There seems to be a clear discrepancy in symptom severity when comparing older and younger men with Post Finasteride Syndrome with younger males being more prone to developing PFS. There must be a defining reason why that is and to me it must come down to a higher ratio of Testosterone/DHT in younger males who’s phenotype rely more heavily on androgens, it would seem plausible that the higher the androgens a person produces in site specific tissues then the more prone they are to developing Post Finasteride Syndrome. Many of the people here were gym goers, had high libido, and were relatively young but what’s also noteworthy is that most will probably only experience libido and cognitive issues because 5ar is highly expressed in these site specific areas more so than anywhere else including the prostate, penile tissue and brain thus these sites are usually the ones to be solely affected in PFS patients.
I have also held onto the belief for some time that raising Testosterone can make users symptoms worse, when I got my Testosterone checked it was 8nml below the national average at this point my libido was still okayish, I still felt androgenic and muscles still had power, I could still play video games and socialize so neurosteroids were still working. For 2 days straight I worked out like I was training for the Olympics for 4 hours at a time this consisted of heavy weight lifting, HIT workout, running, and boxing I was pushing myself to the utmost extreme but what was noticeable in the days that followed was that I lost libido, penile shrinkage, brain fog, eye floaters and had systematic muscle weakness whereby my muscles felt like they were dying off if you have ever had DOMS (delayed onset muscle soreness) from the gym then imagine this 100 fold I legitimately was unable to walk for weeks.
I believe the reason why men “may” see improvements with time is that simply Testosterone levels lower by 1% every year after the age of 30 and methylation decreases with age reducing the sensitivity of overexpressed receptors. I think we have been attacking Post Finasteride Syndrome the completely wrong way. I believe the receptors in our bodies have undergone an epigenetic change and adapted to a “higher androgen environment” essentially our systems are misreading that there is supraphysiological amounts of androgens and are chronically down regulating receptors in response through epigenetic mechanisms- it would seem that lowering our androgens and keeping them chronically low may be a potential therapeutic option as a treatment for Post Finasteride Syndrome.
I believe also why some may respond better to TRT, Proviron or Tribulus is because they have enough working receptors that haven’t been epigenitically modified if someone is the opposite and supplements TRT and they haven’t enough working receptors and are all downregulated and overexpressed this will then have the opposite affect and can make a patient worse causing further desensitization.
If we look at Spinal and bulbar muscular atrophy (SBMA) which shows some comparative contrasts to PFS then this study seemed interesting:
Suppression of testosterone levels for 14 years resulted in a slower disease progression, as measured prospectively with quantitative measurements, than the historical control data reported in previous studies. This suggests that long-term androgen deprivation delays disease progression in SBMA.