A proposed etiopathology of persistent dysfunctions emerging from use and discontinuation of 5-alpha reductase inhibitors: Sequelae of drug-mediated microvasculopathy, Montaigne 2022

Montaigne, M. (2022, February 11). A proposed etiopathology of persistent dysfunctions emerging from use and discontinuation of 5-alpha reductase inhibitors: Sequelae of drug-mediated microvasculopathy. https://doi.org/10.31219/osf.io/86cnm

Abstract

Persistent dysfunctions emerging from use and discontinuation of 5-alpha reductase inhibitors (PD-5ARI) may be explained as the aftermath of a pathological recovery from microvasculopathy or ischemia in multiple systems. Focusing on persistent sexual dysfunction, the most common class of symptoms: 5ARIs’ inhibition of angiogenesis leads to stress on penile microvasculature, depriving the tissue of blood supply and oxygen. These hypoxic conditions lead to tissue injury and atrophy, triggering a pathological recovery that further alters penile tissue, including smooth muscle loss, fibrosis, damage to vascular architecture and impairment of neural pathways supporting arousal and erectile function. This damaging cascade may result in severe and lasting sexual dysfunction. Persistent neuropsychiatric, cognitive, sensory and sleep dysfunctions emerging from 5ARI treatment may similarly be explained as pathological responses to microvasculopathy or ischemia in supporting structures, particularly those in the limbic system. Systemic spread is proposed to arise from a vicious cycle of tissue injury, oxidative stress and proinflammatory activity which spreads via the vascular network, leading to systemic endothelial dysfunction. The latter may in turn set off a damaging cascade in other organs and tissues. Risks of developing PD-5ARI may arise from 5ARI-mediated disruptions of vascular tone, angiogenesis and neoangiogenesis. Pharmacovigilance data, animal studies and human studies provide converging evidence for the proposed etiopathology. It is, moreover, consistent with variable presentation and severity of PD-5ARI symptoms; irreversibility of symptoms; typically normal results of clinical lab tests; and resistance to treatment.

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this article has not yet been accepted by journals, the author is a pseudonym with PFS… I do not understand if it should be published, what do you think?

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How to explain breast development? And body odor and hair changes? I think this is an article of “blind people touch elephants”, which may reveal some things for us, but it may also lead us astray.

This is my point of view

thank you very much for posting it

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Well this is depressing :frowning:

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This has been posted elsewhere previously.

It’s not very plausible to suggest that stress on microvasculature and resulting hypoxia could cause symptoms such as anhedonia, loss of libido and sexual desire, reduced ejaculate volume, watery ejaculate, and others. It also doesn’t explain the brief period of recovery reported by the vast majority of our survey participants before their crash. Further, it doesn’t explain how it could cause specific changes in gene expression as discovered in Baylor.

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