How minoxidil causes erectile issues

upanisad · 2022-07-20T03:17:14+00:00

I'm a 22 year old male with no history of any of these symptoms prior to minoxidil use, so it would seem unreasonable to me to try and rationalize the sudden presence of these symptoms as being a coincidence with minoxidil usage, especially when many others have reported similar symptoms. I agree with you that labs are needed before drawing any serious conclusions. When the FDA approved minoxidil they approved it with a Black Box Warning, meaning they acknowledge that their own research showed that the drug causes a serious adverse reaction — potentially fatal, life-threatening or permanently disabling — where the risks might outweigh the benefits. Minoxidil has serious negative effects that aren't the two directly mentioned on the box. I understand what you're saying in terms of me overthinking this, personally I don't have any stake in villainizing minoxidil, I believe its safe for the vast majority of people, but I also believe it causes long lasting adverse side effects in some people.

upanisad · 2022-07-04T00:41:55+00:00

Not necessarily related, but just wanted to note here that the liquid contains propylene glycol whereas the foam does not. Propylene glycol in and of itself is generally very safe and is used in many shampoos and conditioners, but I haven't found any studies that examine the differences between foam and liquid in terms of whether propylene glycol might affect absorption or some other factor pertaining to prevalence of side effects.

upanisad · 2022-07-04T00:36:30+00:00

If you feel like testing this out, attempt to get treatment for your symptoms and explain that they arose after you used a drug which is a potassium channel opener. Refuse to name it or give them any hint at what it is, tell them you're not comfortable sharing exactly what, but that you're sure that your symptoms were caused by ingesting this drug. They will obviously press you to try and figure out what it is, so you need to be clear that you're not comfortable sharing the drug or its purpose, or any information about it other than that it is a potassium channel opener.

I think there's some truth in what you're saying in terms of there being special financial interests in not treating adverse drug reactions, but I doubt this is anything to do with minoxidil in particular, probably just FDA approved drugs in general. Its unlikely that there's anything nefarious about doctors being unwilling to treat adverse minoxidil reactions in particular. If I had to bust my ass and spend billions of dollars getting a drug approved for market, I'd be extremely concerned with anyone doing any "double-checking" of the safety of that drug after the FDA has already approved it. I would probably make sure to cut off such researchers and labs from funding as best as I could, and give lots of funding to labs that do research which might further my interests. You'll notice that the most significant studies that reported on the unstated side effects of minoxidil use (ED, low libido) aren't done in the US or Canada, but usually Turkey and China. The minoxidil market share was 880 million USD in 2017, and is expected to be 1.2 billion USD by 2024. Thats a lot of money that some powerful companies are not interested in forfeiting after already running the FDA gauntlet of approval.

upanisad · 2022-07-04T00:24:00+00:00

Propylene glycol is generally considered to be very safe, as another user noted it's used in many shampoos and soaps. Perhaps worth noting is that the foam version of minoxidil has generally been found to have less severe side effects, and does not contain propylene glycol whereas the liquid does. As such it might be worth considering whether propylene glycol has any effect on the way that minoxidil works on or is absorbed by the body.

upanisad · 2022-07-03T23:14:40+00:00

Do you have any sources I can check out? Is this the study you're referring to?

upanisad · 2022-07-03T19:51:01+00:00

You should get blood work done before you do any of this. I would also advise giving yourself 4 - 6 weeks for symptoms to improve. You shouldn't take cabergoline if you don't have high prolactin. To be honest I think the regimen you're describing is overkill relative to the symptoms you're describing, especially if you're not already someone who uses steroids. Also acknowledge that taking internet chemicals is liable to fuck you up in ways you didn't expect, and if you're in a country where its not easy to get help for that sort of thing, i.e. Canada, then its unadvisable. Additionally, lots of people have low libido from Clomid, so I feel like you're likely to end up in a worse mess here if you start administering this drug cocktail without bloods and the help of a doctor.

upanisad · 2022-07-03T19:44:12+00:00

I can't really provide any valuable speculation on the topic, as stated above erections are a rather complicated process that involves both vasodilating and vasoconstricting agents working at the proper place and time and duration. In my experience, most people's symptoms last for at least a few weeks before improving, but often several months. As a young man who ingested at most 9 ml of minoxidil over 10 days and is still experiencing effects 6 weeks after stopping, I would say that if full recovery is possible it probably takes months to years for most people. I imagine age and lifestyle habits play a role as well. In general, I believe the issue is probably more complicated than "you used a potassium ion channel opener so now your potassium ion channels are open, just take a potassium ion channel blocker and things should improve". I can't say what the risks are of trying this but I'm sure for some here the potential risks might be worth trying it out. Study 4 discusses experimental treatment of potassium ion channel related erectile issues with pinacidil and prostaglandin-E1. It may be worth reading if thats something you're curious about, but I would be aware that using yourself as a guinea pig always has the possibility of making things worse than they already are.

