Something doesn't add up

Hi guys,

I’m not here to present any weird theory about PFS or something, just to share some observations and possibly stimulate a productive conversation.

It’s a known fact that some of the PFSers become very intolerant to any further exposure to anti androgenic subastances. We’ve seen that with a number of users, some of whom had their condition worsened upon re exposure to AA compounds.

Now, here’s the deal: in the past days/weeks I’ve been reading transgender subreddits for hours a day, looking for stories of Finasteride side effects. And I’ve noticed two things:

  • The incidence of sides seems to be very, very low. Of course they could be masked by the effects of other AA medications MtF transgender usually take (like Spiro), or they could be well tolerated (not many of them care about ED and gyno). Plus, a drop in testosterone usually brings relief in MtF patients so there’s probably a number of sides they just can’t develop. But still, the incidence is (apparently) very rare.

  • Second, and most important, I haven’t read a single story about MtF transgenders not being able to start/continue transitioning because of Fin sides. Haven’t we said that in a number of cases Fin makes us more prone to develop severe sides upon re exposure to AA substances? How come there seems to be no stories of MtF transgenders not being able to keep taking Spironolactone or high dose Estrogens (4mg)?

Has anyone ever heard about something similiar? What are your thoughts on it?

The trangender community is quite numerous. And one would expect to at least find a handful of MtF or nonbinary people not being able to tolerate Antiandrogenic substances after developing sides. We’ve had at least two MaleToFemale users (@harrisoff and @devster12) with PFS, but they never referred to any kind of difficulties in undergoing transition.

Isn’t that in constrast with what we know about PFS?

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I think this is a very interesting question. I know that for many of us, although the sexual side effects are a big part of it, the cognitive and emotional side of it is awful too.

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But it’s not just about the sexual, cognitive and emotional sides.

People in here get joint issues, body aches, vision problems and hearing impairment as well, along with a long list of other manifestations such as weight gain / loss, digestion problems, skin issues and other things.

I get that MaleToFemale folks can at times not care about decline in sexual function, gyno development, and probably experience some mental benefit from lowering testosterone, but what about all the rest?

I never heard of a female transgender quitting AA after developing sides from Fin, Spiro, Saw P ecc.

I wonder why they don’t seem to be have this kind of AA-induced vulnerability to further AA exposure.

How commony are 5AR inhibitors used in the transgender people .

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Very common. A lot of them are on Fin, and many others use Dut and Saw P.

But, almost everyone in the MaleToFemale community uses Antiandrogenic substances, the most common being Spiro.

And there is no common pattern in the use of Fin: some of them start before HRT, other people at the same time or later on. Plus, a small percentage of them use high dose Finasteride (5mg per day) as their AA of choice.

If Finasteride ad AA substances in general can trigger this weird intolerance to further exposure to AA compounds … how come there isn’t aparently any MtF transgender reporting this issue?

Maybe estrogens play a part, but that’d be odd as well considering that at those dosage (usually they take estradiol valerate, 4mg per day) it acts as an AA as well.

I have also questioned why more MtF transgender folks don’t show up here. There are millions of them who take powerful AA’s. I have a friend who is a MtF transgender woman. I actually mentioned to her what happened to me, and she said, “I know about saw palmetto, it is extremely common on transgender forums/ community.”

One of my theories as to why you don’t see MtF people here is that some of the things that are horrible and life altering for us in a negative way, actually have the opposite effect on them. For example, they may love the fact that the penis is not working and morning wood is going away, where this is very disturbing for us.

Still, there must be tons of valuable data from those forums that could be relevant to us.

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Is no secret that plenty of MtF folks actually enjoy some of the things cisgender guys would call “a nightmare”. Often times, you see people in subreddits like r/MtF or r/asktrasngender actually hoping to develop Fin sides, especially gyno.

Now, they probably don’t have a clue about how bad this condition can get, and I’m sure very few transgender women would complain about not having morning woods, or a sensation of reduced androgen activity throughout their bodies, slow grow beard, gyno and stuff.

But PFS is not just about that.

Nobody would ever “cheerish” blurry vision, impaired hearing, joint pain, body aches, digestion problems, emotional blunting, cognitive decline, memory issues and so on.

I’m not asking where these people are. I’m wondering how come they don’t seem to have this antiandrogenic intolerance which is not supposed to show up just in severe cases. I never heard about a transgender woman saying “I developed sides after Fin, and now I can’t tolerate Spiro”.

What does this tell about PFS?

