right setting.
And I’m not just talking about steroid forms, I’m talking about discussions that high level coaches have in more private settings.
Studies are not useful here because the right kind of studies don’t exist. We have to rely on the “clinical” experience of expert practitioners.
“In addition, DHT regulated synaptic plasticity in the hippocampus of mild cognitive impairment (MCI) SAMP8 mice and delayed the progression of disease to Alzheimer’s dementia. In conclusion, androgen-based hormone therapy is a potentially useful strategy for preventing the progression of MCI in aging men. Androgens enhance synaptic markers (SYN, PSD95, and Drebrin), activate CREB, modulate the fundamental biology of synaptic structure, and lead to the structural changes of plasticity in the hippocampus, all of which result in improved cognitive function.” Effects of dihydrotestosterone on synaptic plasticity of the hippocampus in mild cognitive impairment male SAMP8 mice - PubMed
Thanks for the study.
Though mice models haven’t exactly been a good model for AD or dementia in humans. There is reason to believe that androgens are useful in that regard but given that there is no strong link between the use of 5ar inhibitors for BPH and dementia rates, it could be that any androgen helps, not DHT in particular.
It was just a cursory look I’m sure there is more. I certainly feel a bit more switched on. There is a qualitative difference in my experience between high dose testosterone and high dose testosterone + exogenous DHT.
I’m considering Finasteride, following a discovery that I might have BPH. It’s kind of a medical horror story:
As part of the problems I had had with an inner-ear infection, I was asked to see a ENT (ears, nose, throat) specialist. He found I still have some residual fluid behind my left eardrum, and said he could drain it with a tube in a few weeks; but suggested I try over-the-counter meds first. So I did. One of the medicines he recommended was Mucinex D. Although OTC, you have to sign a form saying you won’t give it away or abuse it in any way, and they mention severe penalities, etc.; and you need to show them your driver’s license. This is because Mucinex D contains pseudoephedrine (a compound meth lab criminals use to make meth). I bought the meds, though maybe didn’t notice I had purchased an “extended release” version of Mucinex D (not that that would make too much of a difference, I think).
To make a long story short, taking the meds (which included a morning dose and evening dose of Mucinex D) went fine for the first day. Day 2 I started to notice I was having trouble urinating. By day 3 it reached very worrying levels – it was so hard to urinate that I was afraid I would be blocked completely. Frantically searching the internet (rather than going through a lengthy process of seeing the doctor), I discovered that the pseudoephedrine can “tighten the muscles in the prostate and bladder neck, which constricts the urethra and increases resistance to urine flow” (quoting from Google) in men with BPH.
I stopped taking Mucinex D IMMEDIATELY after reading that. Symptoms improved markedly in about 1 to 2 days.
That’s when I started reading about Finasteride and its prostate-shrinking effects (by 20% over 6 months), as well as reading about various surgeries, including outpatient methods using hot water.
…
As a side note, it seems like every time I go to the doctor for something, this kind of thing happens. I could list like 5 things of similar degrees of worry that happened to me over the past 2 months when seeing various doctors. (e.g. I had to do several CT scans, and during one of them they gave me a contrast agent. Everything went smoothly during the scan itself; but immediately after, I started to feel what seemed like a very severe case of acid reflux – frighteningly bad. Apparently, I’m one of very small percent of the population that has that specific reaction to CT scan contrast agents!)
Pseudoephedrine causes acute constriction of the muscles in the prostate and the urinary sphincter. Those effects go away once it’s out of your system. That’s a completely different thing than prostate enlargement (BPH), a process that gradually happens over years/decades.
Well, I’m 53 years of age, and a decent percent of people my age do have at least mild symptoms from BPH. I do have some of these – e.g. waking up in the middle of the night to urinate (more than when I was young); stream is not as strong as it was when I was young.
It’s just not severe enough to where I have thought I definitely need to see a doctor.
I will get this checked out, as soon as I’m done with all the other medical stuff stemming from that ear infection.
I should also add: (1) The searches I made online mentioned BPH, specifically, in regards to the effect of pseudoephedrine (taking Mucindex D normally doesn’t trigger the symptoms I described; you need something extra, and BPH is one that Google search mentioned); (2) The doctor would not have suggested Mucinex D if he knew I had some condition that causes problems (allergies, BPH, etc.; he did ask me whether I was allergic to medicine, but didn’t ask about BPH; the form I filled-out before seeing him might have mentioned BPH – if so, I said “no”, because I hadn’t been diagnosed at the time, and still haven’t been). It’s possible that I have some other condition that predisposes me to these kinds of reactions to pseudoephedrine, but BPH seems the more likely culprit.
