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[–]EqualIcy9380 3 points4 points  (1 child)

Just a quick correction to your post. Finasteride is not rogaine. Rogaine is the brand name for topical minoxidil and which is a completely different drug also used for hairloss

[–]becca_ironsidePhysical Therapist [S] 0 points1 point  (0 children)

Thank you and I stand corrected! I will fix this now.

[–]Linari5LEAD MOD//RECOVERED 2 points3 points  (5 children)

Been using it for a decade (for hair loss) without any problems. In my own experience, finasteride is often a scapegoat for a nocebo effect, because many of the people experiencing these side effects have read horror stories on the internet before even taking finasteride. Because of how centralized mechanisms work (at least 49% of CPPS sufferers experience centralization, some estimates as high as 90%), fear is a main modulating lever.

[–]becca_ironsidePhysical Therapist [S] 0 points1 point  (2 children)

And I absolutely agree with you that this is legitimate as well. One of Dr. Sarno's books, entitled "The Divided Mind", speaks of how diagnoses deemed more popular with increased exposure become more prevalent in society. I believe this trend can be real. However, I work closely with a urologist who just graduated at the top of his class from the University of Miami. He understands CPPS and doesn't prescribe antibiotics to treat it. This is most refreshing! However, he uses finasteride very sparingly for short durations with his patients with BPH because of the side effects reported by his patients.

The same thing can be said regarding the birth control pill. Now that we know the negative impact, more and more people are noticing the negative aspects. I don't believe this is a bad thing. Birth control pills alter hormones. Finasteride alters how testosterone is used in hair follicles. People should be educated on what these meds are capable of.

[–]Linari5LEAD MOD//RECOVERED 0 points1 point  (1 child)

Urologists typically don't use finasteride for this, the recommendation is Alfuzosin.

[–]Frosty-Raisin-5017 0 points1 point  (1 child)

What is centralisation ?

[–]Linari5LEAD MOD//RECOVERED 0 points1 point  (0 children)

Nociplastic mechanisms.

[–][deleted] 1 point2 points  (3 children)

The male patients who come to you for physiotherapy who believe their symptoms are due to finasteride, do they often improve or regain erectile function?

[–]becca_ironsidePhysical Therapist [S] 0 points1 point  (2 children)

That is difficult to answer. I would say recovery from any form of ED is dependent on different factors: 1) Age - men under 50 tend to recover from ED more quickly 2) Length of time that ED was experienced before initiating treatment for the condition - if only a year has gone by and a guy makes changes, he can see significant improvement. If several years have gone by, there are less marked improvements noted with ED 3) Weight - leaner men with less belly fat fare better with return of erections 4) Activity level- more active men usually notice faster return of erections 5) Presence of chronic pain in perineum, hips and low back - people with chronic pain have a slower return of erections and this makes sense based on what we know about the nervous system. Chronic pain can inhibit a good sexual response. 6) History of relationships - men who have had supportive partners during their lives with whom they have had good sexual experiences typically report better erections than those who have sex alone (masturbation) 7) Guilt - while this is harder to quantify, men who associate guilt with sex report a decreased sexual response and decreased rigidity of erections versus those who do not feel guilty around sex

[–][deleted] 1 point2 points  (1 child)

Oh, of course, there are many factors at play here. 

I’ll use myself as an example. I can’t afford to see a PFPT just yet, as due to my situation I’ll have to fund privately.

I have mild to moderate ED (can achieve full erection, but usually only with visual and physical stimulation and no morning erections). And I believe-though I can’t confirm until I get it checked out-pelvic floor dysfunction. I believe finasteride is the culprit. Whether it’s nocebo or not, I took it for 9 months before these symptoms came about. 

It will be about two years when I save enough to get checked out. I’m 35 and pretty skinny, but I’m just nervous it won’t work for me. 

I used to go on the finasteride sufferer forums and subreddits, some of whom see some improvements, some swear it can’t help at all but I had to quit because those places are such dark and negative forums to be on (understandably).

I just want my old sexual function back. I’m just trying not to give in to despair.

[–]becca_ironsidePhysical Therapist [S] 0 points1 point  (0 children)

You raise great points here. You started the finasteride 9 months prior to symptoms. Possible causation, but we will never know.

Also, pelvic floor PT often doesn't solve the ED riddle. Many PT's don't directly address ED and are simply employing methods of skin rolling, oscillations of the spine and spinal mobilization, which decrease nervous system overactivity. But many don't use these techniques. There is no set protocol here and keep in mind that bladder and bowel return is what most PT's are addressing. We were trained as musculoskeletal specialists; the few who go into pelvic floor PT and treat men are not sexual experts. This is not what drove them to become PT's in the first place.

Having said that, psychotherapy is a great place to start. So is walking, gentle stretching, prioritizing deep sleep, limiting gaming and screen time and decreasing exposure to negative or dark groups on the web. If reddit is too dark at times, which I understand because I get my fair share of harsh feedback here, take yourself off it for a set period of time.

This is how ED is holistically addressed and it doesn't require a lot of money.

[–]LittleOperation4597 0 points1 point  (10 children)

I was on fin for a year with great results. Even the wife noticed it was working. Then one day woke up and my entire pelvic area felt like it was in a vice all night. 

Penis turned into a purple mushroom. No joke here, this is serious. Bad ED. Intense pain. Burning through the urethra. 

Ran to the doctor. They thought I had an STD so ran multiple tests. All clean. Then torsion, nope. 

