Dr Richards,
I’m Glad I found this site.I hope you might give me some suggestion.
I took 4 pills of propecia and I got the side effects of Erectile Dysfunction.
I’m having difficulty gaining erections and to sustain them.
I’m having erections easily while Laying down and I was able to maintain them.
But, I was having difficulty to get erection while standing.
All my testosterone levels are in rang in the upper third level, Even my LH is good.
Please give me some suggestion.
Thank you.
ANSWER
Yes, this is a quite frequent occurrence after using 5-alpha reductase inhibitors. Again, this is an example of a modern drug treating the symptoms and not the cause of the problem. Here is what is happening:
Actually during the teen years the body synthesizes high levels of 5-alpha reductase and low levels of aromatase (for estrogen conversions) and still there is no prostate problems, no hair loss. With much 5-alpha reductase and testosterone our body produces high levels of DHT but one is in the best shape of his life. It is not only the DHT, it is the DHT plus other imbalances and ill processes that will lead to hair loss.
So one has to optimize testosterone-DHT, testosterone-estrogen, and estrogen-DHT ratio. Also, it is very important to provide the needed ingredients to prevent excessive binding of testosterone, DHT, and estradiol to hormone receptors that usually takes place after 25-30 years of age and will lead to ill consequences.
DHT is a needed for numerous processes, it is wrong to artificially lower your DHT levels – it will weaken the erection and result in erectile dysfunction. One just needs to regulate its activities and prevent excessive binding to androgen receptors on the hair follicle cell membranes, especially if the blood circulation is not so great.
The levels of testosterone won’t matter if there is not sufficient conversion to DHT for proper sexual functioning.
UPDATE
Dr. Richards,
First and foremost, thank you for commenting on the above post. Secondly, I wanted your feedback on 3-Androstanediol glucuronide, which is a major metabolite of DHT.
There are over 1600+ individuals on the propeciahelp.com website. We are starting to notice a trend/pattern of individuals who may have normal or subnormal DHT levels, but very low 3-Androstanediol glucuronide levels(I believe the range is (3.4-22 ng/ml) LINK: http://www.propeciahelp.com/forum/viewtopic.php?t=2763…. Most of these individuals are posting #’s between 1.0-5.0 if you look at that link above… THEY ARE in their early to lates 20’s for the most part.. These individuals have Erectile Dysfunction, even with normal or high normal testosterone levels.
My question is, how would a doctor go about treating a condition such as this without supressing Testosterone levels too much?
Best Regards,
Stevens
ANSWER
My guess is that the temporary lowered DHT levels and ruined homeostasis may have altered numerous gene expressions for improper Glucuronosyltransferase release, that in turn may have lead to chronically low 3-Androstanediol glucuronide levels. However, this is just an assumption.