Hello, iv been using propecia for just over 3 years now as loosing my hair was making me depressed. The results have been great, my hair is looking the best its ever done but iv had chronic prostitus for around 6 Monthes and cant seem to get rid of it, its kind of getting to much now where its affecting my way of life. I can only assume the propecia is playing some role in it. If i come off what would be the best resigm to keeping my hair, i no its now going to be a down hill struggle.
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Best way to go after finasteride
- Thread starter robkelv
- Start date
Do you know what type (class) of prostatitis were you diagnosed with? Were you diagnosed by a doctor, and if so, what methods were used to attain diagnosis?
As an effect to the mechanism in which finasteride acts, the prostate will atrophy to some degree. Since prostatitis is defined as inflamation of the prostate gland, it's counterintuitive to conclude that finasteride has actually caused the issue. I have seen little medical evidence to show that finasteride causes prostatitis to a significant degree, but it is still certainly a possible culprit as it does have some effect on the prostate gland.
What does your doctor suggest you do? If you have not seen a doctor about this, I would consult a urologist for the best course of action. If you and your doctor agree discontinuing finasteride treatment is the best course of action, then I would say you could probably go 3-6 months without it before it starts to affect your hair. If finasteride is somehow causing the problems, taking 3-6 months off should be enough for it to go away or get better.
As an effect to the mechanism in which finasteride acts, the prostate will atrophy to some degree. Since prostatitis is defined as inflamation of the prostate gland, it's counterintuitive to conclude that finasteride has actually caused the issue. I have seen little medical evidence to show that finasteride causes prostatitis to a significant degree, but it is still certainly a possible culprit as it does have some effect on the prostate gland.
What does your doctor suggest you do? If you have not seen a doctor about this, I would consult a urologist for the best course of action. If you and your doctor agree discontinuing finasteride treatment is the best course of action, then I would say you could probably go 3-6 months without it before it starts to affect your hair. If finasteride is somehow causing the problems, taking 3-6 months off should be enough for it to go away or get better.
T
Timi
Guest
anti biotics helps nothing thats No a Bacteriell inflamation!!
i had the same side effects from finasteride-Pain and burning
my Urologist gives me anti biotics helps Zero!
Timi
i had the same side effects from finasteride-Pain and burning
my Urologist gives me anti biotics helps Zero!
Timi
So you were not diagnosed with prostatitis then? How do you know if that is the issue then?
Timi is right, chronic prostatitis is not always caused by a bacterial infection. It could be inflamation from other causes. Taking a round of antibiotics when you don't have a bacterial infection is a very bad idea.
Make sure your doctor diagnoses you. Don't diagnose and treat yourself based on what you think is happening.
Timi is right, chronic prostatitis is not always caused by a bacterial infection. It could be inflamation from other causes. Taking a round of antibiotics when you don't have a bacterial infection is a very bad idea.
Make sure your doctor diagnoses you. Don't diagnose and treat yourself based on what you think is happening.
Wuffer said:So you were not diagnosed with prostatitis then? How do you know if that is the issue then?
Timi is right, chronic prostatitis is not always caused by a bacterial infection. It could be inflamation from other causes. Taking a round of antibiotics when you don't have a bacterial infection is a very bad idea.
Make sure your doctor diagnoses you. Don't diagnose and treat yourself based on what you think is happening.
Not necessarily.
Quite often doctors do this and put people on Cipro. Although i think Cipro is a bit too powerful, but that's neither here nor there. The fact is, most antibiotics also possess anti-inflammatory properties and therefore can work via that mechanism.
BACTRIM is a good example of a good anti-inflammatory antibiotic for instance. It would be a good first option IMO.
I also had the chronic testicular pain on finasteride. I dealt with it for years because I liked the fact that my hair loss had slowed down to a reasonable rate of aging and I had some regrowth. It stopped my anxiety and I was able to go on with my life instead of obsessing about hair loss. In the beginning when I started losing my hair (around age 22), it was shockingly rapid. My hairline lost a full inch in only 12-15 months and I went from full head of hair to seeing through my scalp. Unfortunately, the testicular pain (which I believed to be atrophy of the prostate and testicles) was not due to any particular medical condition and lab studies were normal. As a result of sexual side effects, I have been on a four month hiatus from Propecia. More below.
