My visit to see a urologist

Hi guys
Yesterday I had my appointment with a urologist as embarrassing at it was it had to be done.
I told him about my previous prolonged use of steroids and finasteride it was a difficult conversation as I was basically telling him everything what i had been taking and the reasons as to why which isn’t an easy place to be as to me its basically saying I’ve screwed myself up could you please help me out of this situation I’ve created , you have to keep in mind these guys probably have zero time for people that self prescribe / administer these drugs personally I wouldn’t blame them at all.
Luckily for me this guy was first class from start to finish he let me tell him my side of things
( i didn’t go in their ranting on about PFS )
I just explained how much situation had come about … Sexual dysfunction / impotence lack of libido anxiety depression and lack of drive etc.
To my surprise he knew all about finasteride and did not dismiss that it can cause problems.
He obviously knew everything about steroid use too.
He examined me and had a look at my previous blood test results he then explained that my testosterone levels should be between 10 & 29
My test level was 10 he said that due my prolonged steroid use my body now required a higher base level of testosterone and mine being at lower end of the scale had put me into a state of hypogonadism that my body Could not get past as it now has lower T levels.
He also said that the use of finasteride Would of crashed my system even further possibly making it impossible to recover from.
He offered me viagra to help me out for now whilst we find a resolution i embarrassingly explained that had been using viagra for years since the introduction of finasteride as the steroids alone didn’t seem to be the thing that created the whole situation I then explained that i had tried clomid Adex hcg and preg on occasions to try to reset my system he didn’t seem phased by this he just reassured me that he should be able to correct the whole situation.
My Next appointment will be regarding my hypogonadism specific blood test and the results to see what he can do to resolve the situation.
I have the feeling this is going to take time but not as much time as i have waisted by not pushing along with medical assistance and for the first time in a years i feel positive that i will see an end to this situation and regain my lost sexuality and hopefully be in a position that I can inform other guys how to get back to base.
Worse case scenario I will be stuck in the same situation as I am now relying on drugs for any form of sexual activity but at least i will know that I have done everything I can to dig myself out also I will have created further awareness of within the medical world.
Don’t give up on medical assistance until it gives up on you inform your doctor and go the distance.

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ur lucky ur urologist know about fin and stuff
keep up the good work!

regards

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I do not think he will be able to fix you, sincerely. But lets have hope.

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I have high hopes but also realistic expectations I understand its a tall order but its also the most sensible direction to be heading in.
I’ve done the hard parts been through the embarrassment of admitting taking these drugs and the uncomfortable situation of the physical examination Im committed to following this road as far as it will take me having a urologist by my side sure beats guesing at what to do next and certainly beats any further arm chair science protocols which im of in cases just make matters
worse.
I’ve spent years playing the guesing game reading this reading that trying this trying that with zero progress.
I have nothing to lose and im not about to lose Hope .

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Of course nobody has to loose hope. Try it, and tell us. This will add much more info about how ro cure or what is worthless at least.
What i think is that our condition is not hormone related, but receptors.

I will keep this post updated with each visit
My next appointment is weeks away which is really frustrating but when you have been in these shoes for years I suppose its not the end of the world.

Thanks zadig777

I was very lucky that the urologist knew about finasteride but trust me mate this appointment didn’t come easy it came after seeing several doctors that didn’t really know much about finasteride at all.
I had to ask again and again Could i please see a specialist …

It is certainly worth while to look into this. I am under the impression that some guys did improve on higher testosterone levels in the past. However, others (like myself) got substantially worse after raising T. It is possible that changes, in whatever direction, will happen slowly. I tried keeping a little diary and was tracking some key symptoms to see how I was progressing. If you do get onto TRT, and find that it makes you worse, stop immediately, regardless of what your levels are. We often are not reacting normally to testosterone anymore in our situation.

Thanks awor
I’m going to be logging everything as you say things Could go either way so its important to keep track.
I hope that this is the answer only time will tell.

How long did you stay on TRT mate ?

