New Member, 9 years of fin, 2 months of Treatment w Dr. Goldstein

note: I have a fairly long personal story I typed out at the end of this survey. My history, my issues, and my recent visit to a doctor along with treatment and initial feedback. I cover more than just Fin with regards to E.D. So you may want to read through the end.*

  1. How did you find this forum?
    Googled finasteride/side effects

  2. What is your current age, height, weight?
    31, 6’1”, 180

  3. Do you excercise regularly? If so, what type of excercise?
    Weights 2x / wk, Jogging 2x / wk

  4. What type of diet do you eat (vegetarian, meat eater, raw, fast-food/organic healthy)?
    Well balanced, high fiber, lean. Chicken, fish, pasta, salads, etc.

  5. Why did you take Finasteride (hair loss, BPH, other)?
    Hair Loss

  6. For how long did you take Finasteride (weeks/months/years)?
    Approximately 9 years. From 2000 thru late 2008

  7. How old were you when you started Finasteride?
    21

  8. How old were you when you quit?
    30

  9. How did you quit (cold turkey or taper off)?
    Cold Turkey

  10. What type of Finasteride did you use – Propecia, Proscar, Fincar or other generic?
    Proscar

  11. What dose did you take (eg. 1 mg/day, 1 mg every other day etc.)?
    1.25 mg/dialy

  12. How long into your use of Finasteride did you notice the onset of side effects?
    In my 7th and 8th year, ED issues were undeniable, and energy and mojo and just…”lifeforce” started fading severely. Looking back, there were signs of degradation in sexual ability even as I was exceptionally horny and active and capable.

  13. What side effects did you experience while on the drug that have yet to resolve since discontinuation?

Put an X beside all that apply:

Sexual
[ ] Loss of Libido / Sex Drive
[x ] Erectile Dysfunction
[ ] Complete Impotence
[x ] Loss of Morning Erections
[x] Loss of Spontaneous Erections
[x] Loss of Nocturnal Erections
[ ] Watery Ejaculate
[x] Reduced Ejaculate
[ ] Inability to Ejaculate / Orgasm
[ ] Reduced Sperm Count / Motility

Mental
[x] Emotional Blunting / Emotionally Flat
[x] Difficulty Focusing / Concentrating
[ ] Confusion
[ ] Memory Loss / Forgetfullness
[ ] Stumbling over Words / Losing Train of Thought
[ ] Slurring of Speech
[x] Lack of Motivation / Feeling Passive / Complacency
[x] Extreme Anxiety / Panic Attacks
[x] Depression / Melancholy

Physical
[ ] Penile Tissue Changes (narrowing, shrinkage, wrinkled)
[x] Penis curvature / rotation on axis
[ ] Testicular Pain
[ ] Testicular Shrinkage / Loss of Fullness
[ ] Genital numbness / sensitivity decrease
[ ] Weight Gain
[ ] Gynecomastia (male breasts)
[ ] Muscle Wastage
[x] Muscle Weakness
[ ] Joint Pain
[ ] Dry / Dark Circles under eyes

Misc
[ ] Prostate pain
[x] Persistent Fatigue / Exhaustion
[ ] Stomach Pains / Digestion Problems
[ ] Constipation / “Poo Pellets”
[ ] Vision - Acuity Decrease / Blurriness
[ ] Increased hair loss
[ ] Frequent urination
[ ] Lowered body temperature

[ ] Other (please explain)

  1. What (if any) treatments have you undertaken to recover from your side effects since discontinuation of the drug?
    -Began treatment about 2 months ago.
    -6 weeks of Clomid, 2x / wk, 50mg
    -6 week boodtests indicated doubling of T & DHT (but DHT still below the lowest # in typical range), so dosage of Clomid was increased to 3x a week and daily ½ tube of 1% Testim

