Another update from me, sadly things have continued to deteriorate. It seems like contrary to what I initially hoped for, my PFS is no stable but progressive, resulting in a very slow, continual deterioration (after the intial surge of symptoms after stopping the medication).
A) Sexual:
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Loss of Libido - In the first years after PFS onset, I could occasionally still achieve a spontaneous erection or a libido “surge” (nothing like before PFS but at least something), especially if out in the sun (something about what the sun did, improved libido). However this slowly degraded further over time, the sun now has zero effect on libido. So lets say that after stopping finasteride my libido was 95% reduced from prefin. Now its 99.99% reduced. Basically there is no connection between my brain and my penis, its cut off completely. I still remember this sensation when I first crashed back in 2014, the weird feeling that my brain couldnt “communicate” with my penis anymore. Thats how loss of libido felt like to me. Basically no brain activity regarding sexual thoughts etc anymore and as if the signal to my penis was lost. But occassionally I could still get a surge under the right conditions and luck. Now its completely gone. I cant even remember when the last time was I had a libido feeling. It has been a very long time. Remember: Before Fin i had a very high libido, to the point of it being annyoing. Basically 2 spontaneous errections per hour on average. Now I havent felt a libido surge in years. Think about that. So this has gotten worse over time for sure. There is a big difference between a 95% reduction and a 99.999% reduction. I wouldnt really call what I had at the 95% state libido, more like coaxing the body into some sexual feelings under sun light and all the conditions plus luck. But there was at least some neurons firing/spontenous errection, even if it was “artificial” and “muted”. Now its gone completely. If I look at a hot girl, I know that she is hot, but I dont “feel” it. My brain only reacts on an intellectual level, not a visceral physical/sexual one. I dont have sexual thoughts anymore, which were a constant facet of my life pre PFS.
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Loss of morning erections (before Finasteride I had a huge raging morning erection, that only went away after urinating), now I dont have any morning erections. Zero. For years now.
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I have no spontaneus erections. To me this is the physical sign of libido. Libido is of course mental but also results in sponteneus erections typically I still remember that before PFS I had probably a spontenaous erections at an average rate of 1-2x per hour. I know it sounds a lot, but thats what it was. I havent had a sponteanous ereciton in years.
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I still have watery and reduced ejaculate. This also got worse in the sense that the semen volume dropped further.
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I have started to develop ED. Not a severe form, but significant. I.e. I have to wait days before I can get properly hard again (with proper of course nothing like pre PFS). Also I can lose it quickly even if I wait a few days. Its basically a struggle to stay hard. Before fin I could jerk off / have sex multiple times a day, even multiple times in a row while retaining both erection strenght and even semen volume (although of course less if straight in a row). Now if I try to do that daily, I actually cant get properly hard. This has been a progressive thing. Over the years my erection quality has gotten significantly worse.
B) Mental
This sadly got significantly worse too. Anxiety is now more prominent not less prominent like in other cases. Its a constant struggle to try and keep it at bay. Like I said before, its always in the background a bit, the question is how high the “volume” is turned up. This basically means that its impossible for me to be anxiety free, the best I can hope for is that its at a low volume.
And now comes something very interesting, maybe also for scientists: In the first years after getting PFS, jogging /running still had a dopamine effect. I.e. if I ran for 5km for example, after finishing the workout, I felt dopamine/better mood (although much reduced vs pre finasteride). Now I do not feel the dopamine effect of running anymore. This is something I noticed not immediately. Because you still feel the exhaustion of the run, i.e. you are out of breath, higher blood circulation etc. And if you talk with a jogging partner right after, sometime you dont notice that the dopamine rush isnt there, because you are used to feeling like shit with PFS anyway.
But it hit me one day, when a friend said on a particularly hot day that he feels a dopamine rush, that I have lost that ability. It just quitely went away. This happened I would say in the last 12-24 month timeframe.
