Methyl steroids as a treatment for sexual symptoms


Helpful “top notch” medical research!

Peripheral Nervous System Involved in PFS Patients with Severe ED, New Study Demonstrates

SOMERSET, N.J., April 18, 2017 – Post-finasteride syndrome (PFS) patients suffer from altered levels of critical brain-function regulators, including neuroactive steroids, according to a new clinical study published in The Journal of Steroid Biochemistry and Molecular Biology.

Titled Neuroactive Steroid Levels and Psychiatric and Andrological Features in Post-Finasteride Patients, the three-year study also uncovered evidence of neuropathy of the pudendal nerve among those with severe erectile dysfunction.

In all, 16 men with PFS and 25 control patients were evaluated in the study conducted at the University of Milano’s Department of Pharmacological and Biomolecular Sciences by a team of 12 researchers led by Roberto Cosimo Melcangi, Ph.D. The PFS patients had discontinued finasteride for a median of 5.4 years at the time of evaluation, and had no prior history of erectile dysfunction or depression prior to finasteride use.

Key findings of the study include broad effects on plasma and cerebrospinal fluid (CSF) neuroactive steroid levels observed in 14 PFS patients, as compared to 25 controls. Statistically significant decreased levels of DHT, pregnenolone, progesterone, 17-beta estradiol and dihydroprogesterone (DHP), and increased levels of DHEA, testosterone and 3-alpha diol were observed in the CSF of PFS patients.

In plasma, statistically significant decreased levels of DHP and allopregnanolone, and increased levels of pregnenolone, DHEA and testosterone were observed.

Decreased plasma levels of allopregnanolone and decreased CSF levels of progesterone are common features of anxious/depressive symptomatology. Important physiologic effects of neuroactive steroids on brain function include neuroendocrine control of reproduction and sex behavior, synaptic plasticity, morphology of neurons and astrocytes, maintenance of cytoskeleton proteins and myelin, adult neurogenesis, and cognition-related functions.

The study also identified, in 25 percent of PFS patients, the first objective evidence of abnormal somatosensory evoked potentials (SSEP) of the pudendal nerve. Abnormal SSEP findings were observed in PFS patients with severe ED.

Peripheral neuropathy of the pudendal nerve, the major nerve supplying the genitals that is critical for peripheral neurogenic control of erection, in PFS patients is a novel finding that demonstrates for the first time involvement of the peripheral nervous system in PFS patients with severe ED.

Additionally, 50 percent of the PFS patients were diagnosed with major depression based on the results from validated questionnaires, the Mini-International Neuropsychiatric Interview, the Beck Depression Inventory and the Beck Anxiety Inventory.

Such depression represents the first confirmation of findings in research led by Shalendar Bhasin, MD and published last year in The Journal of Clinical Endocrinology & Metabolism (Characteristics of Men Who Report Persistent Sexual Symptoms after Finasteride Use for Hair Loss), which suggested that men who experience persistent sexual dysfunction after discontinuing finasteride have “neurobiological abnormalities.”

“Among the most important milestones of Professor Melcangi’s research is that it builds directly on Dr. Bhasin’s work,” said Dr. John Santmann, CEO of the Post-Finasteride Syndrome Foundation, which sponsored the study.

“Medical science is now one step closer to characterizing the underlying biologic mechanisms of PFS, which in turn promises to pave the way for the development of effective therapies,” he added.

The full JSBMB study is available here.

Post-finasteride syndrome occurs in men who’ve taken finasteride to treat hair loss, or enlarged prostates. Reported symptoms include: loss of libido, erectile dysfunction, depression, suicidal ideation, anxiety, panic attacks, Peyronie’s disease, penile shrinkage, gynecomastia, muscle atrophy, cognitive impairment, insomnia, severely dry skin and tinnitus. The condition often has a life-altering impact on victims and their families, such as job loss and the breakup of marriages and romantic relationships, while also being linked to suicides.

As of April 2107, the World Health Organization Programme for International Drug Monitoring’s database of adverse drug reactions contained 13,533 finasteride ADRs, including 2,694 reports of erectile dysfunction, and 3,109 psychiatric disorders including 44 completed suicides and 31 suicide attempts.

In March 2015, the U.S. National Institutes of Health listed PFS on its Genetic and Rare Diseases Information Center, noting that “some patients who have taken finasteride have referred to side effects such as sexual dysfunction and depression (sometimes severe)… Studies sponsored by the NIH and other organizations are underway to better understand the effects of 5-alpha reductase inhibitor drugs.”


Does anyone have swollen lymph nodes?


I wonder if the 5-ar enzyme in the CNS never regenerated and that’s why we have low levels of DHT in the CNS vs. serum levels.


Well I’m not following you all. The key finding is " suffer from altered levels of critical brain-function regulators, including neuroactive steroids,

Dr Irwig today wrote me that he believes “methyl steroids” cannot change “neuroactive steroid deficit” in the brain:


It’s encouraging to hear of those who’ve overcome PFS, and while I’ve tried ever over the counter “remedy”, I’m eager to try pharmaceutical solutions to overcome this decade of PFS grief. I’ll do so only under the supervision of a well qualified doctor, and eager to find such a person.


Does such a person exist? I would imagine a doctor who took an interested, collaborative approach would be your best bet in absence of the desired expert.


Unfortunately no such doctor exists, just quacks.

Maybe Dr. Irwig will refer you to some one.

Write him at

But Irwig will probably say “there is no known effective treatment” unfortunately.

I probably just got extremely lucky.


On a lighter note:


…Looks delicious.


Well it’s tough out there for us - even though I am 90% cured of PFS maladies except world-class insomnia.

I’ve gradually become more interested in enjoying life - just bought this $450 travel poster from the 1960s for myself. (99% were trashed after being displayed, so they are rare(ish). Enjoy!


Hi, @anonymous1968, I’m glad things are working out for you. If you’re 90% back, what’s the 10% that remains?

Oops, see the next two posts. Sorry.


Insomnia. /20 chars.


Holy crap. Thanks for pointing out an excellent example of not reading anything at all. Sorry!


He used as a cure a massive dose of Methylprednisolone.


What happened to your gait / movement disorder? Did that recover as well?


I was just prescribed methylprednisolone for a root canal. Obviously not going to be the massive doses he receives but should be an interesting side effect.


Please do keep us informed. Hopefully there may be some positive outcome.


So, I’m on my 3rd day of methylprednisolone, I don’t know if it’s a good day (because I have those regardless of circumstances,) or a coincidence but, today I have more energy and less anhedonia than usual. I haven’t noticed much in term of downstairs, but any improvement is welcomed. Will keep updated as I only have 3 more days on it. Regardless, I don’t know that this has much merit in regards to the original story as I’m taking 4mg tablets versus the MASSIVE dose OP received.


Good luck man! Are you planning on tapering your dose to eliminate suppression sides?


@trav Curious how your remaining days on the medication went. Any noticeable improvements?