  2. If you have pre or post-Finasteride bloodtests, what hormonal changes have you encountered since discontinuing the drug (pls post your test results in the “Blood Tests” section and link to them in your post)?
    Bloodwork ordered by Dr. Irwin Goldstein (San Diego Sexual Medicine at Alvarado Hospital) prior to meeting with him in November of 2009:
    DHT 17
    T 335
    TSH 1.41
    E2 30
    FSH 3.0
    LH 3.9
    PROLACTIN 5.2
    SHBG 13

After 6 weeks of Clomid (2x a week, 50mg), my Testosterone was in the 600 range, DHT was doubled. Dr. G. said DHT was still very low and that we needed to get T to 1000. He upped my dosage of Clomid to 3x a week and added ½ tube of topical Testim 1% (50mg) gel (Testosterone).

Quick Update (full story at end): after just a few weeks of Clomid, I felt much more upbeat & energetic. 2 months later, I’m far more motivated to workout, run, and do simple things like empty the dishwasher which used to feel like a monumental task. I realized just how damn exhausted and out of it I’d been in the last couple of years pre-treatment. I’ve always been horny: pre, during and post fin. I’ve “just” suffered E.D., lack of energy/depression/melancholy. Meaning, even though erections are difficult to initiate, I’ve never stopped wanting sex or masturbating. Just avoiding situations due to performance anxiety, etc. Nevertheless, 2 months later, I’m starting to feel a little hornier, I’m masturbating slightly more. Also getting regular morning erections. Still not recovered, by any means, but this is what I’ve noticed and I’m trying to keep track as I notice changes.

  1. Anything not listed in the above questions you’d like to share about your experience with Finasteride?

Perhaps I have not read enough posts yet (I’ve been jumping around on different sections trying to make sense of this cursed circumstance and absorb as much as possible), but what I’ve generally observed is that most people here suffer from a lack of libido/desire/lust along with E.D. Is there a strong differentiation in post-fin sufferers between no libido vs. libido with inability to perform? I can’t just be with a girl, have a fantasy, or look at porn and get aroused like I used to, but if I jerk it, I’ll eventually get hard (takes longer than it used to), and I can maintain the erection. In other words, I masturbate a lot. Do you guys have zero to little desire to?

  1. Tell us your story, in your own words, about your Finasteride usage and side effects experienced while on/off the drug.

I was 21, started losing my hair, started freaking out, getting teased by friends, etc., so I saw the dermatologist and started taking Proscar 1.25mg daily along with Rogaine. Results were dramatic, people noticed, seemed to work pretty damn well, I was happy. Stopped the Rogaine after about a year because it just was a pain in the ass and it crusted the crown of my head.

I’ve always been super horny, very easily aroused, and just generally over-sexed. A girlfriend’s mere scent or tap on the shoulder would get me sprung in college. I could get erections easily, I could remain hard even after ejaculating, I could get restarted without too much effort. I could go and go and go. I could get wasted drunk and not suffer “whiskeydick.” It was a personal source of pride, it very much defined a large part of me. When I was first prescribed fin and read that a small percentage of fin users experienced sexual side effects, I thought “well that definitely wouldn’t be me.”

After a couple of years on fin, in a post-college relationship, I remember thinking “I used to be a little bigger, fuller down there.” I was still horny, still had a lot of sex, no real problem getting aroused. But I felt a little off. Like…just a few years ago, it was just a little easier to get an erection. Somewhere around this time I remember also noticing in passing that I didn’t get public erections as often. I used to come out of the water at the beach sporting an embarrassing hard-on. I thought back to the side effect I had read, and decided to stop taking fin. Within two weeks, my hair was noticeably thinner and more brittle. All this time, fin had definitely slowed the rate of balding, but I was still losing hair. But the weakness in hair without Fin was noticeable. My girlfriend asked what was going on, I told her, and she said “get back on that pill.” I did. Stupidest fucking thing I ever did. I ignored the obvious. I pushed aside the voice in the back of my head that was catching on to slight symptoms.