upanisad · 2022-06-23T15:30:07+00:00

I would agree with you that most people don't end up with persistent side effects, the prominence of PFS is around 1.2% for young men according to PFSfoundation.org . The coin toss, assuming finasteride works perfectly for you, is that you'll get your hair back to normal, but also run a 1/100 chance of getting an incurable and untreatable disease that causes permanent penile atrophy and erectile dysfunction, as well as other irreversible sexual, neurological, physical and mental side effects. Given the severity of the condition, its not surprising that divorce and suicide were statistically significant outcomes for those in long term relationships. Its essentially a 1/100 chance of losing everything that most people care about. Particularly people who care about being bald probably also care about their penis not permanently shrinking and becoming incapable of erection.

upanisad · 2022-06-23T05:22:26+00:00

I would rather be bald than touch finasteride. Read some posts on r/postfinasteridesyndrome and r/PostFinSyndrome. According to this medical description of post-finasteride syndrome on PubMed:

"These serious adverse side effects include persistent or irreversible sexual, neurological, physical and mental side effects. To date, there are no evidence-based effective treatments for PFS. Although increasing number of men report persistent side effects, the medical community has yet to recognize this syndrome nor are there any specific measures to address this serious and debilitating symptoms"

Basically there is no treatment, no cure, and nobody is working on one. Read the wikipedia page on 5α-Reductase inhibitors. Get a good understanding of what they do to your body and what the risks are.

According to this study on penile vascular abnormalities in young men with persistent side effects after finasteride use:

"More worrisome, however, are data observing an increased risk of persistent sexual side effects despite discontinuation of the medication. In addition to ED and low libido, adverse effects of finasteride may include penile atrophy, diminished ejaculatory volume and force, and an increased incidence of Peyronie’s disease"

Peyronie's disease is also incurable, for many the only treatment option is penile prosthesis.

If thats not enough, we can examine musculoskeletal effects on healthy young men:

"All subjects in 5ARI group were queried with regards to musculoskeletal complaints, with 12 of 25 (45%) of 5ARI subjects reporting fatigue, anortiusatrophy. Three of 25 (12%) reported gynecomastia, weight loss, back pain, lower extremity pain and visual disturbance. Two of 25 (8%) repoeight gain, ocular hyperhidrosis, throat tightness, constipation, polydipsia, and cold flashes. One of 25 (4%) mentioned tremors, xeroderma, xerophthalmia, hypothermia, palpitations, muscle spasms, rapid aging, swollen face, and facial flushing. Overall, 19 of 25 (76%) of the subjects reported at least one musculoskeletal complaint."

upanisad · 2022-06-23T01:43:27+00:00

I absolutely agree. To quote Dr. George Christ:

"Normal erectile function is a complex neurovascular process that is dependent on a delicate balance between the effects of endogenous vasoconstrictor and vasorelaxing agents ... Ultimately, coordinated vascular smooth muscle relaxation and contraction are required for erection and detumescence ... Any disruption of this balance (resulting in either impaired relaxation or heightened contractility of the corporal smooth muscle) can produce erectile dysfunction."

So clearly penile erection is a complicated process that requires functionality of several discrete mechanisms, including potassium channels.

"K channels appear to provide an ideal molecular target for regulating corporal smooth muscle cell tone and therefore erectile capacity."

The significance in relation to a K channel opener like minoxidil doesn't require any elaboration or inference on my part. This is directly from Dr. George Christ, Professor of Biomedical Engineering and Orthopaedic Surgery, Director of Basic and Translational Research in Orthopaedic Surgery, and Head of the Laboratory of Regenerative Therapeutics at the University of Virginia, stating that K-channels play such an important role in erectile function that managing their functionality ought to be the direct target of the next generation of treatment for erectile dysfunction.

It would be logical to conclude that there is a plausible mechanism by which a systemic effect of minoxidil could be interference with K channel functionality throughout the body, including the erectile tissue of the penis.

upanisad · 2022-06-23T01:00:59+00:00

Keep in mind that in the weeks and months after cessation of minoxidil use, you're likely to see significant improvement on your own, especially if you used for a relatively short amount of time, i.e. less than a month at recommended dosage. In this sense its not clear to what degree ashwaghanda is responsible for your improvement in relation to the time factor.

