Androgen Levels and Semen Parameters Among PFS users

[MajorTom]

https://endo.confex.com/endo/2014endo/webprogram/Paper11432.html
http://archderm.jamanetwork.com/article.aspx?articleid=1904925

Program: Abstracts - Orals, Poster Preview Presentations, and Posters
Session: SUN 0046-0070-Hormone Measurements, Pharmacokinetics, Sexual Dysfunction, Genetic Andrology
Basic
Sunday, June 22, 2014: 1:00 PM-3:00 PM
Hall F (McCormick Place West Building)

Poster Board SUN-0051
Michael Scott Irwig, MD
George Washington University, Washington, DC
Background:Recent postmarketing studies have found that finasteride 1 mg for male pattern hair loss has been associated with persistent sexual and non-sexual side effects. Finasteride is also known to alter androgen levels and semen parameters in healthy younger men.
Objective:To assess the serum levels of androgens (testosterone and dihydrotestosterone) and semen parameters in former users of finasteride who developed persistent sexual side effects.

Methods:Otherwise healthy former users of finasteride (n=24) with persistent sexual side effects for ≥3 months were administered standardized interviews. Subjects were asked to obtain two sets of morning androgen measurements (testosterone and dihydrotestosterone) and two semen analyses performed at least one month apart.

Results:The mean serum levels of total testosterone (542 ng/dL) and dihydrotestosterone (48 ng/dL) were similar to baseline androgen levels in other studies. Nonetheless, 3 out of 24 subjects (13%) had two confirmed low testosterone levels and 3 out of 23 subjects (13%) had two confirmed low dihydrotestosterone levels. As compared to a reference sample of unscreened men, the median semen volume (2.7 mL) and total motility (50%) were lower in our population. Three out of 19 subjects (16%) had severe oligospermia (< 5 million/mL) and 4 out of 9 (44%) had two low motility values.

Limitations:Retrospective study design, small sample size, recall bias

Conclusions: Although mean levels of androgens were similar to those in healthy men, a subset of men with persistent sexual side effects associated with finasteride had severe oligospermia and low levels of serum androgens. Further research is needed on additional subjects.

[davey]

Thanks for posting this - anyone have any insights (all I really understand is that more research is needed!).

[dannyfc]

Wonder if someone could enlighten me, how do these studies get funded?

I mean it’s what we have known for long time - the benchmark hormones are normal in Finasteride users yet sexual side-effects persist.

Surely the researchers would have known this prior to the study, they would have read previous studies that have reached the same conclusion.

So what was the motive? Seems an entirely inefficient use of money and effort.

The Italian ones are good are as they explore the lesser known hormones and have highlighted discrepancies between control subjects.

Frustrates me when I hear of doctors exploring TRT and/or viagra. It’s the obvious answer to sexual dysfunction - so would have been the first treatment people tried 10 years ago.

Hopefully the Foundation are more forward thinking in their approach. We need to know why androgens aren’t as potent as they should be. What are the density of the androgen receptors? Whats the activity at these sites compared to controls? How about the hormones that counteract androgens, such as the estrogen agonist 3B-Diol which is higher in PFS subjects. Why is it higher, and how could it be returned to baseline?

Maybe I’m being naive. But it seems such a ponderous and slow process.

If we had a doctor on our side with access to a lab - I’m sure as a community we could pool resources that would be a hell of a lot more efficient. We could publicise the need for subjects more readily and quickly - and target testing of hormones we know little about.

At this rate I’m struggling to see how anything will happen within the next 10 years.

[depressedguy]

I respect dr irwig but doing same studies over and over is completely pointless.

[Fanjeera]

I still feel most of the people here are hypogonadal. For example, the 8 penile skin study patients were all hypogonadal. And why couldn’t he specify what symptoms the men actually have? Sexual side effects is a broad term and post-finasteride syndrome even more. His papers are not worth much, because they’re so linear, narrow and lazy. I wouldn’t even call it research. I don’t understand that guy. If he has all the patients at hand, why can’t he come up with something more conclusive?
Anybody have access to the full study?