Life went on. Girlfriends, flings, breakups some hair loss, some missed Fin dosages, one night stands, etc. Overall, no real issues. Until some time in 2007. All of a sudden, my erectile performance embarked on a rollercoaster ride until I couldn’t deny there was something going on and finally brought the issue up with my doctor.

I’m sure most all of you have been in some sort of variation of this. You’re with a girl, and stuff just doesn’t work. You think it’s in your head. You think you’re nervous, or it’s a fluke. It happens again. The girl blames you, you feel horrible. You’re ashamed to be with the girl, the situation flames out. You try again. Maybe it works this time, maybe it doesn’t. Then it happens again. It’s all in my head, I just need to have a few drinks and relax. And on and on.

But this wasn’t the flukish case of nerves. The type of situation where you just relax, focus on kissing a girl, and go on autopilot and be ok. I couldn’t figure out what the hell was going on!! I’d be fine one day with an ex-girlfriend, then I’d have a one night stand and have difficulty in the morning. Then I’d be ok. Then I’d have complete failure. I’d have to jerk myself and get hard and enter a girl and then maintain that way. I first thought it must be psychological, since I was playing the field but still had feelings for an ex. Thought it might be desensitization to porn. Stress, etc, etc. But it got to a point where I flatlined, and it just wasn’t working.

I saw my doctor who told me to stop Fin and gave me come Cialis and told me to have fun. I avenged my previous horrid performance with a girl I was seeing. I felt alive, I felt like my old self. We went out drinking, we’d fuck, fall asleep, fuck again. Doctor said that Fin would clear out of my system in a couple of weeks, and that Cialis would help give me some confidence.

Well, without Cialis, I was back to square one. Went back to the doc. Blood tests. “You’re testosterone is normal.” More Cialis. Then Xanax. Nothing. WTF?? Went to see a urologist. “Your testosterone is normal.” Ruled out prostate cancer, diabetes and other things. But he acknowledged that there was a lack of admission in the medical community that Fin had serious and permanent sexual side effects. He thought I might have an excess of adrenalin, gave me Doxazosin for a month, nothing. All he could tell me is that Fin was probably the cause and that there’s nothing he could do but prescribe Cialis.

Next stop, finding a damn specialist. I wasn’t going to accept that there was no treatment. Started googling around and saw that there were a lot of post-Fin sufferers going through what I was going through. Finally, through asking around, I was referred to a urologist who ran a center specifically designed to diagnose biological causes of E.D. and eliminate psychological causes (which, contrary to my misconception, account for the minority of cases).

I visited Dr. Irwin Goldstein at San Diego Sexual Medicine at Alvarado Hospital (www.sandiegosexualmedicine.com) in November of 2009. (Note: this is not a plug. My experience has been positive thus far, but I’m not recovered yet. Just giving you the play by play so that you can get in touch with a specialist in E.D. if this story is similar to yours, and if you have not eliminated non-hormonal causers).

I started with a free 15 minute phone consultation where Dr. G. asked me to explain what was going on, and in particular heavily inquired about any childhood trauma to the penis I may have incurred. I then had bloodwork performed prior to my visit.

The office visit in and of itself is $400. There are a series of tests you can opt to take (which can put you out 2k total—but totally worth my relative peace of mind), to step by step probe and narrow down the cause of your E.D. and determine what a course of treatment would be in your first visit. I ended up having my penis pumped up with fluids, needles stuck in my penis, blood pressure/flow measured, Doppler ultrasound, etc, etc. I’m going to skip going into detail about each test for the purposes of this initial post; the bottom line is that it doesn’t hurt (just some needle shots), and you come out understanding whether your issue is initiating, filling, or storing (maintaining) an erection. If you have scar tissue or arterial blockage, etc. The penis is observed in an erect state and monitored for heat/cold sensitivity, etc, etc. You can see the blood flow on a screen. And the whole time, Dr. G. is cracking jokes, he’s very obviously sexually liberal and open, the setting is surprisingly comforting and accepting.