The sexual side effects have been persistent though I have regained about 30% of my libido back. I am able to get partial albeit functionally inadequate erections now. I am not dating yet. My semen volume remains tiny (I used to have a lot of ejaculate volume, so this is noticeable decrease). I also had atrophy of penis some. About 30% girth decrease and some length loss (about an inch). I thought I was crazy for thinking it looked smaller (and chalked it up to psychological factors). Some bloggers have also complained about this. My urologist confirmed that shrinkage had occurred and he sees it all of the time with Proscar patients or those who have had prostatectomies. It is not necessarily permanent but is most likely due to the fact that if you do not have erections for a long time (or morning erections), the erectile tissues begin to atrophy. Use it or lose it. He also told me that the ischiocavernosus and bulbospongiosus muscles atrophy (which raise the penis and contract ejaculate out, respectively) as well due to declining use.
So what has happened four months off Propecia? Well I have already said that my sexual desire has improved but still low. I am interested in women again and that is a breakthrough. I was not able to have even romantic thoughts! My erections remain inadequate though. Testicular pain is gone and the testes actually have a tingly sensation to them now. BTW I do NOT have any medical conditions to explain it and early ED does not run in my family (I was known to be able to keep a hard for a long time prior to the therapy). I am fit, 6'0", 175 lbs. My labs were normal. Blood pressure fab, etc...Off the Propecia has also initiated the alarming shedding of hair and once again my hairline is on the move. I now only have an inch wide frontal hairline. My density is thinner and my hair feels softer, more downy. The floor, brush, and drain are once again visibly covered with my hair (like I experienced at 22). I hate to imagine myself in 12 months. I am scared of being bald but I am also scared of the unremitting sexual side effects. I am one of the unfortunate ones who got the terrible and persistent side effects. That is my difficult dilemma. I guess like most I was hanging on, praying for a breakthrough treatment, but I have to start dating again and the lack of sexual and romantic interest was destroying my life. I wasn't able to fall in love. Suddenly I have feelings for many of my female friends. Crazy. I also now realize being off the med, the spaciness (brain fog) I was experiencing was the Propecia since my brain is suddenly as sharp as it was in my early 20's again. No more dreaminess and dysphoria. Sorry for the long story but it is my first post and I had to get it out of my system. Appreciate your taking the time to read my post.
The sexual side effects have been persistent though I have regained about 30% of my libido back. I am able to get partial albeit functionally inadequate erections now. I am not dating yet. My semen volume remains tiny (I used to have a lot of ejaculate volume, so this is noticeable decrease). I also had atrophy of penis some. About 30% girth decrease and some length loss (about an inch). I thought I was crazy for thinking it looked smaller (and chalked it up to psychological factors). Some bloggers have also complained about this. My urologist confirmed that shrinkage had occurred and he sees it all of the time with Proscar patients or those who have had prostatectomies. It is not necessarily permanent but is most likely due to the fact that if you do not have erections for a long time (or morning erections), the erectile tissues begin to atrophy. Use it or lose it. He also told me that the ischiocavernosus and bulbospongiosus muscles atrophy (which raise the penis and contract ejaculate out, respectively) as well due to declining use.
So what has happened four months off Propecia? Well I have already said that my sexual desire has improved but still low. I am interested in women again and that is a breakthrough. I was not able to have even romantic thoughts! My erections remain inadequate though. Testicular pain is gone and the testes actually have a tingly sensation to them now. BTW I do NOT have any medical conditions to explain it and early ED does not run in my family (I was known to be able to keep a hard for a long time prior to the therapy). I am fit, 6'0", 175 lbs. My labs were normal. Blood pressure fab, etc...Off the Propecia has also initiated the alarming shedding of hair and once again my hairline is on the move. I now only have an inch wide frontal hairline. My density is thinner and my hair feels softer, more downy. The floor, brush, and drain are once again visibly covered with my hair (like I experienced at 22). I hate to imagine myself in 12 months. I am scared of being bald but I am also scared of the unremitting sexual side effects. I am one of the unfortunate ones who got the terrible and persistent side effects. That is my difficult dilemma. I guess like most I was hanging on, praying for a breakthrough treatment, but I have to start dating again and the lack of sexual and romantic interest was destroying my life. I wasn't able to fall in love. Suddenly I have feelings for many of my female friends. Crazy. I also now realize being off the med, the spaciness (brain fog) I was experiencing was the Propecia since my brain is suddenly as sharp as it was in my early 20's again. No more dreaminess and dysphoria. Sorry for the long story but it is my first post and I had to get it out of my system. Appreciate your taking the time to read my post.
