21/6/11
Just back from urologist.
Man oh man, what a difficult session. I now understand exactly why some guys have almost blew their brains out over this shit. Trying to reason with some medical “professionals” is simply impossible.
Anyway, so i went in. I hand him my referral letter with a few letters from my endo (That were sent to my GP) and he has a read. He then asks me “so what erection problems are you having?”. I explained that they haven’t been the same for a good 14 months (since March 2010 when i stopped fin for this reason). I then tried to mention my other sexual sides, he interjected and “explained” that finasteride can cause “irreversible” sexual dysfunction to a small subset of men and that he is very aware of that. He seemed to imply that he has seen it before although ultimately he said he’s been prescribing finasteride for a long time.
Anyway, i obviously too issue with this “irreversible” thing and said “well, many guys in my shoes also recover, so i don’t think we can say ‘irreversible’ especially when unsure of the mechanism of cause right now”. He clarified that he meant a small group that don’t recover, ever. He then “explained” that “all finasteride does is block the DHT conversion from T”. I, without any form of confrontation added that it actually “also blocks the conversion of progesterone into dihydroprogesterone and also blocks synthesis of the critical neurosteroid that is allpregnanolone”.
At this point he said “ok, so i take it you’ve been doing alot of reading about this. Are you still taking cialis?” I told him yes but i found that i had to cycle it to get decent effect otherwise things tail off. He asked why don’t i take it every other day and i said my experience was the more i take it the less it helps. He “disagreed” with me and told me that’s not possible, that the effects cannot wear off and that any such experience is placebo. He went into detail about how the enzymes worked to make that a physical impossibility. Supposedly. Again, I ensured to stay composed, retain a very unconfrontation tone and stay articulate despite it being clear he had already made his mind up. I said “well, I can’t comment on the science of it, simply that that was my exact experience and one that ive read many other men also having” …i even reiterated that i “didn’t know much about the science side of this”.
He then said “so anyway, what do you want ME do to?” again. I said, “well basically we know that finasteride is a prostrate drug that affects the prostrate, we know that this is where semen fluid is made and we know my symptoms are sexual and definately physical…i wanted to get a prostrate screening”. He asked “why, exactly?” and i told him because i wanted to check for any irregularities and potential inflammation or enlargement. He said “but you don’t have prostatitutus”. I said “how do you know?”, and he said “because you don’t…I’m happy that you inherited this problem from finasteride and you are in this subset of men but hopefully you recover”.
I then said “yes i am in that subcategory of men but many are presenting with prostrate problems, myself included…i think that warrants prostrate screening of some sort”. He again said “but these problems are from finasteride not prostatitus”. At this point i knew it was a losing battle and there was no chance of him playing ball so i figured i’d atlest try, respectfully ofcourse, get my point across given it might help a future patient.
I said to him “Look, i appreciate this isn’t your everyday case, but I’m asking you for a transrectal ultrasound to see what comes up, that’s all…”. He said “i don’t like where this conversation is going to be honest…you came in to me with a preconceived notion about things…but really, you need to accept you have taken a drug with sexual risk and you have these problems”…he continued “you’ve became obssessed with this and i think you’re on a dangerous path.”
I then said “so how can you sit here and tell me i don’t have any prostrate problems when i’ve got prostrate pains, sexual dysfunction and messed up semen quality?”. He said “because im the expert and im telling you you don’t”. I then told him others have had their prostrates screened and some have found inflammation and they treated it with a cocktail of antibiotics and massages. He interrupted and said “i know how to treat prostatitus”. I just about refrained myself from telling him he probably doesn’t really 
…
Instead I said, “how can you tell, sitting here” that i don’t have bacterial prostatitus, even? Without looking?". He reitterated that he’s the expert and that i don’t have the symptoms. I said “well i appreciate your opinion but i am sitting in front of you and telling you i’ve got physical problems that i want to you help me with”. He replied that i’ve probably made things worse by worrying about it. I said "it’s hard not to worry about things when you have shooting pains in your penis, penis tissue change, watery semen, ED and prostrate pains…‘how can i think this up’? " There’s no way he believed me completely DESPITE me speaking excellently (im a solicitor i know how to communicate professionally) and being well presented. I said “well, I’m assuring you these problems are real whether you believe it or not”.
He then said “Look, as i said, you’ve taken this drug and this is where the problems have came from, hopefully your system will clear out over time”.
We interchanged for a few more minutes, he said he wasn’t going to “take this any further” but that he also wouldn’t charge me for the consultation. He suggested I stop following this avenue up to which i said “doing nothing hasn’t got me far yet…as a 25 year old man you should maybe appreciate that this is difficult to for me and i want to do everything i can”. I then shook his hand and left with a sour taste in my mouth…basically in disbelief of what just happened.
Let’s recap: he’s know finasteride can cause persistent side effects, he’s SEEN this before, but didn’t care to look at the prostrate “because finasteride causes these problems”. How is that logical? Yes, finasteride does cause these problems…it’s a fucking prostrate drug and it messes with the prostrate. He clearly was a very intelligent man, too, that was the most difficult thing to swallow.
This sucks. He’ll now write back to my GP basically telling my GP that im crazy to be asking for a prostrate exam. I appreciated him not charging me but I’m getting fucking sick of these ego-maniacs with this face to face diagnosis’ and continual self-preservation regarding their “expertise”. It could even be difficult to get another GP referral after this. I’ll tell my endo what has happened and hopefulyl he will help out. If not ill try another urologist.
This is exhausting. I now realise how lucky i am to have a semi-decent endo who actually takes me seriously and admits this thing is complicated, as opposed to someone who is more worried about being seen as not knowing everything. I also realise how difficult this coudl have been without having that endo - having continual knock-backs from the beginning must be soul destroying for many guys. I now appreciate the feeling. I cried in the car in sheer frustration about how all this is turning out but im now more motivated to try recover through living good etc, too. I need to keep a good mindset and keep chipping away at things.
I do worry about where this is all leading if im honest but right now there’s zero quit in me. If the does ruin my life atleast i’ll have tried my best to fight against this hell. If i can even make small improvements ill be happy to be honest, i think i can attain that through very good living and exercise so i’m going to attempt this.
Disappointing overall, though. I think i need to start realising how difficult this whole thing is to get good medical attention. Sexual health is something medical professionals seem to care about very little beyond STD’s and prostrate cancer…and selling you cialis!!! Cruel world but i’m here now so gotta roll with it. Greece mightn’t be too far away…
Over and out.