But let me back up. Before I got to these tests, I sat down with Dr. G. and he explained the basic process of getting an erection, went over my history, asked me to demonstrate on a model the extent of my erection capability, etc. And he relayed that my Testosterone wasn’t “normal” as previous doctors had claimed. I was 31 years old, 300 level is not normal!!! And of course he tested for DHT in his panel. That wasn’t normal. AND THAT WAS NOT TESTED BY PREVIOUS DOCTORS!!! Again, here were my results at the time:
DHT 17
T 335
TSH 1.41
E2 30
FSH 3.0
LH 3.9
PROLACTIN 5.2
SHBG 13

Dr. G. told me that my T and DHT were extremely low, particularly DHT. He said that DHT was below the lowest number on the range of “normal.” Clearly, the anti-DHT medication I was on for 9 years had done something. “How do you feel?” Dr. G. asked. I felt exhausted. I didn’t realize, until that visit and subsequent research how much Fin screws with your system, how low T makes you feel exhausted and depressed, and half a man.

On to the physical penis tests. Turns out, I had a minor arterial blockage. I was able to achieve an erection while pumped with fluids watching porn and hooked up to probes and such, and I was able to maintain it well. The tests showed a blockage (usually due to childhood trauma: bike accident, getting kicked, falling on a fence) which interferes with ability to “initiate” and “fill” an erection. But I didn’t suffer from, say, “leakage” issues, or scar tissue, etc.

So now what?

Well, much like a bypass procedure for the heart, as a young, healthy man with only minor blockage, I could get an arteriogram (google it) and further “x-ray” the situation and decide to have a re-vascularization surgery where another path is created to aid blood flow. This is supposed to have excellent success. After 6 weeks of laying low, recovering.

But you don’t do that until you have stable hormone values. Dr. G. said it was possible and optimal to treat the hormonal deficiencies and not need surgery.

And so now, as mentioned under the previous “bloodwork” survey question, I’m 2 months into my treatment, taking Clomid 3 times a week and using ½ tube of Testim 1% (50mg).

My initial dosage of Clomid was upped, and Testim added to the mix after bloodwork performed at 6 weeks indicated double the T and DHT, but still not enough DHT.

I had begun to feel better after a few weeks. And I realized just how much of a funk I’d been in the last few years. I’ve always been energetic, athletic, optimistic, fun-loving. And I wore a happy face throughout this ordeal. But I was sooo damn drained, so mentally exhausted, so easily panicked and stressed. I couldn’t focus on one thing, past my normal, untreated ADD. My mind raced about how get things done, my confidence and zest for life had evaporated. I would go out drinking, but felt myself progressing deeper into a funk due to sexual incompetence, stress, and lack of energy or desire to do things. I needed energy drinks to keep up. I look back and it’s all so clear now. I couldn’t get up off the couch, I couldn’t be bothered to do simple things like check the mail.

Fortunately, I now feel a lot better, just 2 months into treatment. I’ve been working out, eating healthy, just filled with more desire to get up and about. And I’m further motivated to eat well and exercise since “what’s good for the heart is good for the penis” as Dr. G. says.

I am still not recovered, however. I do now have regular morning erections (60-85% full) with or without taking the 5mg nightly Cialis (helps circulation—very important to not atrophy down there) which I’m hoping is a good sign, but I still can’t just get an erection on demand. I take 20mg of Cialis when I think I’m going to get lucky. I typically need to drink quite a bit to lose my nerve and not focus on my penis and let the Cialis do it’s thing. But this cycle of behavior has taken its toll on me. If I can’t pursue a relationship or have sober, weekday sex, what’s the point? I’ve just decided to stop drinking alcohol for a while. Let my body strengthen even more, allow the medication to metabolize correctly, and hopefully function will be restored.