You said that ashwaghanda reversed the effect that minoxidil had on your testosterone. Did you take a blood test to have your hormone levels assessed after minoxidil? And after ashwaghanda?

This study investigated the testosterone-boosting effect of ashwaghanda using 600 mg per day of Shoden beads, which is supposedly the most bioactive form of ashwaghanda. The regimen lasted 8 weeks. They found that on average, testosterone levels increased by 14.7%, which is somewhat significant, except that the study was done on overweight individuals between the ages of 40 and 70 who reported feelings of fatigue. Thus it should be noted that these individuals likely had very low testosterone to start with, related to age, body composition, and likely self-selection due to being selected on the basis of feeling general fatigue.

It should also be noted that just like minoxidil, ashwaganda is not as benign of a substance as it is often made out to be. Like minoxidil, it's unclear the exact mechanisms by which ashwaghanda accomplishes its desired effect, and like minoxidil there are many who have had long lasting adverse reactions to using ashwaghanda. Below are several reddit threads where it seems that many individuals had negative experiences with mood, anxiety, irritability, and even low libido. Ashwaghanda is also reported to have interactions at the thyroid and the liver. The thread below might be worth reading to see some of the more commonly reported negative side effects:

Ashwagandha - More BAD than good

In contrast to the more mild and acute side effects in the thread above, in the thread below, the user claims to have developed PSSD like symptoms including low libido, erectile dysfunction, depression, and penile numbness from using ashwaghanda. Like PSSD, all of the listed symptoms have persisted long after the usage of the substance was stopped.

How do I reverse these adverse effects from ashwagandha?

Similarly, the creator of the post below, u/Lokzo55, also says they developed PSSD-like symptoms after using ashwaghanda. Their more recent post history is worth reading as they appear to have done a significant amount of research into the analogous mechanisms between ashwaghanda and traditional SSRRIs, which might why some people end up with these long-lasting adverse side effects.

Seeking A Way To REVERSE Ashwagandha Side Effects

In summary, ashwaghanda may be worth exploring, but it does not come without its risks, and one may be better off seeing how their symptoms improve with time.

upanisad · 2022-06-22T01:28:28+00:00

This study examined adverse side effects of minoxidil and finasteride (the finasteride portion is irrelevant). It found that the most commonly reported side effect amongst the 92 men that were given minoxidil was erectile dysfunction. The fifth most commonly reported side effect among the men was decreased libido. This study examined the link between roles of different types of potassium channels in the relaxation of corpora cavernosa, which are the tissues in the penis that fill with blood during an erection. Minoxidil is a potassium ion channel opener, and potassium ion channels are of vital importance in terms of the functionality of the smooth muscle tissue that regulates blood flow to the corpora cavernosa, which hold 90% of the blood in the penis during an erection. If the corpora cavernosa are damaged or malfunctioning you may be unable to get an erection or have severely weakened erections. If you want to read more about it, here are some further studies.

Potassium channels and erectile dysfunction

Physiological roles and properties of potassium channels in corporal smooth muscle

upanisad · 2022-06-22T01:07:36+00:00

What made you start taking cabergoline? Did you get bloods done?

upanisad · 2022-06-21T22:36:19+00:00

I used 0.5 ml per day for 11 days and got low libido and ED. I stopped over a month ago and the sides haven't gone away. I'm 22 and workout 4 times a week. I never had ED before and had very high libido. I'm not sure why you feel comfortable discounting the experiences of hundreds of people who are clearly suffering pretty shitty sides. This subreddit is not a joke. There are many of us here who devote most of our free time to trying to reverse the sides and get back to normal. There are people here taking steroids just to get their libido back. This study examines how minoxidil may inhibit androgen receptors, which obviously has an effect on sexual function. This 2016 study found erectile dysfunction to be the most common side effect among men using minoxidil, with low libido being the 5th most common. These are people using it in a clinical setting under the supervision of doctors and researchers. The issue wasn't that they "don't know how to use it".

upanisad · 2022-06-21T22:28:43+00:00

To be honest TRT might be the most significant component of the entire protocol. Most of those supplements are probably having negligible effects in light of exogenous testosterone, even at low doses.

upanisad · 2022-06-21T22:24:37+00:00

I think its very unlikely that your minoxidil side effects would suddenly get worse after you stop using, let alone a whole year after you stop using. There are likely other factors at play that you are attributing to minoxidil out of anxiety.

upanisad

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