Before starting 5-ARIs, get your prostate checked. There are non-pharmacological options, such as limiting liquid intake to 4-5 hours before bed and wearing compression socks in the afternoon etc.
In my opinion, there are better medical options for managing prostate than 5-ARIs. You can maintain your hair using topical treatments, eliminating the need for systemic medication. Tadalafil is one of better options for mild to moderate lower urinary tract symptoms.
None that affect the root-cause of BPH - an overgrown prostate.
And if you’re already willing to go on tadalafil, might aswell combine it with finasteride.
Right. 5-ARIs and surgery are the only things that can actually shrink it. OTC remedies like pumpkin seed oil can be a weak 5-ARI and provide some degree of mild symptom relief, but I’ve never seen evidence that they’re potent enough to actually reverse BPH (unfortunately).
I have a short GPT response on the link between BPH and splicing (which would imply acetylation interventions would assist)
Here’s the short version:
BPH tissue shows gene-specific alternative splicing differences. Example: the prostate enzyme transglutaminase-4 (TGM4) has multiple splice isoforms; the “L” isoform is enriched in BPH samples compared with prostate cancer, indicating BPH-specific splicing patterns in the prostate. (Nature)
Androgen signalling can reprogram splicing in prostate epithelium, which is central to BPH biology. Androgens up-regulate the epithelial splicing regulator ESRP2, which in turn drives epithelial-type splice decisions (and opposes EMT). Epithelial–stromal crosstalk and EMT/mesenchymal features are key in BPH nodular growth, so androgen-controlled splicing regulators provide a mechanistic link. (eLife)
Androgen receptor (AR) splice variants are detectable in benign prostate tissue (including BPH). Several AR isoforms (e.g., AR-V1/4/7 mRNAs) have been measured in benign and primary tumor tissues; while best studied in cancer, their presence in benign tissue shows that AR pre-mRNA is alternatively spliced in the BPH context too. (PLOS)
Extracellular matrix genes implicated in BPH undergo extensive alternative splicing. Elastic fiber remodelling is characteristic of BPH; the elastin (ELN) gene’s complex alternative splicing has been highlighted as a hurdle and focus when profiling BPH tissue, underscoring splicing’s role in stromal changes. (PubMed)
Broader RNA-processing signals show up in BPH cohorts. For instance, a BPH patient series identified a circular RNA (circ-102004) that interacts with U1 snRNP, tying BPH to core splicing/3′-end processing machinery activity (though functional consequences in BPH need more work). (ScienceDirect)
Takeaway: In BPH, splicing is not (so far) a single, defining lesion like in some cancers, but it modulates key pathways—androgen-regulated epithelial programs, ECM remodeling, and gene-specific isoforms (e.g., TGM4)—that contribute to the stromal-epithelial imbalance and nodular growth characteristic of the disease. (eLife)
If you want, I can pull together a compact table of BPH-relevant genes with known splice isoforms and what’s reported for each.
Since I have been open about my experience with finasteride, I’ll volunteer two observation that might shed light on post finasteride syndrome. Some side effects came on almost immediately (a couple days in), and others took longer to develop (a few weeks in). First came physical effects (e.g. erection related), and later came mental effects (e.g. drive changes).
Observation one: After stopping the drug it took longer for those changes to reverse than it took for them to emerge. Observation two: Like Wile E. Coyote noticing he had run past the edge of the cliff, behavioral changes lagged the above primary effects.
Pairing these observations from just three or so months of use, I can extrapolate to how one might rationally perceive PFS because of a mix of side effect reversal taking longer than onset and behavioral changes persisting after underlying conditions change. Add to that the bidirectional impacts of anxiety and sexual performance, and it is not hard to see how somebody could experience a protracted period of disheartening effects even if their body has in some sense returned to baseline.
And, of course, there might be people who end up with permanently changed baselines.
Glad you are back on track… different results hapoen…I probably have been using finasteride close to 35 years and no ED… or depression. At almost 68 years.
Fortunately, good benefits like small prostate size, kept my hair, no prostate cancer, reduction of cholesterol in blood… no calcium or plaque observed in coronary scans.
Same could be said for rapamycin… I might be a super responder at 6 mg weekly, it seems, improvements in muscle maintenance and strength, skin quality, blood flow… arteries, test show low inflammation… good DNA methylation, stronger immune function… no allergies, no arthritis, dysphagia gone… plantar fascia gone, menory improved and general euphoria.
Others 1 mg and body goes into major negative health side effects.