Part of me is encouraged and so grateful that this forum exists and that people are sharing stories and increasing awareness and the potential for cut and dry “cures.” Part of me is discouraged by the insane complexity of the chemistry of the problem, and by reading that many have taken similar drugs and not been cured. At this point, I’m still trying to be positive and healthy, and arm myself with as much knowledge as possible.

I 100% believe that Fin has f’d me up…but I still don’t know how much the blockage issue is contributing, or if that was possibly caused by the Fin.

My main question is if people generally have a lack of desire, or if just as many people have desire but inability as I do.

I also would like to know if anyone here has used/is regularly using ketoconazole (brand name: Nizoral, topical ointment for dermatitis) or cortisone creams? I found out that when ingested, this acts as an anti-erection medication! Applied topically, it is supposedly not absorbed into the bloodstream. But why take the risk? I found that taking a Biotin supplement (5,000mcg/day) is a natural, side-effect free treatment for dermatitis (along with light Selsun Blue shampoo/selenium sulfide topical/face usage). Works much better too! (I’m highly suspicious of all meds now!!!)

Thanks for reading this book, please feel free to communicate with me more about my treatment, any advice you might have, any similarity with my case, or anything at all.

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“typically need to drink quite a bit to lose my nerve and not focus on my penis and let the Cialis do it’s thing. But this cycle of behavior has taken its toll on me. If I can’t pursue a relationship or have sober, weekday sex, what’s the point? I’ve just decided to stop drinking alcohol for a while. Let my body strengthen even more, allow the medication to metabolize correctly, and hopefully function will be restored”

This statement crystallizes my situation and i thank you for writing “this book”. I also feel I need to drink to loosen up, the alcohol acts as a sexual lubricant for me. I also take a small does of viagra most of the time with my girlfriend. It’s fucking debillitating.

I was also on the medication for a little less time than you and generally always had failry serious girlfriends. But the initial onset of side ffects was pretty subtle.

After getting over one serious relationship I met a hot girl who I wanted to fuck extremely badly but when time came it was like my dick just wouldn’t get up even after intense make out sessions and ass grabbing etc ( FYI, I was extremely horny during this point and whacked off wih impunity) But when I was with a girl I just couldn’t do it. it drained my confidence and this kept perpetuating a failed penis.

This happened a couple of times before i was like what the fuck. I also thought it might be psychological.

Anyway fast forward a year and a weekend long drinking binge my dick would not work, a flaccid noodle. This lasted for tow weeks and then after that I was back to normal for five months. Then these side effects came back but not nearly as bad.

I have a miniscule libido which is the worst part and just whack off to feel normal. My erections are there in the morning but not nearly 100% and no spontaneous ones.

My uro also prescribed me Clomid last week which I will try for the first time this weekend.

Also it is of note how closely related the motivation to work out and fuck are correlated. I don’t have much of a desire to work out but do just to do it.

Anyway, it seems our stories are pretty similar and if you have any questions fel free to PM me. Hope you don’t mind if I do the same…

I think it’s more in the desire for me. But it has been the other way also :frowning:.

At my worst, I had no libido at all. Didn’t care if a girl was naked on all fours begging for it. No tingle, no feelings of horniness, nothing. I’m still not up to code in the desire dept., but functionally, I’m fine.

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You’ve just about sold me on Dr. Goldstein, in large part because of the whole exhaustive analysis of what’s causing sexual issues. The thing is, Dr. Crisler is a two hour drive away, while Goldstein is on the other side of the country. Still, Goldstein is apparently cheaper for that first visit, so maybe I’ll consider a trip when I find myself in the southwest.

Mikey428, I can relate to being horny as hell like you and “whacking off with impunity” but not being able to do anything with a live girl. In fact, I had a situation where I was struggling to get turned on, the girl passed out, and I whipped up some porn on my computer, stroked until I got hard and then tried to wake her up before losing my erection. Absolutely ridiculous!