My urologist confirmed that shrinkage had occurred and he sees it all of the time with Proscar patients or those who have had prostatectomies. It is not necessarily permanent but is most likely due to the fact that if you do not have erections for a long time (or morning erections), the erectile tissues begin to atrophy. Use it or lose it. He also told me that the ischiocavernosus and bulbospongiosus muscles atrophy (which raise the penis and contract ejaculate out, respectively) as well due to declining use.
This is not true. Millions of men have been taking finasteride for over two decades and I have not once seen a piece of medical literature that describes shrinking of the penis while taking finasteride. I've read studies involving thousands of men taking finasteride and never seen a single mention of this.
There have been studies done on men who take finasteride that show it does not suppress nocturnal erections to any significant degree. The penis is not a muscle that must be exercised regularly.
Im just a bit surprised your urologist would tell you he's seen it all the time, because i've never heard of this outside hair loss forums.
That being said, i'm genuinely sorry to hear about your situation and I hope you are able to recover soon.
Actually atrophy due to disuse is not restricted to muscles. In fact penile shrinkage happens to those with restricted blood flow to the penis in general such as those with atherosclerosis. As such the corpus cavernosum which expands with blood flow during erections will go into disuse. Penis actually starts to decrease in size after about age 30 anyway as do the testicles. Neither are muscles.
As for the notion that "millions" have been on finasteride and you haven't seen studies showing this is not in itself evidence. The reason is that it is simply not the focus of the research and most of the studies have not been powered to look for that. There is however research on the effects of genital size and finasteride. For example, very recently animal studies have shown 25% reduction in genital size (the rat is the animal model used for human urogenital research):
http://www.ncbi.nlm.nih.gov/pubmed/22375859
Studies are important but they most often lag the anecdotal reports by years and even decades. For example, when Prozac came out, Pfizer reported sexual side effects in the range of 3%. Most SSRI studies today continue to publish those sorts of numbers. The American Psychiatric Association and psychiatrists now recognizes sexual side effects to be as high as 40-70% on that class of antidepressants (and now studies coming out of persistent sexual dysfunction after discontinuation). The problem lies in how the study is designed and what exactly they are looking for. Drug companies will actually ask the survey questions in a way that generate the most favorable profile. For years they were also saying that Zyprexa did not increase weight any more than other drugs in the class. They had reps going around calming doctors down who had noticed it and had complaints from patients. Other reasons were always given for the weight gain such as you are not exercising, maybe you are eating more because you feel better, people put on weight as they get older, etc...Finally after 15 years the NIH (US gov't) did the largest study ever done (and least biased as no pharm companies were involved) comparing most of the drugs in the class and the results showed dramatic weight gain, increased blood sugar, increased bad cholesterol of the drug relative to others in its class, and so on. So, penis size and finasteride has not been the focus of the research. Very important point: Pharm companies do not fund or sponsor studies designed to show their drugs cause disturbing side effects and the government (with dwindling research monies) sponsors clinical trials with more serious health implications than penis size shrinkage. There are however reports on hair loss/propecia forums now where young guys are reporting this penis shrinkage (though often chalked up by others as paranoia or anxiety).
The urologist I sought out is a well known and well published Doctor at an academic medical center, so his clinical observations over two decades with the stuff is useful information. Again I am not convinced it is permanent and feel that once erectile function and libido normalize, the tissues will reengorge and maintain a different tone.