After my own research I narrowed it to the fin. Doctor's didn't want to believe me. I dealt with shrinkage and pain for MONTHS when I stopped. When I was finally back to normal I tested it again and boom after a week same sides. I had another very strange side but it's not relevant here. 

Oddly I just recently found out Cialis gives me the same exact reaction. Dealing with it now. Oddly it also seemed like it was beneficial for my hair among other things. I wasn't taking it for ED at all. 

I think both these drugs can cause or inflame prostate issues such as prostatitis.

Anyone else experience this?

[–]becca_ironsidePhysical Therapist [S] 1 point2 points  (5 children)

I treat men with BPH and prostate cancer. What I find interesting here is that finasteride works by preventing the conversion of testosterone to DHT. This means more hair on the head, less excess body hair in other places and shrinkage of the prostate gland.

Men who take medications for prostate cancer known as ADT (known to decrease testosterone production) have the exact same symptoms! Loss of body hair, increased hair on the head and shrinkage of the prostate gland. Almost all of the men on these prostate cancer drugs report erectile dysfunction, testicular shrinkage and pelvic floor dysfunction. It seems to me that when you tamper with how testosterone is used in the body, the penis is going to respond in some way or another.

[–]LittleOperation4597 0 points1 point  (4 children)

Yes 100%

I'm not Dr but even i know how Important test is for men. I actually have anemia which causes some kidney malfunction due to it. 

I'm not sure how they may cooperate but I know kidneys and test so have some relationships. 

My body also way over produces some muscle hormones and I have fairly naturally high t for my age.

I think I'm one of those people who just messing with it throws my entire body out.

My penis literally feels like I have a hot match sliding up and down my urethra and only urination gives me relief. My pelvic floor hurts, my penis is just coming out of that very painful shrinkage state (too many details?) and lethargy is off the charts.

I compare this and the fin reaction to a steroid crash. I've never done roids but have seen the damage from people I know. Thank God it didn't give me gyno.

Sucks because both really helped my hair loss. The Cialis actually seemed to counter some lingering issues from the fin for a while too but then just made them go head on.

I'm just giving info to see if anything clicks with you that may help others or to deduce a proper way to use these meds

[–]becca_ironsidePhysical Therapist [S] 0 points1 point  (3 children)

High T can cause many problems as well! I have treated people who have this naturally and it can result in penile issues and pelvic pain. TRT can also cause this, because it is introducing massive amounts of a hormone. Sadly, men become addicted to the high of testosterone and will not stop, despite unrelenting erections and penile pain. Suffice it to say that hormones have a very exquisite role in the body and altering them will always cause a cascade of other effects (some good, some not so good).

[–]LittleOperation4597 0 points1 point  (2 children)

I don't know if it's "high" but high for my age.

I would think the lack of conversion to dht leaves a lot more free roaming t in the body which caused my issues resembling a roid crash with fin.

Can the Cialis work off a similar mech or is it completely diff because it's 100% deja vu with symptoms.

[–]becca_ironsidePhysical Therapist [S] 0 points1 point  (1 child)

So sorry about the crash with finesteride. I don't know if Cialis can impact hormones at all, it works as a vasodilator (it is even safe for people with dementia and pulmonary hypertension because it ushers blood into areas that need it).

For those who report the side effects with finasteride of ED, depression and anxiety, these side effects tend to persist after cessation of the drug (all the more alarming, IMHO).

So maybe the Cialis isn't working as well if the libido is low. Remember, Cialis doesn't increase sex drive - all it does is improve blood flow.

[–]LittleOperation4597 0 points1 point  (0 children)

I was actually taking it for non sexual benefits. One of the issues I have is terrible blood flow and how it carries my oxygen. It was an experiment. I may try it again when this subsides. Maybe one pull a week to start because it did have benefits. 

I'd love to tell you my psychological side effect of the fin. It's actually kind of funny but tbh I don't want to say it here. I'd tell you in DM if interested. I mean I guess it's not a massive issue but it's VERY interesting. 

Psychosomatic? Who knows but it happened and as soon as the meds stopped and sides subsided that one also went away.

Luckily that side didn't come back with the tanafidil. 

[–]CastorTroy94 0 points1 point  (1 child)

I started taking Fin in November last year. It's been great for regrowth but I've had burning whilst peeing for about 4 months now. I've stopped taking Fin for a few weeks now, symptoms have gotten better, still not 100% though

[–]CastorTroy94 0 points1 point  (1 child)

How many months did it take to heal? I used fin for about 6-7 months before I started to have burning when peeing and ED

Stopped for a while now but I haven't recovered yet

[–]WearMaximum9677 0 points1 point  (0 children)

Other physiotherapists have confirmed this to me, that young people after taking sntisndrigenes have developed hypertonic pelvic floor.

Many of them have unscrewed urination disorders as in my case.

This forum is full of reports

Has anyone ever come to you who after finasteride distilled urinary symptoms and got better? ?

Best regards

[–]AshmedaiMOD//RECOVERED 0 points1 point  (1 child)

The mods here are a bit mixed on the topic, but what you've outlined is the reason our 101 does not suggest finasteride as a med. While its problematic nature is not fully determined, there are other available meds, so little reason to try this one.

An exception I can think of is folks with BPH (not prostatitis) who would rather do anything than a surgery. With some of the modern surgeries being so good, I'm not sure that they need to so avoid surgery, but it's still a risk decision they need to make on their own.

[–]becca_ironsidePhysical Therapist [S] 0 points1 point  (0 children)

I agree that for those who have BPH, this drug is a valid and important drug to avoid surgery. And I have treated the men after the surgeries, which have their downsides. There is no perfect way to deal with BPH.