So it sounds like you’ve gone from horniness/inability to flatlining as far as desire? So you don’t look at hot chicks and have that urge to jump them? I do, but there is this disconnect between my brain observing beauty and a spark firing off down there.

You mention the drinking a bit. I’ve been a weekend warrior when it comes to partying for a while. Never had failure due to booze. But the booze became a crutch to loosen up and allow the bandaid solution of Cialis to work. Problem is, that I don’t know when to stop. And then I might overdo it. I’m not certain, until the actual Cialis-induced erection emerges that it’s gonna happen, I’m that messed up in the head. So I avoid the situation, until the girl is forcing herself on me, stripping, and I “get the notification.” I’ve gotten sick of facing this anxiety, and as I mentioned in my original history, I’ve decided to lay off booze altogether, try to maximize the strength of my system and hopefully the efficacy of my medication. And of course save up money for Cialis. Geez.

Btw, any preference for those who use assistance from those drugs…Viagra, Cialis??

Mikey428, I wish you luck with your Clomid therapy (I’m assuming you had bloodwork done to see before and after?). Definitely feel free to write me and I’ll be frequently visiting and posting on this site and updating everyone on my progress.

On quick glance (still getting up to speed on all this information, this could be an over-simplification), it appears there are sexual dysfunction specialists (urologists, etc?), endocrinologists, and anti-aging professionals who are getting involved with testing out treatments on post-fin sufferers.

I definitely think that anyone suffering from E.D. should consider ruling out the physical causes along with addressing the hormonal. Dr. Goldstein’s operation is definitely first class, you can research his background, he’s very intelligent, very accomplished, and I really liked him. Thing is, I don’t know just how many cases of post-fin ED he’s seen or cured to any extent. He seems very cautious and conservative in his course of treatment, and I appreciate that. But he (and perhaps all these doctors) cannot/do not give you all the answers, they refrain from saying with certainty that if you raise this, then you get this, and you should be on your way. I keep hearing that every case is different. And it is. I’m curious as to anyone else’s experience with Dr. Goldstein and Clomid and topical T. Any results?

Also, the initial visit/consultation is $400, but if you do any major testing, the a la carte tests range from 150 and 200 to 800 bucks if I remember correctly. (And you do your own bloodwork prior to going in to give him a starting point). Again, if you want to 100% isolate causes, shelling out up to 2k on the spot may be in the cards. They give you an insurance form with “hypogonadism” etc, checked off for you to file with your insurance, but I was told to expect only a small % back.

Does that mean that if a girl tackles you and rips your clothes off, you can get an erection…but that you’re not feeling any horniness, not getting much pleasure?

I don’t have that “tingle”, that spring, that “mojo”, but I have incessant desire.

There’s something missing in between my brains and balls…but I can’t stop masturbating or checking out girls. I wonder if I’m in the minority on this, or if people experience this and then get worse, just eventually lose all desire?

Yes, exactly. I have been in recent months able to experience more pleasure, but that musty feel of horniness, that intoxicating chemical cocktail of hormones, that feeling of wanting to take her and dominate her, it is almost non-existent. Once I’m in the act, things loosen up a bit, but like you said, there is something missing. Whether or not this “spot” in my head comes back on line, I’m waiting to see. Maybe it will, maybe it won’t. I’m just glad I can think again, and talk to people without flying into a panic attack and collapsing from exhaustion.

In regards to your other comment, many men here have NO desire whatsoever. Like I said, could care less if it was right in there face. Nothing happens the way it should anymore…depressing

I will now limit myself to women whom I’ve built somewhat of a connection with before attempting sex. Even then, I’ll have them cumming first before I even enter them. That usually gets me fired up enough to fuck, and I don’t have to worry about them being dissapointed. It works, keeps them coming back for more (no pun intended) but it is not the same as my youthful, healthy days of indiscrimate man whoring…

It’s a similar experience for me, although this has been going on for over a year now and there have been so many ups and downs that it’s impossible to keep track. I do notice attractive women, but I don’t have that primal urge to have sex with them like I did when I was a teenager… there really is a kind of disconnect between my brain and my penis, although it’s been so long since my pre-fin days that it’s hard for me to gauge it. I can always get an erection sooner or later with physical contact, but after that it’s almost impossible to maintain it… I have to limit myself to certain positions or go kind of slow. There have been some ups where I’ve gotten erections just standing next to my girlfriend at the airport, but these moments have been few and far between, whereas I feel like a 21-year-old male should be like this most of the time.