For the record, my thread is not designed to bash finasteride or to have it removed from the market. I think if you use the drug, it works for you, and does not cause the problems mentioned, then the option should be made available to you. But if you are in the camp that feels that everyone who reports (remarkably similar) problematic experiences with the drug can be always explained in other ways, then you may also be making an erroneous conclusion. I am here to benefit from others experiences with the persistent side effects and what they have done to regain function.
As for the notion that "millions" have been on finasteride and you haven't seen studies showing this is not in itself evidence. The reason is that it is simply not the focus of the research and most of the studies have not been powered to look for that. There is however research on the effects of genital size and finasteride. For example, very recently animal studies have shown 25% reduction in genital size (the rat is the animal model used for human urogenital research):
http://www.ncbi.nlm.nih.gov/pubmed/22375859
Studies are important but they most often lag the anecdotal reports by years and even decades. For example, when Prozac came out, Pfizer reported sexual side effects in the range of 3%. Most SSRI studies today continue to publish those sorts of numbers. The American Psychiatric Association and psychiatrists now recognizes sexual side effects to be as high as 40-70% on that class of antidepressants (and now studies coming out of persistent sexual dysfunction after discontinuation). The problem lies in how the study is designed and what exactly they are looking for. Drug companies will actually ask the survey questions in a way that generate the most favorable profile. For years they were also saying that Zyprexa did not increase weight any more than other drugs in the class. They had reps going around calming doctors down who had noticed it and had complaints from patients. Other reasons were always given for the weight gain such as you are not exercising, maybe you are eating more because you feel better, people put on weight as they get older, etc...Finally after 15 years the NIH (US gov't) did the largest study ever done (and least biased as no pharm companies were involved) comparing most of the drugs in the class and the results showed dramatic weight gain, increased blood sugar, increased bad cholesterol of the drug relative to others in its class, and so on. So, penis size and finasteride has not been the focus of the research. Very important point: Pharm companies do not fund or sponsor studies designed to show their drugs cause disturbing side effects and the government (with dwindling research monies) sponsors clinical trials with more serious health implications than penis size shrinkage. There are however reports on hair loss/propecia forums now where young guys are reporting this penis shrinkage (though often chalked up by others as paranoia or anxiety).
The urologist I sought out is a well known and well published Doctor at an academic medical center, so his clinical observations over two decades with the stuff is useful information. Again I am not convinced it is permanent and feel that once erectile function and libido normalize, the tissues will reengorge and maintain a different tone.
For the record, my thread is not designed to bash finasteride or to have it removed from the market. I think if you use the drug, it works for you, and does not cause the problems mentioned, then the option should be made available to you. But if you are in the camp that feels that everyone who reports (remarkably similar) problematic experiences with the drug can be always explained in other ways, then you may also be making an erroneous conclusion. I am here to benefit from others experiences with the persistent side effects and what they have done to regain function.
Also you can see the penis shrinkage reports in men using Proscar/finasteride as well on other blogs:
http://www.topix.com/forum/drug/proscar ... R2U8AJJGBJ
http://www.baldingblog.com/2007/05/03/m ... -propecia/
It is not a side effect reported with many other drugs if you google it. There is a surprising number of folks that report it with finasteride.
Also something else that is important is that free testosterone is believed to play a role in maintaining the penis. A recent study revealed average decrease of about 27.4% free testosterone levels for men on finasteride 1 mg daily (actually every male in the study had 15-40% decrease). More food for thought. Most guys using finasteride for balding are young and have larger amounts of testosterone and free testosterone to perhaps compensate. The shrinkage would also be insidious.
http://www.topix.com/forum/drug/proscar ... R2U8AJJGBJ
http://www.baldingblog.com/2007/05/03/m ... -propecia/
It is not a side effect reported with many other drugs if you google it. There is a surprising number of folks that report it with finasteride.
Also something else that is important is that free testosterone is believed to play a role in maintaining the penis. A recent study revealed average decrease of about 27.4% free testosterone levels for men on finasteride 1 mg daily (actually every male in the study had 15-40% decrease). More food for thought. Most guys using finasteride for balding are young and have larger amounts of testosterone and free testosterone to perhaps compensate. The shrinkage would also be insidious.