Well, my situation is quite unique in that I was on TRT for many years before taking finasteride and getting PFS after only 20 pills. I was doing great, dosage was perfectly adjusted. Very quickly after starting with fin I begun getting side effects and quit, after which I almost immediately crashed. At this point, my TRT did not work anymore, and my injections actually made me feel worse. Since I was on TRT well before finasteride, I also had many labs from that time. Because of this I 100% know that T levels are not the problem in my case. These days, I still am taking T, but at very low levels (about one third of my pre pfs dosage). Either an increase or decrease from this new baseline is not good for me.

I have this EXACT problem. Except it is with estrogen.

Thanks for the info really appreciate it
Could i ask why only one third of your trt
Is this because your baseline T is naturally higher post finasteride ?
I was on 2ml 500mg testosterone injections done weekly i was into bodybuilding this is double trt treatment but my natural T levels are now lower post finasteride and my body requires higher T levels to function that’s why I’m suffering hypogonadism post fin and post steroids …

No, my natural T production dropped after crash. Since crash, I cannot handle the same T levels anymore. In other words, my combined endogenous production plus supplemented T must now be substantially lower than pre crash, less than one third. Increasing T makes my symptoms massively worse. At the beginning, when I was still supplementing at a higher dosage, I got so depressed that I nearly killed myself. This is when I started gradually reducing T, thereby feeling better (relatively speaking, not talking about recovery).

Thanks again awor
I will keep all of this in mind when the time comes it’s good to know what to watch out for although it’s strange i suppose things are just so unpredictable.
Cheers mate

Just want to say a big well done Baz! You have definitely done the right thing and I now hope you are on the right track to a reasonable recovery.

I think hypogonadism makes sense given your blood test results, symptoms and previous steroid use. Its certainly a reasonable hypothesis and I pleased your Urologist is considering this. Presumably he has sent you for more blood work, specially testosterone? A 10 is definitely in the ‘borderline’ category. Your hypogonadism may also have caused some venous leakage over the years too further contributing to the ED and it would be interesting to see if this is the case with a Doppler ultra sound using erection producing medicine. Perhaps worth asking for this?

The good news TRT (and probably continued viagra) should go a long way to correcting the underlying problem. There is also evidence that testosterone replacement repairs venous leakage in the penis. So I do feel hopeful for you.

Two things are on my mind though. Firstly, you said you tried Clomid in the past as a potential therapy to correct all this without noticeable results? Of course, clomid increases testosterone production so theoretically should have worked. How long were you on the clomid for? It may well be there case that you were simply not on a testosterone increasing agent for a long enough time to produce the desired effect. For example, the venous leakage studies with testosterone were six months in length. It may well be the case you just need longer on the tester one boosting medicine. The other possibility is you need TRT and not clomid. It does sound sound like there are more failures with climbed than with TRT for guys who have low T.

The other issue is of course how much of this is Low T and how much of this is PFS? I suppose we will never know until you properly treat the low T and really give it a good course of therapy (several months). I would take T replacement and viagra for several months and this should give you a pretty good answer.

I think you have good reasons to be hopeful. It sounds like you have found a good doctor and have a way forward. Stay off all non-doctor advised medicines and supplements for now and just stick to the doctors advice. We are all rooting for you to get better mate.

