Evidence for atrophy, cell death in men's prostates from Fin

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#1

IMPORTANT.

Study with photo evidence @ cellular level depicting how Fin causes involution of the prostate via shrinkage and aptosis (cell death):

Involution = a progressive decline or degeneration of normal physiological functioning occurring as a result of the aging process.

PDF: jcem.endojournals.org/cgi/conten … t/81/2/814

Conclusion:

"… These results indicate that a progressive decrease in epithelial cell size and function occurs during the first several months in the prostates of men treated with finasteride.

The staining for DNA breaks and the tTG staining also indicate that an increased rate of apoptosis is occurring transiently in these prostates.

We conclude that finasteride causes prostate involution through a combination of atrophy and cell death."

#2

What does this mean if there is potentially damage to the prostate, and reduced intra-prostatic DHT levels ?

Is the prostate effectively a valuable ‘store’ of free T ??

#3

Another study:

Long-term effects of Fin on Prostate tissue composition

PDF: usrf.org/news/070703_finaste … f6D1E3.pdf

INCLUDES COLOR PHOTOMICROGRAPHS SHOWING FINASTERIDE’S EFFECTS ON PROSTATE TISSUE.

Objectives. To determine the long-term effects of finasteride treatment on prostate tissue composition; to relate these effects to clinical outcomes; and to test the hypothesis that finasteride exerts a selective or preferential action on the transition zone.

Methods. Nineteen men with symptomatic benign prostatic hyperplasia (BPH) who completed a 6-month double-blind trial of finasteride were enrolled in a 24-month open-label extension study of drug responders. Magnetic resonance imaging and prostate biopsy for morphometric analysis were performed together 70 times: at baseline (n 5 19), after treatment periods of intermediate duration (6 to 18 months, n 5 32), and after long-term drug treatment (24 to 30 months, n 5 19). At baseline, prostate volume averaged 51 cc, of which 57% was transition zone.

Results. Decreases in symptom score, dihydrotestosterone and prostate-specific antigen levels, and prostate volume occurred at 6 months (P ,0.01), stabilized, and were maintained without further long-term decreases. Prostate epithelium contracted progressively from baseline (19.2% tissue composition; 6.0-cc volume; 3.2 stroma/epithelial ratio) to intermediate (12.5%, 3.3 cc, and 5.6, respectively) to long-term treatment (6.4%, 2.0 cc, and 17.4, respectively, P ,0.01 for all). Percent epithelial contraction was similar in the peripheral and transition zones (P 5 NS). The transition zone remained a relatively constant proportion (53% to 58%) of whole-prostate volume from baseline to long-term observation.

Conclusions. Long-term finasteride treatment (24 to 30 months) results in a marked involution of the prostate epithelium, which continues to progress for many months after clinical effects stabilize. The effect on the epithelium is similar in the peripheral and transition zones for both morphometric and volumetric changes. Progressive contraction of the prostate epithelium appears to constitute the underlying mechanism for sustained action of finasteride.
Longterm effects of Finasteride on prostate tissue.pdf (528 KB)

#4

so does this mean that it can regrow, or return to normal, so to speak? Or are you understanding this as irreversible change?

#5

Possibly can regrow, unsure as to how much. See the following study of androgen-induced REGROWTH of a rat prostate, after Finasteride therapy.

propeciahelp.com/forum/viewtopic.php?t=496

#6

Protein Profiling of Rat Ventral Prostate following Chronic Finasteride Administration

mcponline.org/cgi/reprint/5/11/2031.pdf

Note: the images are from rat prostate.
Protein Profiling of rat ventral prostate following chronic Finasteride administration.pdf (651 KB)

fin-rat-organs.jpg1000×378 167 KB


fin-rat-prostate.jpg407×1020 296 KB

#7

Well, I assume it is well-understood that finasteride shrinks prostates via involution/apoptosis, so my question is…

Does this have a negative health effect, and are those effects always naturally reversible? Just looking for clarity as to why doctors don’t consider this action of finasteride dangerous, especially in Propecia.

#8

3pm,

Doctors (particularly endocrinologists and urologists) are well aware that it shrinks the prostate. Finasteride’s other usage beyond hair-loss, is for treating BPH (benign prostate hyperplasia). This is when the prostate begins to grow and can cause serious problems with urinary flow. In addition to this, the prostate becomes more susceptible to infection. Hence it is common to prescribe Finasteride as Proscar (5 mg) to BPH patients to effectively shrink the prostate.

As for doctors knowing that Propecia shrinks the prostates of non BPH patients, they probably aren’t informed. Since Propecia is prescribed typically at 1 mg or 1.25 mg, they are told (or assume) it’s a lower dosage than the average 5mg, so as to not cause the dramatic shrinking. Also, while the docs who prescribe proscar for BPH tend to be endos and uros, the docs prescribing Propecia (for hairloss) tend to be dermotologists, who focus more on the cosmetics, so they’re not as informed as an endo is.

Hope this helps, as that’s my best explanation.

#9

Right, and if an involuted/shrunken prostate can be included in a list of unwanted damages from the drug, think the ignorant docs prescribing could be charged for malpractice?

I guess that might depend on my first question… what are the health complications of prostate involution? Through these and other studies Mew has posted regarding prostatic apoptosis, I gather it can mean loss of neural integrity down there, can cause hypoxia, penile cell death/size/weight changes… just wanting a clarification though.

Also is there any way to determine if this has happened to us (tests, imaging, etc) aside from our own anecdotal claims of size change?

#10

Problem is that if you check this research paper carefully you will find more than just an involuted prostate. Moreover, involuted epididimys and glands and vesicles too. This is why i get more and more decrease and shrinkage in my testicles and other parts of my genitalia each time i try to stimulate LH/FSH. The full extend of the damage is too nightmarish to think of. I cant believe it literally

#11

do you think that having a prostate biopsy could show if something wrong is going on with the prostate ?.. i’d like to see what is happening down there .

#12

The research says what goes wrong. Your T levels rise and DhT drop inside the prostate. DHT is important for continuous and PROPER prostatic growth between its different compartments. Several Protein systems are affected from low dht levels, and apoptotic protein expression is increased. Its logical that we develop inflammed prostates. since dht seems to pose and antiinflammatory action down there (to some extend- if higher than normal it causes benign increase in its size- but this is also caused by high testo levels and low dht or high estrogen and low testo- depending on the parts of the prostate affected. (actually high estrogen levels may cause malignancy…).

I wonder what happens in our pituitary though. What is the dht levels there like?? Is it same as in the prostate?? Thats why we may have suppresion of our HPG axis while our body reckons this as normal. Its similar mechanism as what happens in chronic fatigue syndrome and the HPA axis . A sort of reset of the clock in the hypothalamus to a lower level. If our pituitary or hypothalamus renders testo levels as high which are not reduced to dht then its logical that the body doesnt bother produce normal amounts of GnRH. Dht play a role in the excitatory signal production from hypothalamus to pituitary gland (as seen in latest research), so with that low of dht and that high of testo our system is very logically confused. Similar things happen in overtraining too. You get hypothalamic suppression of Gonadotrophins and while LH/FSH levels are within normal your GnRH signal is lost, your penis becomes very very small or atrophies and free T levels are also VERY LOW. Its a similar mechanism (overtraining syndrome is accompanied by a mild adrenal suppression). I have suffered from so many similar problems or other problems that go hand in hand so i can tell pretty much what is going on after finasteride