Post-Finasteride Syndrome, Erectile Dysfunction

Is Porn and not Propecia Causing your Erectile Dysfunction?

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The most popular article in today’s Guardian newspaper is titled:

“Is porn making young men impotent?”

One of the astonishing statements in the article is that between 14% and 35% of young men now suffer from erectile dysfunction (ED). Until 2002, this figure was around 2%.

What changed after 2002? According to the article, its the proliferation of readily available high-definition internet pornography. And faster internet speeds and free streaming, especially after 2008. Clinical studies also suggest a correlation between internet pornography addiction and sexual dysfunctions.

What will happen to men in the coming years, with the widespread availability of 5G internet speeds and lifelike female sex robots!?

Is it Propecia or Porn that is causing your ED?

Finasteride Erectile Dysfunction PillsOver the years, there has been huge controversy when it comes to how often Propecia causes erectile dysfunction and other sexual side effects in men.

Almost all major studies suggest that Propecia (Finasteride) does not cause permanent sexual side effects in the vast majority of men. Most of these studies conclude that less than 1% of men end up with permanent erectile dysfunction as a result of taking Propecia.

On the other hand, internet forum and blog comments seem to suggest that this number is substantially higher. Of course this could be due to the fact that people with side effects are typically the most vocal and vociferous. There is a renowned online group called Post-Finasteride Syndrome Foundation that has publicized this issue regularly and effectively.

In any event, before you conclude that your erectile dysfunction is definitely caused by Finasteride, please remember that there are other potential causes too. Some unfortunate men will have sexual dysfunction issues due to genetics.

Others will have blood flow issues that result in erectile dysfunction. This is especially true when it comes to men who are obese, or have diabetes, or have high blood pressure, or are just getting older.

Research has also blamed excessive chemicals, pesticides and even estrogen in the environment for increasing rates of male sexual problems. Cycling, laptop usage, depression and many other factors have also been blamed.

Most significantly, it now seems that the biggest reason by far for erectile dysfunction in young men could be “watching too much porn”! A shocking development, although not entirely unexpected in hindsight.

Note: The NoFap forum has several sections that can aid people who are trying to stop or reduce their intake of pornography. Reddit also has some help for you.

Dutasteride Dosage, Finasteride Dosage

Finasteride and Low-Dose Dutasteride Combination Treatment

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Finasteride and Dutasteride Combination
Finasteride and Dutasteride combination treatment for hair loss. A 2012 case report from Boyapati and Sinclair.

Almost anyone who takes 5α-reductase inhibitors to reduce dihydrotestosterone levels (and treat hair loss) chooses either:

  1. Finasteride (1 mg/day; brand name Propecia). Or,
  2. Dutasteride (0.5mg/day; brand name Avodart).

I have discussed the dosage and efficacy of both Finasteride and Dutasteride in lengthy detail in the past. Most people take either 1mg Finasteride per day or 0.5mg Dutasteride per day to treat their hair loss.

While Dutasteride inhibits all three isoforms of 5α-reductase (types I, II, and III), Finasteride only inhibits the type II and III isoforms of the enzyme. Dutasteride inhibits a significantly greater percentage of dihydrotestosterone (DHT) in comparison to Finasteride.

Taking Both Finasteride and Dutasteride to Treat Hair Loss

A few years ago, one of this blog’s frequent commentators mentioned taking Finasteride for six days a week and the much stronger Dutasteride for one day a week. This would theoretically limit the side effects from taking the much more potent Dutasteride for all seven days of the week.

I blew off this idea as pointless, since Dutasteride by itself has such a long 5-week half-life (Finasteride has a 6-hr or so half-life). So one might as well just take Dutasteride once or twice a week and completely ignore taking Finasteride to keep things simple. In fact I myself have been taking 0.5mg Dutasteride every two days rather than daily for a couple of years now.

However, a short time after the above commentator made the suggestion, another blog reader made the following comment:

Dan
DECEMBER 8, 2016 AT 2:58 PM

Hi,

I have just been advised by a hair transplant surgeon, that if you combine 1mg finasteride daily with 0.5mg dutasteride once a week, you can expect regrowth. He learnt this from a recent conference he attended. A hair specialist presented a paper which showed good results from combining finasteride regularly with just one capsule of dutasteride per week on top. I’m yet to try this, but am willing to give it a go and just stop the dutasteride if there is no change or bad side effects.

And then yet again, someone else made the below comment last year:

Tom
FEBRUARY 8, 2018 AT 6:20 AM

I had been on Propecia alone for 15 years. Noticed hair started to thin again in 2016. Added Avodart in Jan 2017 and I can honestly say my hair is better and thicker than all the years on just Propecia. I take Propecia every day and one 0.5 Avodart once a week. Never had any sides at all. I did have a shed when I added the Avodart, but stuck with it.

Within about 4 months I could feel and see new hairs. My hairline is better than I can remember. It has taken one full year of this dosage to fully appreciate just how effective it has been. I will continue until things change and then reassess, but hopefully that won’t be for a very long time.

Combination Therapy: Finasteride and Low-Dose Dutasteride

While doing research for this post, I came across a 2013 study from Australia that found combination treatment on one male patient quite effective. Finasteride by itself was not working for him, but adding 0.5 mg Dutasteride once per week drastically improved the hair growth results. Before and after photos can be seen in the study. The screenshot of the abstract of this study is posted at the top of this post.