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Thanks Will
Thankyou for your hopeful kind words mate you really are level headed guy that speak words of wisdom and great advice.
I know exactly what you mean regarding is the damage steroid induced or PFS this is the big question to mind at the moment and the main reason I’ve headed back towards medical assistance.
As you say my T level being at 10 is borderline keeping in mind that this test was done early morning after hours of fasting at a time when you would presume T levels are at their highest it does lead to speculation that average T levels probably drop down to 7 at some point in the day.
On top of this I’m bearing in mind that i live a healthy lifestyle plenty of exercise and adequate rest high intensity weight training a healthy high protein diet meat and fish and supplements i.e high doses or vitamin B creatine powder L glutamine powder and protein shakes containing full spectrum branch chain amino acids along with a daily multivitamin and omega 3 & 6 fish oil capsules you would think that my body has everything it needs to produce an abundance of testosterone.
I’m currently in progress of doing more blood work to get an average of where things are.
It’s all a bit of a mess really mate as you see I’m back to first base looking into things along the steroid line but in the back of my mind i know exactly when the problems started steroids alone didn’t effect my libido or errections negatively as long as followed pct correctly.
It was when i added the Finasteride to the mix the shit hit the fan.
I have tried clomid in the past but it wasn’t for more than a week or so as it was just left over tablets from pct.
One other thing that screams out trouble is that when i was on fin i was taking high doses of ibuprofen throughout the whole time I’ve now seen studies linking finasteride use along with Nsaids gives a much higher chance of ED issues.
I really don’t know what to make of it all its a mess i look back and ask myself how did things get so out of hand.
It’s all been a bit like that old rhyme
I know an old lady who swallowed a fly
She swallowed a spider to catch the fly
Etc etc etc
My version is
I was constantly prescribed pain killers and ibuprofen to deal with pain
The pain got worse but nobody seemed to be able to or want to help
So i swallowed the steroids to strengthen myself and help fight the inflammation
I couldn’t keep taking them orally so injected the dam things
I noticed my hair was falling out
So i swallowed the Finasteride to sort this out
The next thing you know the shit hits the fan
So i swallowed viagra to get it over this
Etc etc etc

Hopefully things will be looked into this time mate and I can come back with some positive information.
The urologist thinks Hypogonadism seems to be the first thing to look into in his opinion also keeping in mind that long term steroid use can lead to your body requiring a higher T level than pre steroids and not being able to deliver that can add to the mess also adding Finasteride just throws things all over the place.
As I said in my last post i did not go into the urologists clinching paperwork regarding studies into PFS howling finasteride has broken my Dick
I don’t want to be thrown out of the building or to be told hold it their whilst i just make a quick call only to find myself waking up in a white padded cell wondering why I’m strapped to a bed.
No disrespect but I have tried in the past with doctors they don’t even bother to ask themselves “is this plausible” I highly doubt that they even have a clue what side effects could come from any drug they are very A to B quick as you can type guys i.e this guy has come in with a broken Dick hmmmm “take these viagra and see how it goes chap” job done.
If I’m honest it’s like they don’t really have time on their side to think about what the real problem is At my last appointment with a doctor after alot of questions from me a fair share of heads knocking together I was told it was venous leak take cialis or viagra " Plausible" but it doesn’t explain much in reality it doesn’t explain why the problem has persisted so long or why i feel weak tiered depressed anxious struggle to remember things have low sex drive zero errections morning or night and it doesn’t matter how much i eat how many supplements i take or how hard i train nothing grows but my waist.
I was faced with a doctor that after listening to everything i had to say on the day and knowing that i had been in the surgery for this exact same reason and mentioning finasteride years previously a doctor that has full access to my medical history in front of him is now offering me prescription viagra even though I’m in the surgery talking to him because i want to know why i need to take it ???
Talk about missing the whole point of me being their …
This same doctor told me that my testosterone levels are normal he didn’t mention borderline or on the low side even after knowing all of my history blood test results you name it he writes me a prescription for the tablets I’m already holding in my hand after me showing them to him and telling him i would like to know why i have to take these bloody things.
This is where you have to get back up pat yourself down climb back up on that horse and politely ask could i please see a specialist i.e urologist.
This shouldn’t be an issue as you have a valid reason but when you get their don’t be one for howling PFS blah blah blah
Yes we have the so called symptoms the sexual issues the memory problems etc … But nobody is going to diagnose you with PFS at this point in time and who knows who has it and who doesn’t have it …
In reality we have a set of symptoms that need explaining to a urologist or a doctor depending on your symptoms we mention finasteride then we let them decide what the problem is and the best way forward.
Follow what they say and see where it goes from their.
Howling PFS is not really practical until we have done all of the groundwork to rule anything and everything else out.
Then when no one has any answers and we are still stuck on first base we are left to hope to god Baylor eventually has an answer.
If you don’t follow in this sequence then you have pretty much diagnosed yourself with PFS
It’s easily done when doctors have no answers for you and all the symptoms fit into place you took Finasteride things went wrong it all stacks up its PFS
But you have now diagnosed yourself with a syndrome that no one can help you with the medical world are in denial of its existence and your as good as on your own taking this taking that trying this trying that buying this buying that
Playing with your hormones again and again
I did this myself and all to no avail
I maybe slipping back into denial that all my symptoms are PFS or I maybe just heading back to the medical world to rule PFS out with my fingers crossed its all just been a case of low testosterone.
One thing is for sure I want to rule everything else out in this world that possibly could be causing me these issues before I condemn myself to another 10 plus years of scratching my head drugging and supplementing myself silly whilst hoping for a cure to something that just seems so incurable.
I want to rule out all of the simpler things with the assistance of a professional so little room for mistakes rather than the wild stab in the dark mindset a trap that we all end up falling into.
Fingers crossed its just been low testosterone levels all this time so help me god…

