As we are all well aware, our androgen receptors upregulate when taking 5ari’s. I believe AR upregulation is the current theory for the root cause of this condition.
I am not a scientist but I have been thinking long and hard about this upregulation, any I think that it may not be the issue at all. IMO, the upregulation is probably the body just trying to compensate for a messed up AR signaling pathway (which may be the real root cause). People who eat soy or take mild AA’s probably experience improvement because the AR’s are once again upregulating when they sense less DHT, but in the long term, the signaling pathway gets more messed up.
It’s like how a cortisone injection helps pain, but in the long term damages the body more.
When I first too saw palmetto, I had ED and went to the doctor but like an idiot continued to take it because I thought my body would get used to it. For the next 1.5 years I had no symptoms which I think can be attributed to the AR’s upregulation to a lower DHT environment. Then after a certain point I bet something in the signaling pathway crapped out and the upregulation didn’t work anymore. This signalling disruption / endocrine malfunction can take a day to happen as we know or years.
All speculation of course