Also with going to the gym. Here I have a direct comparison to PRE PFS because I used to go to the gym a lot when I was younger. I felt like a king after the gym, huge dopamine rush, adrogen flair and masculine feeling. Now it does nothing for me except reduce anxiety a bit. I have zero dopamine effect here either. Its crazy to think this is possible but its the truth: From feeling like a million bucks to no effect other than physically feeling that the muscles are “worked out” and blood flow increased. Zero action in the brain though. Ridiculous. If you knew my old personality, you would understand how unusual this is because I used to be very intense, have a high zest for life.
Also anhedonia has significantly increased. Initially maybe I didnt even realize that, as you can see from my post in 2014. Maybe I thought that the anxiety/flatness was normal as a reaction to this PFS shock. But now I have not only become more aware of this symptom but it actually has worsened significantly. I am basically flatlining most of the day with an anxiety backdrop. I.e. no emotional highs anymore. The way I can describe this best, is to think of different situations and the emotional reaction you have to them, and then imagine that that is gone. I once made a list of “situations” so I could better describe anhedonia to my parents and others. For example: A warm summer night, Walking through a lively city at night, the touch of a girl in a club, the feeling of comfort and coziness at home, the feeling of excitement thinking about the future, driving at night on the highway etc etc. All these emotional experiences require a complex symphony of androgens, correct nerve wiring, androgen receptor functioning etc. that has been destroyed by finasteride. Now everything is exactly the same: A emotionally flat feeling anywhere from slight to significant anxiety/dread in the background.Again this is a ridiculous changed because I used to have a high zest for life. I also had a good memory, probably because I lived intensely. I can still remember very well the pre finasteride life and situations but I have a hard time remembering anything that happened post finasteride because its all meaningless emotionally. It all grey. It also feels like I am not really present connected to the world, like living in a fog. Not necessarily brainfog, although I cant think as shaprly or am as quick witted a before, but literally being on a lower state of consciousness. Like not being part of the same world the rest inhabits, physically present but disconnected, looking through a cloth that reduces visibility.
C) Physical
The most traumatizing part of the pyhsical symptoms is the facial changes I referenced in my posts before. However they have gotten even worse. I cant tell exactly how I looked before fin, because photos are 2D but I can tell you that when I look in the mirror I see an exhausted wasted face, and I feel terrible looking at it. Before fin I felt great looking in the mirror, it was a boost. Thats now significant the change is. I still remember in the gym mirrors when working out I loved having “eye contact” with myself. Now I look absolutely horrific in any lightning. Basically I look both less mature and older, a very weird combination. My face looks “androgen deprived” and its not cohesive anymore. It looks deflated, disharmonious, feminized, immature and old at the same time, exhausted. Thats the feel part of it. A big picture overview. Thats what hits you in the morning. From a vibrant, intense, androgen influenced, harmonious face to what I described above. Concretly I can say: I lost basically all subcutaneous fat, the skin is dry and thin, I lost bone mass in the cheekbones, jaw and chin. My skin is paler. Its terrible and also only getting worse over time.
My adams apple is still way less prominent. This also results in my on average having a higher pitched voice. My neck is significantly thinner too.
I have bloating/adding of fat in the midsection, that can only be controlled via strict diet. However even if I am on a strict diet, I have fat on the side of the hips, a typcially femine place to have fat, that doesnt go away.
I still have slower, less dense beard growth.
I have penile shrinkage. Before fin i had a sig. above average length and gridth. I have lost both length and gridth, this also has gotten worse over time. Also weird large veins have started to appear on my penis, when errect.
I regularly have very hot feet. An absurd symptom I have had since the crash.
I still havve head pressure. This is a weird symptom. Basically its present all the time but on a low level on the right side of my brain. Sometimes its flares upa bit. Its like my brain is numb there. have had this since the start.
D) Summary:
I think I am one of the worst PFS cases on this site. I really dont know how I survived 11 years of this and counting. The fact that its actually getting worse over time is crazy but makes sense in a severe case like mine. My body is literally not receiving the androgens and neurosteriods it needs anymore, so all structures that rely on that are slowly degrading (like the face, skin). Same with the brain, it seems like the neurosteriods needed to keep it healthy are gone, thats why in the last 24 months I now even lost the ability to feel dopamine after intense jogging etc. However more accurate is probably to state that dopamine after workouts slowly reduced over time, and suddenly you realize that its gone completely.
