Thanks everyone for the critical feedback. I believe the theory I advocate for can account for most of the points raised above. I am not claiming that what I am going to say is the only possible explanation but it is certainly a logical one.
The gist of the criticism above is that normal people without PFS do get an androgen response from systemic DHT, whereas people with PFS do not. The quotes below summarize this criticism.
It is important to know exactly what kind of androgenic effects normal people get from systemic DHT. Are we talking about falling hair, higher libido, larger muscles or deeper voice? It is crucial to specify exactly where the effects are and how strong. More about this later.
Of course we need to exclude from this particular analysis any effect of “other androgenic steroids” that in normal people may work through conversion to DHT in tissues or may require the balancing of DHT they already have present in tissues.
For example, you cannot claim that because Testosterone raises libido in normal people but not in PFS people, therefore PFS people are not sensitive to Testosterone. This is because Testosterone may exert its effect on sexual function largely through its conversion to DHT in key tissues.
Back to the effect of systemic DHT. It is entirely possible and is in fact most likely the case that different tissues in the body require a different concentration of DHT in order to function properly. It is known, for example, that skin at different places in the body has a different concentration of 5a-reductase.
This distribution is not likely to be binary - i.e. either 5a-reductase is present or not, but it is likely that even within tissues with high DHT requirement there is a range of optimal concentrations. There must be a lot of research about this and I encourage anyone to try to verify or disprove the claim above.
It is therefore expected that systemic administration of DHT will be adequate to different degrees for different tissues. One tissue may be getting close to optimal or in fact way above optimal levels of DHT, while another may still be starved.
My only evidence of the systemic effects of DHT administration in people with PFS comes from my own experience. I have observed androgenic effects in a wide range of tissues, which does confirm that systemic DHT indeed reaches tissues and has an effect on them, despite PFS.
What I claim, however, is that the effect is differentiated for different tissues based on their base level requirement for DHT. The tissues responsible for sexual function may require a higher level of DHT, which cannot be supplied through reasonably high systemic administration.
Some of the effects of DHT I have observed are the following:
First, my hair is significantly affected and sheds a lot when I supplement systemic DHT.
Second, my joints react immediately to systemic DHT and stop hurting. This is a profound effect and is the main reason I use DHT.
Third, I also experience stronger body odor when I use systemic DHT.
Forth, I experience a deeper voice, which I admit is quite unexpected and puzzling to me, because I have always assumed that voice masculinisation reaches a peak during puberty and it is not possible to further lower the voice with androgens. I did not observe a significant effect on voice previously with a liquid DHT formulation but I am currently observing it with a liposome formulation, which may indicate a different degree of absorption. I don’t know yet if the effect is permanent or transient but this is an androgenic effect nevertheless.
Fifth, I observe psychological effects of increased aggression and impulsivity and reduced anxiety.
Sixth, I also do observe an effect of systemic DHT administration on sexual function (libido, erection frequency and strength, sensitivity and pleasure) which is dose dependent but it is indeed rather weak for the doses I have used. (I do not use doses that would raise my serum DHT above the normal range). This may easily mean simply that the DHT requirements of the tissues responsible for sexual function are much higher than what’s possible to achieve with systemic administration.
This is confirmed by my experience that sexual function improves significantly more when DHT is applied topically to a broad abdominal and genital area, and the effect is also dose dependent. I get no morning and nocturnal erections when I am at my PFS baseline but I do every night when I apply DHT topically. I can also get spontaneous erections of various strength, which is impossible otherwise.
In no way, however, does this local administration of DHT lead to a complete reversal of PFS, as no doubt numerous unreachable tissues in the body are involved in sexual function, such as the pudendal and vagus nerves, the prostate muscle, and regions in the brain.
The fact that application of topical DHT on the broader genital, perineal and abdomen area (likely reaching the prostate and pudendal nerve to some extent) works better than narrow application to the penis, but worse than systemic application (i.e. application on the hands) indicates the importance of high DHT concentrations in key tissues involved in sexual function.
I cannot explain reports about shrinking penis from local DHT application but I do not find them sufficiently credible. I did read reports about such an effect but one guy claimed to have used the formulation only once and the other only briefly. I find it highly unlikely that any perceived shrinkage as a result of a single or brief DHT application represents in fact tissue loss, as that is simply not physically possible in my opinion.
At the same time, I have also read reports about the opposite with topical DHT administration - penile tissue growth, which I do not necessarily trust either. I have so far not observed any effect one way or another in myself. I believe any effect on the penile tissue is likely to require long-term administration.
As I have said before, such application is likely very risky before proper dosing can be determined and I do not recommend it due to cancer risk. I currently apply the DHT only to the abdomen and not on the penis.
I would like to solicit evidence about the effects of systemic DHT administration in healthy people - not on androgenic functions in general but on sexual function specifically. If systemic DHT in reasonable ranges has only a week effect on sexual function, as I believe is the case, this would completely explain the lack of effectiveness of systemic DHT in PFS people without indicating androgen insensitivity.
Finally, this theory supposes that 5a-reductase type 2 function is absent from key tissues to a greater extent in PFS than during regular fiansteride administration in non-PFS subjects. At least it is my experience that while on finasteride I had reduced but almost normal sexual function, whereas now I have almost complete absence of sexual function.
Any further feedback or criticism would be highly appreciated.
