Permanent hyperandrogenism after stopping Finasteride

[Dench57]

Hey guys, I quit 3 Propecia 3 months ago after developing side-effects that have still not subsided. Here's my story:

I've always had thick hair but noticed slight temple receding in November so I got on .5mg of Propecia. I've never had any diffuse thinning or scalp problems such as itching, flaking, dandruff or oiliness. Within a month of taking Propecia I noticed a slight burning, itchy, tingly sensation along my frontal hairline. My hair became oily if I didn't wash it twice a day, my skin became oily and my sex drive went through the roof. I looked online and it became obvious I was having a "hyper-androgenic" reaction to finasteride:

"When the effects of androgens in the body are lessened, e.g. through lowering DHT or by blockading hormone receptors systemically, the body seeks equilibrium through a process called upregulation. This can take the form of increased hormone production and/or increased tissue sensitivity to the remaining hormones."
It's generally accepted that Finasteride can cause "intense upregulation" of androgen receptors. I will be happy to corroborate this if anyone wants me to - there's information about it all over the net. What I cannot find is any information regarding how long this "upregulated" state continues after stopping finasteride...or if it's permanent. There was NO physical signs of inflammation on my scalp, no flakiness, no dandruff. Just the itchy tingle and increased oil production. Anyway this was obviously unbearable so after 2 months on .5mg Propecia I came off the drug, expecting my body to return to normal within a few weeks. Well 3 months later and it's still as bad as ever. The frontal area where my scalp itches and tingles is quite tender and has thinned considerably. My temple recessing has accelerated markedly since this scalp stuff started. The itching/tingly/burning sensation is incredibly strong and 24 hours a day and is hugely stressful.

I've tried every type of medicated and anti-inflammatory shampoo, coal tar, keto etc. As I mentioned there is no redness or visible inflammation so I'm convinced the root cause is an internal/hormonal problem. I'm currently using Fluridil and topical spironolactone in a desperate bid to block the androgen receptors in my scalp, but neither seems to work. My doctor doesn't know what the problem is. I've been referred to a dermatologist but as I'm in the UK the NHS waiting list is months. I'm considering going private and spending hundreds of pounds to see a specialist endocrinologist but I fear even they won't be able to help me.

MY QUESTION IS: Has anyone else experienced this before? Does anyone know how long this "upregulated" state would continue after stopping finasteride, if it's permanent? Is there anything I can do to stop it?

- - - Updated - - -

To give you a measure of how desperate I am I am considering taking internal anti-androgens like spironolactone or Flutamide which pretty much guarantee god awful side effects such as ED and gyno. But I've realised that if my body had THIS extreme upregulation to something comparatively weak like Finasteride's 5ar inhibition, the upregulation I'll experience from hardcore internal anti-androgens will be ten times worse.

I understand what's happening to me is extremely rare and Propecia works for most people, but I still can't believe this drug for hair-loss treatment has the possibility to permanently accelerate male pattern baldness due to increased AR sensitivity.

 

[bilboswaggins]

Others here will call you a hypochondriac but this can definitely result from taking finasteride.

Unfortunately if your receptors have indeed upregulated, there is nothing you or even endocrinologists can do to help. There was a study done on androgen receptors in men who took finasteride for prostate issues. It was found that the androgen receptors in some men were highly upregulated even 5 years after they had stopped the drug. Granted these were not androgen receptors in the scalp but somewhere else....

are you shedding a lot?

 

[Dench57]

Yeah most people just give sarcastic responses or tell me it's all in my head. I can't believe there's so little information about this...it must be incredibly rare to have a reaction this strong. Obviously the idea that this is permanent is hugely distressing as this is scalp pain is ruining my life right now. Is this the study you're talking about, a fairly recent one?

http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0100237

"Our findings revealed that modulation of local AR levels might be implicated in long-term side effects of finasteride use."

Read most of it and pretty conclusively states that AR sensitivity is affected long after stopping finasteride. Great. This study is obviously based on tissue taken from the penis, for guys who got permanent erectile dysfunction and penile numbness from finasteride, but I'm sure if the ARs are permanently affected in the penis then they'll be permanently affected in the scalp. Can't believe that I potentially have this permanently after just 3 months of taking 0.5mg. There must be SOMETHING that can be done about it.