As far as doctors and costs, I’m still a broke college student, so I’ll probably stick with my plan to visit Dr. Crisler sometime in the not too distant future. I already have an appointment with a local endo just to check up on my hormones for the first time in a while.

I can really relate to this…I found for a while…that giving a girl a backrub and brushing up against her allowed some blood to flow down there, and helped a bit. Also found that the freedom to explore any positions was gone.

Absolutely, get that blood panel done. Not just a basic Testosterone test, but DHT and all the other crap that people list on this sitee. It never hurts to have a snapshot of the present time on hand to compare to future testing. I’m waiting for my doc to send me the full lab results so I can post precise #'s and ranges and see what people on here think.

Xhorndog, my situation was almost identical to yours. I don’t have insurance right now, so blood tests are going to be out of my budget, but I will have to figure out a way to make it happen here soon. I will follow your thread, keep updating it>

I know Merck doesn’t want to hear this…but…get your 3 Adiol G tested…THIS IS VERY IMPORTANT as most of us have LOW 3 ADIOL G levels.

Xhorndog,

Welcome aboard. There is a wealth of information on this board, on a collective basis far more than Goldstein, Crisler or Shippen knows individually. Read the Adiol-G thread under Bloodwork, and Finasteride caused Androgen Insensitivity or altered Gene Expression? under Theories, for starters.

Since you are on clomiphene, also read through the My Recovery Via Clomid thread under Recoveries. While 50 mg 3x week is not without precedent (see AT Guay’s study linked in the thread) it is considered by Crisler and Shippen to be a whopping dose. In my own experience, 35 mg 3x week had me feeling pretty good for about 2 months (& T >900), and then my estrogen started to rise into the high 40s and libido went down significantly and ED crept in a bit.

In my opinion, what you want to do is find the lowest dose of clomiphene that will get your T over 600 without raising estradiol (and bump your FSH to 4 or higher), save the topical T when you need a boost e.g. out on a date or whatever.

Taking topical T daily suppresses the pituatary, and leads to Serotoli cells going dormant/testicular shrinkage, while clomiphene enhances pituatary secretion of LH and FSH. Not the greatest idea to have two opposite effects on the pituatary simultaneously. Goldstein should have waited to see how much T you could make on clomiphene alone, but at least you found a doc that recognizes post fin issues. One issue with topical T is that it comes through your skin in a low, long wave. In natural form with a properly working HPTA testosterone comes through in pulsatile fashion every 10 to 20 minutes. Clomiphene more closely mimics this secretion pattern by stimulating the pituatary (via occupying receptors on the hypothalmus).

Hope this helps - kazman

thanks, wish I never had to be here! lol. I’m digesting, I feel like I’m back in bio and chem class. Should’ve paid more attention.

Thank you for this info. I don’t think the doc intends to keep me on this regimen forever, but he did, frustratingly say that “the damn DHT is still too low, we’re gonna have to get you to 1000” in reference to T level. I can’t argue your position (I simply do not know enough), but what risk is there to pituitary function if (and pardon my ignorance) there is a cancellation effect between the two drugs? And if I were to eventually stop the topical T, what would happen?

Thanks again for your help. I’m debating getting bloodwork done before my visit next Friday, or waiting to discuss 3 Adiol G and other markers (although I don’t really know what the hell I’m talking about just yet from binge-studying the 100s of posts on here) and seeing if the doc wants to/is willing to explore other testing. Thoughts?

