You draw many useful observations that helps us get closer to conclusions. Kudos to you
Now onto your your āsurvival modeā hypothesis. Iāve been trying to look at PFS from a different view angle thatās different from classifying everything as either anti-5AR or pro-5AR. My answer to this āsurvival modeā is āexcess/chronic inflammationā. See, when ever the body is put under stress, it reacts through this āsurvival modeā mechanism. Imagine being starved in a desert or in life-or-death situation, then it stands to reason that sex is the furthest thing from your mind. Iāve another term for the āsurvival modeā that I call āsickness behaviorā. Itās caused by releasing inflammatory cytokines that leads to hypothalamicāpituitaryāadrenal axis (HPA axis) overactivation. This is bodyās way for adaptation and is infact healthy when it occurs over short period of time. However, problems arise when this adaptation mechanism shifts from short to long-term.