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As part of a campaign to raise awareness of enduring sexual dysfunction after antidepressants, isotretinoin (Accutane) and other drugs, RxISK has featured finasteride (Propecia), and had a lot of reports from people affected by it.
When used to treat male pattern baldness in men, finasteride can utterly shut down sexual function – and in a subset of men, this can be permanent. In some people it also causes suicidal depression.
It is also now being taken by born-male transwomen to suppress their natural testosterone. And it’s also offered to transmen to counter excessive hair loss caused by “T” injections. The side effects can be hard to spot when you’re already in emotional turmoil, as this transman found out.
The acne drug isotretoinin, also an androgen suppressor, can have very similar effects.
Then there’s spironolactone, the most common T-suppressor.
A problem for transgender patients is that talking about the downsides of their drugs is often frowned on by peers and any criticism of cross-gender treatments can be dismissed as “transphobic.”
But even avid transgender activists seem to agree that spironolactone is a nasty drug. One young transwoman found the effects so bad that surgery to remove their testicles seemed like a much milder alternative.

It’s possible that the subset of trans people who are affected are shouted down, or are less able to find a support group that they feel suits them, I suppose.

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Taking a cocktail of drugs with the goal of trying to reverse someone’s genetic gender is obviously going to have some serious negative effects.

It’s going to be hard to pin down which drug is causing what in that scenario.

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Yeah, I’ve noticed that criticisms of any sort around Finasteride usually get downplayed pretty fast within the trans community.

But I’m not questioning the incidence. Higher than cisgender men, lower then cisgender men, that’s not the point.

If it’s true that Fin and other AA’s in general (including antidepressant, which a lot of transgender people use) make some of us vulnerable to further AA exposure … how come you never read about crashes of any magnitude like the one we experience, within the MaleToFemale community?

Is it because of the estrogens they take?

I really can’t see any other difference.

Just in case anyone reads this and thinks they’d like to give it a go, this is extremely dangerous, people who have done this have worsened their condition and subsequently killed themselves.

Wait, what? Really?

Can i ask you who are you referring to?

I’m just trying to understand, obviously is not something I’m advocating.

It’s likely that a transgender sighting insomnia, anxiety, suicidal ideation would be quickly dismissed and this would tabled as part of their weirdo shit!!!(as some would put it) similarly some say we have these symptoms because we were already odd ball bald losers I expect the numbers of transgenders who commit suicide is a lot higher than the percentage across the average populas. This will be again put firmly at the door of their apparent physiological problems because of their identity issues. How much if this is actually because of the pills they take.

I get it.

What I don’t get is why there aren’t transgender people reporting crashes from Fin or subsequent AA’s exposure.

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Yeh one would expect to see some to speak out. However because of their years of identity issues/ no acceptance they could possibly be tight lipped and suffer in silence as part of the coping mechanism/strategies they developed as part of what they grew up with. I don’t/can’t believe that some don’t develop PFS.

Man, I’m not talking about PFS.

I know transgender folks develop PFS. We’ve had transgender users in here as well.

What got me curious is something else: we know that when you develop PFS, there’s a chance you might react very bad to further AA exposure. We lost a guy to Resveratrol, and one of our former admin got his condition worsened after Milk Thistle, and those are jsut the first two I remember.

Now, given that MaleToFemale folks develop PFS as well, why none of them seem to report a crash from subsequent AA exposure? I mean, most of them are on Spiro, and 100% of them takes Estrogens at high doses (which have an antiandrogenic action).

That’s what puzzles me.

I’m sure some of them develop PFS.

But I’ve never read of any crash after developing PFS, despite the further exposure to AAs.

When I refer to Pfs I imean everything that it encompasses, inclusive of a crash and sensitivity to 5ars etc I was dealing with all of this on my own for 15 years before I discovered the forum. So for me it was because there was no forum or literature when i started suffering. It is possible to remain quiet with this disease. . Most people who get Pfs have a crash but not all. The crash is generally tied to the flood of dht. I can’t see it being different for transgenders but what do I know.

What I don’t get is why there aren’t transgender who had to halt their transition after developing PFS.

That’s what I’m talking about.

When you get PFS, you usually cannot tolerate exposure to other AAs.

So if you’re MtF and you develop PFS, you shouldn’t be able to continue your transition, right?

That’s the point: where are these people? Where are their stories?

I developed Pfs within weeks of first taking the drug I unwittingly continued to take it on and off for years. I’m aware of two young guys locally who know the risks and are trans gendering and they both said they’ll continue to take it no matter what.

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Good luck to both of them.

But that still doesn’t asnswer my question.

Is because they don’t drop AAs so they don’t face that testosterone/DHT surge?

I don’t get it.

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