Horndog,

I know who dr. goldstein is…He is a very good doctor, infact dr. munnarriz(who use to work with dr. goldstein at one time) was my doctor for awhile…Dr. Goldstein is extremely smart…I thnk you are in good hands.

They did the same exhaustive procedures with me along with the vasular arteriogram.

However, in this email there is something YOU MUST mention to him, and he needs to research this and give you DHT supplementation. JN on this board has been right all along(their are people who unfairly criticised him and some who actually…anyways, DHT supplementation is key for us to getting better. I’ll tell you why now(through my countless exhaustive researching).

A low DHT and abnormal 3-Adiol G(metabolite of DHT) WILL AFFECT your copera canversora and vascular nerves. Please read the PDF file I just posted in the Other Studies section. READ all of it, print it out, and GIVE IT TO DR. GOLDSTEIN. This WILL GIVE HIM MORE CLARITY. He has seen othe finasteride sufferers before, I know that to be true.

So, anyways, this explains why our blood flows and vascularity are weak. Without an ample amount of DHT and 3-adiol G(which is the best MARKER for 5 AR II activity, our systems get messed up much like a person undergoing a radical prostectomy(again refer to article mentioned agove). I draw this conclusion because of a few things 1.)numerous posters on this message board follow a similiar pattern(low 3 adiol g levels) 2.) I have done all of the exhaustive procudes just as you, but have decided not to go ahead with any vascular surgery 3.)I’ve read a very good article on radical prostectomy which also has a study on finasteride as well. This must be read and not ignored 4.)Their are people on this forum who took DHT supplementation, and began to start feeling better(follow JN posts).

So, what I think Dr. Goldstein should do is assist you in prescribing some DHT GEL along with some kind of testosterone therapy(whatever he prefers).

I’m tired, I’m exhausted, but I’m not giving up. We are getting there…

Link to article I’m talking about

diss.kib.ki.se/2009/978-91-7409-462-6/thesis.pdf

Anonnn1, thanks very much for sharing this link and the vote of confidence in Dr. G. My impression is that he’s extremely bright. Coming on this board and reading some cautionary and sometimes contradictory advice, amidst all the great research and connections people have put together…well, it can get a bit frustrating and scary, to say the least. It’s assuring that several of you out there have written me regarding your high esteem for the doc. I will definitely read through your link and print it out, share it with the doc and post my experience.

On my list to discuss with the doc:
-why clomid + Testim? Is this just for a jumpstart, but not maintainable? (I’ve been told that one stimulates the pituitary, the other suppresses it)
-3 Adiol G test
-supplemental DHT
-liver function?

Any other suggestions for things to bring to the doc’s attention? Any other things to test for?

Thanks Anonnn1 and everyone for your insights and help!

CD,

I feel much the same in terms of that sensation that you had to have sex with a certain girl. The fact that many of us are seeing positive improvements in energy and erection quality, yet we are still missing something tells me there is certainly more than low T with us. There are a number horomones that are screwed up.

Boston,

I FEEL it is a brain issue for me at this point. That’s where you get the feelings of horniness, in your head first, then things cascade down the ladder to your unit. I have said this a hundred times since joining this forum, but I can feel this spot where these feelings used to be, and it feels burnt out. Maybe burned out for good, who knows. Androgen deprivation can cause brain damage, especially to parts of the brain dependant on adrogens to function correctly.

There are times when I can feel a very faint horniness, like I used to, but it feels distant, far away. As if what ever part of my brain that used to work in that dept. has a couple neurons firing, but not all cylinders are going.

This is my main issue now. Everything else has been fixed. My test is up, my muscles are swollen, I’m getting morning erections again (70-85%) I can feel aggressive, have conersations, be witty, etc, etc. So, I am moving in the right direction. Also, I have been kegeling for half a month or so, and it definitely has a positive effect on everything downstairs.

Oh, I still have the damned ringing in my ears. Some days it’s louder than others.

.