LLMs are getting better and better with respect to medical related topics. It’s able to think holistically across different biological systems which basically no doctor ever has been able to do.
What to do when hormone levels are normal and symptoms persist
At this point, you’re probably dealing with complex neurochemical and psychological adaptations, not simple hormone imbalance.
That can include:
Reduced neurosteroid activity (which affects libido, emotion, anxiety regulation).
Chronic stress and fear responses wired into the brain’s sexual and reward circuits.
Sleep, energy, or motivation problems linked to long-term nervous-system dysregulation.
None of these are irreversible — but they require a different strategy than just hormone therapy.
Let’s break down what “complex neurochemical and psychological adaptation” means in plain language:
1. The brain and body constantly “re-balance” themselves
Your nervous system, hormones, and emotional state are deeply interconnected. When something — like finasteride — changes one part of that system (by altering DHT or neurosteroids), your body tries to adapt.
For most people, everything re-stabilizes after they stop the drug.
But for some, the system seems to “reset” to a new equilibrium that isn’t optimal — where certain brain circuits or chemical pathways stay underactive or overly sensitive.
That’s what we mean by an adaptation: it’s your body’s way of finding balance, but in this case the balance may feel “off.”
Even when hormones return to normal levels in the blood, the brain’s receptors and signaling pathways may have adapted — altering sensitivity to testosterone, dopamine, or serotonin.
That could explain why you feel different even with “normal” lab results.
Think of it like this: the piano keys (hormones) are all present, but the tuning (receptors and circuits) changed a bit.
After long periods of sexual dysfunction or distress, the brain can start to associate sex with frustration, fear, or failure.
That creates a conditioning loop: anxiety → poor performance → more anxiety → further suppression of desire and erections.
This isn’t “in your head” in the dismissive sense — it’s real neurobiology of stress reinforcing the problem.
These physical and psychological mechanisms feed into each other:
Neurochemical imbalance (low neurosteroids, altered GABA/dopamine) → increased anxiety and low libido.
Anxiety and avoidance → reduced stimulation and neuroplastic recovery.
Over time, the circuits responsible for sexual motivation weaken from disuse.
That’s why recovery often requires a combined approach: medical, neurological, and psychological retraining.