I've not had any noticeable shedding. I never shed before, during or after finasteride (yet). That may be because I'm purely receding at the temples and not diffuse though. If I'm correct though and this burning itch is Test/DHT attacking my hair follicles, then when eventually these hairs do shed they'll come back completely miniaturised.

 

[bilboswaggins]

yeah i think that's the one

btw spironolactone, flutamide all that stuff won't help since they are meds for managing excess androgens. I doubt you have excess androgens, if you take a blood test your DHT and T levels will probably be normal. However your receptors are just upregulated so even normal levels of androgens are causing those sides for you

 

[Dench57]

Not what I wanted to hear obviously but thanks for the sincere reply anyway.

I'm still unsure whether upregulation means:

a) increased amount of receptors
b) increased sensitivity of receptors
c) both

You're probably right about Flut and spironolactone. Don't they have a different mechanism to finasteride though? I thought they bind to the receptor instead of DHT, effectively "blocking" it's harmful action. Whereas finasteride inhibits the 5ar enzyme, thereby reducing the amount of DHT in the body altogether.

I've read a bit about Fluridil "downregulating" or "degrading" the androgen receptors themselves. There's not really any science to back this up so it sounds too good to be true. I'm using it anyway as I don't really have anything to lose at this point, apart from time and money. I'm hoping that in the world of 21st century modern medicine there must be something capable of a similar mechanism that "downregulates" or "degrades" androgen receptors. Though I guess if there was it would be the no.1 hairloss treatment.

 

[hmm]

So 2 months on .5mg finasteride and you think you developed this?

You noticed the burning and tingly feeling in the same place that was reseeding and caused you to take finasteride?

Sounds like you have the classic male pattern baldness itch. Sorry if I don't jump on the bandwagon to blame finasteride but I doubt that had anything to do with this.

 

[g.i joey]

I think you taking finasteride for a short time maybe made your follicles very sensitive to dht so the surge back did some damage? I'd blame finasteride if that happened to me... how can you not correlate the two?

 

[Notcoolanymore]

I believe this could happen. Sorry you are going through it. Unfortunately it is the risk we take when we decide to take prescription drugs to treat hair loss. I have read so many stories of the negative potential sides you can get from finasteride. Still isn't enough to get me to stop taking it though.

 

[Dench57]

I think you taking finasteride for a short time maybe made your follicles very sensitive to dht so the surge back did some damage? I'd blame finasteride if that happened to me... how can you not correlate the two?

Is your question aimed at me? I AM correlating the two. I don't see how it could be anything else. The burning/itching began WHILE I was on Finasteride, within 1 month of starting it. I've never had even the slightest itch or burn in the 2+ years my temples were receding before finasteride. So even while I was inhibiting all the DHT with finasteride it was still itching/burning, and has just continued since I quit it 3 months ago.

 

[g.i joey]

No it wasn't directed at you.. it's directed to the general public who believes finasteride doesn't cause any adverse reactions and who think 2 months isn't enough time to notice anything(hmmm). these people are stuck in delusions.. finasteride can have adverse effects on diff people.. like ya I understand there could be a couple loonies over exaggerating at propecia help... but they can't be on every forum occupying 50% of posts. Yes people can take finasteride with no side effects but that's not the case for everyone, it's like their stuck in such a deep denial in order to feel positive when they take their finasteride... it's sad because it's not helping anyone.

 

[Chris-lee09]

It is obviously from the finasteride,i cant believe people try to defend finasteride so much when your clearly distressed about it, it's obviously not a male pattern baldness itch,its like people dont like hearing that finasteride does actually give some people nasty sideeffects.

 

[Cue Bald]

I had a scalp itch in the male pattern baldness area before I ever took finasteride - I thought it was the typical male pattern baldness itch that every male pattern baldness guy had?

This won't help much but I thought I'd post my experiences - I take 1.25mg daily (1/4 proscar) and my sex drive went up 10 - 20% (I got called a merck shill for saying this once...) - I had ball ache quite bad too. The ball ache went away after 2 weeks but the sex drive remained high. I came off finasteride for about two months a little while ago just to see if I'd feel any difference, my sex drive went down within days of discontinuing. (nothing else changed)

 

[project100]

I had a scalp itch in the male pattern baldness area before I ever took finasteride - I thought it was the typical male pattern baldness itch that every male pattern baldness guy had?