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You should really be showing your urologist the literature about Finasteride upregulating the AR receptor. Serum levels of Test probably won’t anything. I’ve got my T to 980 and didn’t feel a damn thing in the sexual department. It’s an issue with binding not serum levels.

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I agree 100% mate
In an ideal world i would do this but you have to understand I’m in a bad place and have been for years and the reason I have had such little help previously is down to pointing the finger at finasteride as the cause of my issues.
This time round I’m keeping an open mind myself I’m still reporting the exact same issues but without the immediate speculation of the finasteride as the main cause.
If they can find a problem and possibly fix it I don’t mind what they tell me they think is the main cause.
Going in with the mindset that everything is due to Finasteride has previously been highly counter productive to say the least.
If they do their tests and some obscurities pop up I can be more assertive about my thoughts of the cause at this point I can show them paperwork etc but up until that point I have to keep in mind the possibility that steroids haven’t done me any favours.
The bottom line is doctors and urologists will only spare you their time if they believe that you have a valid credible medically accepted reason if you go in howling PFS you can only expect one thing from it
a visit to the accident and emergency department with a bloody nose from the door being slammed in your face.

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I really would like to point the doctors and urologists in the direction of this forum as their is some quality information here along with some great guys stuck in the same situation as myself it would be fantastic to get some form of feedback as to their professional opinion of all of the studies and data available here
But you have to be realistic as to keep in mind that you have already admitted using a multitude of hormone altering drugs one on top of another in a bid to counteract the side effects of the last drug then you have pressed on with advice from a forum on the internet inspiring you to try a stack of protocols drugs and magical supplements in yet another bid just to get back to normal.
It’s all pretty ironic really the more you think about it.
which leaves me to ask
How do you think it would go down if I was to point these professional minded people towards this forum where there is talk of people using not only hormone effecting drugs but talk of drugs that could seriously effect people mentally i.e magic mushrooms and LSD
Hmmmm after raising an eyebrow or two I dare say it would lead to yet another trip down to accident and emergency after having the door slammed in my face yet again.
I know this probably all comes across as very negative on my part but I’m afraid it’s the reality in the medical world.
We can spill our hearts out bleating on about PFS we can throw studies at them we can bring them to this forum which is very professional with big wig names of professors and Baylor studies in progress but its all going to mean very little to them in reality topped off with talk of what they would class as insane drug use I really can’t see any positives coming from this approach myself its a tried and tested method that leads to nowhere.
I know some folk are going to hate me for what I say next
I can’t help but think that we need to change our mentality stop with the drug testing lottery approach this is a needle in a haystack situation that will eventually harm someone before it cures anyone.
If drugs are in trial great but realistically needs to be done under medical supervision prescribed by a doctor and followed up by a doctor.
The goal needs to be to get through this in one piece mentally and physically in the safest way possible with as much professional guidance as possible to rule out every single other possible explanation.
Leave the drug trials to the doctors and the lab rats if they can’t fix things how do we expect to.

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