Does anyone else get erections that are pretty close to normal but experiencing narrowing in the flaccid state? Any theories on how this is possible?
It depends on the overall bloodflow.
I have this, but my erections are not pretty close to normal.
Narrowing in the flaccid state is pretty normal in PFS. I also think it is the typical response to finasteride even without PFS. I think it is due to tissue loss due to apoptosis. It is definitely more obvious in the flaccid state though. Perhaps the reduced density of certain cells reduces overall tissue mass which shows in flaccid state but less so in erect state.
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If DHT deprivation puts you in a chronic low on nitrogen oxides, that seems to be the case. Continued in this state, the cells die out.
Does temporary DHT deprivation lead to chronic NO deficiency? I never heard this. I dont know how likely this is in my case though since I didnt experience shrinkage till 2019 after 16 years off fin. All the while, my hormones were in range as well. If cells were dying, having normal erections doesnt make any sense to me. I am stumped.
The NO deficiency step is not necessary to explain or understand penis shrinkage from Finasteride. Cells of the penis need DHT to stay alive. Without it, they die. It’s that simple.
What do you mean by temporary DHT deprivation?
Does you mean you have stopped Finasteride? That doesn’t matter. The cells have already died and have been replaced by scar tissue and that’s that.
There is evidence in animal studies that penis tissue can at least partially recover over time when androgens are restored. In PFS however androgens are not restored as, in my opinion, 5ar2 in penis tissue is not being made due to a methylated gene.
Even if you don’t have PFS it may take years to restore tissue loss. Scar tissue is likely to stay and negatively affect function.
I also had normal erections before I got PFS even though I already had tissue damage and shrinkage.
You didn’t experience shrinkage before after 16 years have passed because it happens gradually and it is hard to notice things that happen slowly over time.
Your hormones were not in range. You had low DHT…
Thanks for that explanation. Do you think theres any validity to long term cialis helping to regenerate tissue? Or do you think this will only get worse with time no matter what since our genes are methylated?
Also, if tissue is dying over time, then why after 16 years is my scarring only “very mild” according to Goldstein? I would think it would be pretty significant after all that time, no?
Do you have PFS and for how long have you had it? During these 16 years you didn’t have PFS, so presumably you still had some DHT left in the tissue. Finasteride only reduces it by 70% or something like that, if I remember correctly.
I have no idea if Cialis can help. Maintaining tissue health must be a multifactorial issue depending both on androgens and blood flow. If urologists say blood flow and erections are important, who am I to disagree.
I tried Cialis for a couple of days, very low dose, and I almost died from low blood pressure. This is yet another drug with significantly underrepored side effects, in my opinion. I can deal with a single dose but a couple of days in a row is impossible for me.
Well its not as black and white in my case. I had sexual problems over the span of the past 16 years, so I at least had some form of PFS, but they only recently got worse because Ive had physical changes that seemed to just manifest last year. It seems that that isnt all that common here. Most people seem to notice physical changes in tissue long before 15 years off the drug and some notice very quickly, which prompts a lot of questions about how this condition deteriorates.
My changes came pretty suddenly from what I could tell, beginning with temporary testicular shrinkage, and my penis twisting on its axis and pointing left. It no longer twists or bends but what im left with now is shrinkage.
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