This won't help much but I thought I'd post my experiences - I take 1.25mg daily (1/4 proscar) and my sex drive went up 10 - 20% (I got called a merck shill for saying this once...) - I had ball ache quite bad too. The ball ache went away after 2 weeks but the sex drive remained high. I came off finasteride for about two months a little while ago just to see if I'd feel any difference, my sex drive went down within days of discontinuing. (nothing else changed)

Did your sex drive come back? Or is it just on pre-finasteride levels?

 

[Dench57]

Judging by the lack of response or information from anyone in hairloss forums I do think my reaction is extremely rare. People get this hyper-androgenic reaction but to have it continuing long after stopping finasteride is honestly terrifying. I put off trying finasteride for so long because I was so scared about the horror stories of persistent/permanent side effects after stopping. Naive to believe in the people on forums, and the Merck studies, that said it wouldn't cause permanent alterations. Now 3 months after stopping I'm stuck with this scalp pain/itch all day, everyday. There's no reason at this stage to believe it will resolve itself naturally. Biggest mistake of my life.

 

[hmm]

You were so scared to try finasteride (your own words) that when you finally did try it you probably had a self induced psychological reaction and began feeling these symptoms. The symptoms you describe can occur from anxiety (research it) which you probably caused from over reacting and are now in a vicious cycle. I really doubt finasteride did anything there is no medical proof of lasting effects especially from such a short duration of use.

 

[Dench57]

You were so scared to try finasteride (your own words) that when you finally did try it you probably had a self induced psychological reaction and began feeling these symptoms. The symptoms you describe can occur from anxiety (research it) which you probably caused from over reacting and are now in a vicious cycle. I really doubt finasteride did anything there is no medical proof of lasting effects especially from such a short duration of use.

This is the standard response I expect, "it's all in my head". Firstly, there's plenty of medical proof of lasting effects from finasteride. Several studies showing intensely upregulated androgen receptors years after stopping finasteride. I'm sure that stress/anxiety exacerbate the problem, and may make the pain seem worse than it is, but finasteride is undoubtedly the root cause.

Slight exaggeration when I said I was "so scared" about taking finasteride - I was apprehensive about long-term sides but no more than the usual person taking a prescription drug. As a NW1 I was pretty comfortable with my hair and fairly relaxed and confident that if I got sides from finasteride or it if didn't work, I could stop it and they would disappear. At the time of taking it I was in a good place, zero stress, very happy in my personal and professional life.

The sensation in my scalp ranges from slight tingling and itching, to extreme burning/itching and often pain that becomes excruciating. It's 24/7 and never stops. I got oily scalp, increased acne, increased sex drive after trying finasteride. I had none of these before. These are all tell-tales signs of hyperandrogenism, which finasteride can cause with it's effect on Test/DHT and ARs. There's no way symptoms this pronounced are psychosomatic when there's hundreds of threads all over hairloss forums of people experiencing this "reflex-hyperandrogenicity". What I don't understand is how it can be so extreme after 3 months of stopping finasteride. I would have hoped my body would have found its "equilibrium" again and rebalanced my hormones.

- - - Updated - - -

I should also add that the area where this "burning" is worst, just above my right temple, has thinned noticeably more than anywhere else, say above my left temple. This would suggest inflammation, but there's no redness, or flakiness, or any physical signs there.

 

[ben760]

you can visit propeciahelp and see how many men messed by finasteride. finasteride gave me permanent tinnitus and ED

 

[Dench57]

you can visit propeciahelp and see how many men messed by finasteride. finasteride gave me permanent tinnitus and ED

I've made a post on Propeciahelp but nobody so far has experienced the same scalp pain as me. They all have the more common finasteride sides like ED, gyno etc. that I don't have.

The fact that most of their sides are permanent, or at least persistent for 3 years+ terrifies me that this scalp pain/accelerated loss/itching won't ever go away

 

[abcdefg]

I would agree finasteride or more specifically DHT and the hormones that are altered are not that well understood. Neither are most things addressed with drugs. That being said its still use finasteride or go bald so many more men will continue trying it until something better comes out. Its not enough to say propecia sucks without giving real viable alternatives and there arent any. Men dont take it because they like drugs they want to keep hair and its the only option.

 

[Aeroes]

Yeah Finasteride, made my junk numb and lifeless freaky experience and I only took 2 tablets! Took me 3 months to work again.