- Reaction score
- 306
I have read for years concerns from finasteride/dutasteride users that reducing their DHT may deprive their penises of androgen stimulation and lead to penile shrinkage over time. I have seen the animal studies showing this does in fact happen in rats. I have also read some claims from long term finasteride/dutasteride users that their penises have noticeably shrunken over the years.
This is especially pertinent to me now as I am on darolutamide, which is the most powerful androgen receptor antagonist (and completely experimental), so I looked to see what I could find. I found this study, showing that yes, in fact, androgen deprivation can definitely lead to penile shrinkage over time:
"The effects of long-term androgen deprivation therapy on penile length in patients with prostate cancer: a single-center, prospective, open-label, observational study."
Before therapy, the mean stretched penile length was 10.76 cm. After 24 months of ADT, mean penile length had decreased to 8.05 cm. However, these changes plateaued after 15 months.
https://www.ncbi.nlm.nih.gov/pubmed/21699669
So, in other words, with very aggressive androgen deprivation (much more aggressive than anyone here is considering), considerable penis shrinkage did occur. It was a fair amount. Penises shrunk from 10.76 cm stretched to 8.05 cm stretched after 24 months of treatment.
Fortunately, the effect plateaued over time, leveling off after 15 months, which suggests that no matter what, your dick won't shrivel away indefinitely until there's nothing left at all. But the amount of penis atrophy was considerable and should probably be taken seriously.
Is this relevant?
Before we go any further, it must be clarified that things like finasteride/dutasteride/RU do not block or reduce androgens to nearly even a fraction of the extent as the agents used in the study quoted above. So probably this is not even something to worry about for standard med users.
But I do think it is important to be aware of, given that we all have different androgen sensitivities throughout our bodies, and most of us are aiming to treat our hair loss for 40-50+ years, over which time even subtle effects could become more obvious.
Solutions
The first solution to avoiding this problem over time (besides just not worrying about it) would then obviously be to limit your anti-androgens (finasteride/dutasteride/RU/whatever) to the lowest dose possible.
The second solution, which I am debating employing for myself, would be to add a bit of topical androgen back to your penis, in the form of testosterone or DHT gel applied directly to the penis. DHT gel (Adractim) is commonly used in the penis enlargement community to help maximize androgen stimulation of the penis. Testosterone gel should work similarly.
The first trouble with this approach is DHT/test gels/creams fall under "anabolic steroids" and may be highly illegal depending on where you live. (Don't blame me if you get arrested trying to procure some.)
The second trouble is that adding extra androgens to your system may undo any benefits you are getting from your hair loss treatment. The hope would be that the test/DHT gel/cream would stay "local" to the penis, but the penis is so incredibly vascular, this is almost certainly completely unrealistic.
In my case as I am using daro topically to my scalp, I would not be worried about a little extra DHT/test circulating from penile application. It would never overwhelm my topical daro. But if you are on a more conventional/safe regimen, then the extra DHT/test could be problematic. You'd probably have to monitor carefully if you were trying anything like this.
https://www.hairlosstalk.com/interact/threads/androgen-deprivation-can-cause-penis-shrinkage.110075/
This is especially pertinent to me now as I am on darolutamide, which is the most powerful androgen receptor antagonist (and completely experimental), so I looked to see what I could find. I found this study, showing that yes, in fact, androgen deprivation can definitely lead to penile shrinkage over time:
"The effects of long-term androgen deprivation therapy on penile length in patients with prostate cancer: a single-center, prospective, open-label, observational study."
Before therapy, the mean stretched penile length was 10.76 cm. After 24 months of ADT, mean penile length had decreased to 8.05 cm. However, these changes plateaued after 15 months.
https://www.ncbi.nlm.nih.gov/pubmed/21699669
So, in other words, with very aggressive androgen deprivation (much more aggressive than anyone here is considering), considerable penis shrinkage did occur. It was a fair amount. Penises shrunk from 10.76 cm stretched to 8.05 cm stretched after 24 months of treatment.
Fortunately, the effect plateaued over time, leveling off after 15 months, which suggests that no matter what, your dick won't shrivel away indefinitely until there's nothing left at all. But the amount of penis atrophy was considerable and should probably be taken seriously.
Is this relevant?
Before we go any further, it must be clarified that things like finasteride/dutasteride/RU do not block or reduce androgens to nearly even a fraction of the extent as the agents used in the study quoted above. So probably this is not even something to worry about for standard med users.
But I do think it is important to be aware of, given that we all have different androgen sensitivities throughout our bodies, and most of us are aiming to treat our hair loss for 40-50+ years, over which time even subtle effects could become more obvious.
Solutions
The first solution to avoiding this problem over time (besides just not worrying about it) would then obviously be to limit your anti-androgens (finasteride/dutasteride/RU/whatever) to the lowest dose possible.
The second solution, which I am debating employing for myself, would be to add a bit of topical androgen back to your penis, in the form of testosterone or DHT gel applied directly to the penis. DHT gel (Adractim) is commonly used in the penis enlargement community to help maximize androgen stimulation of the penis. Testosterone gel should work similarly.
The first trouble with this approach is DHT/test gels/creams fall under "anabolic steroids" and may be highly illegal depending on where you live. (Don't blame me if you get arrested trying to procure some.)
The second trouble is that adding extra androgens to your system may undo any benefits you are getting from your hair loss treatment. The hope would be that the test/DHT gel/cream would stay "local" to the penis, but the penis is so incredibly vascular, this is almost certainly completely unrealistic.
In my case as I am using daro topically to my scalp, I would not be worried about a little extra DHT/test circulating from penile application. It would never overwhelm my topical daro. But if you are on a more conventional/safe regimen, then the extra DHT/test could be problematic. You'd probably have to monitor carefully if you were trying anything like this.
https://www.hairlosstalk.com/interact/threads/androgen-deprivation-can-cause-penis-shrinkage.110075/