Testosterone, could this be causing me a problem

Hi Alan. Yes, he had a prostate problem a few years ago and ended up with Turp. He gets his testosterone checked regularly. It was low originally. Rubs in prescription or gets patches. 

Hi Chris. How did you know you had a testosterone problem and did you replace Finesteride with another tablet.? I am on finesteride and Doxozasin and now am experiencing problems.

Thanks Chris. I wouldn't class my doctor a urologist! They seem to dish out the Finesteride to anyone who mentions having a water problem. My Psa is okay and DRE has indicated an enlarged prostate. I am not running to the toilet all day but my stream is iffy. Today I'm stopping the Finesteride and going to see if there is an alternative due to lack of sex drive and sensitivity down below. I'm holding out on surgery as even Rezum gets mixed reviews. Cheers.

Thanks Barry. Yer, they do a couple of tests Psa DRE say you have an enlarged prostate and send you on your way with a packet of Finesteride. I've been on these for over a year now, not good feelings see above. I'm stopping them and see what happens when I manage to see a doc. I'm sure the meds are not improving my situation and most of the hospital procedures have. Mixed outcomes. I hope to have this sorted but wouldn't count on it!

Chris,

How long were you on Finasteride?  You said it didn't work for you.

Generally, reduction in prostate size occurs at around 6 months.  By then PSA values will reduce around 50%. 

If you're on Finasteride for less than 6 months, you may not see results, i.e., reduced LUTS.

But you are correct, Chris...... Finasteride wrecks havoc on sexual function.  It causes libido to fall off a cliff; it often produces retrograde ejaculation or dries a man up; it can result in ED.  And it can produce gynecomastia (man boobs) and result in serious bouts of depression (men have been reported to commit suicide while on it).

Finasteride does what it claims to do: shrink the prostate.  But it comes at a high price in far too many men.

I think men, like myself, consider this drug - despite its many side effects - out of desperation to be able to urinate (without needing to self-cath) and to postpone surgery.

Hopefully, as newer prostate reduction methods gain traction (e.g., FLA, PAE, even REZUM) and men are left to better options than TURP, we can leave behind drugs with potent complications and turn to procedures that will give us quality of life and the ability to function sexually.

Far too often, we're left with the choice between sexual function and ability to urinate naturally (i.e., w/out a catheter).  It would be nice to be able to have both.  As for me (speaking only of myself) at 60, and having suffered loss of QoL, I'd rather pee like a 30 year old and never have sex again than have sex 3x a week and have to self-cath or undergo major surgery with potential complications (e.g., partial prostatectomy, which would open up urinary flow and remove a good portion of the prostate).  I hope something like FLA or PAE will allow me both in time but I've only seen PAE studies going 2 years out and there's never been a published study on the efficacy of FLA.  I believe HoLEP is great for treating BPH but results in RE in 90% or more cases.  I would never consider TURP under any circumstances.  I don't think there's any real risk of ED with FLA or PAE.  I don't know about HoLEP.  I think FLA is the best hope.

Chris. I have hit a brick wall and I am only 62. My. Sex drive has gone all together. Feel uncomfortable all the time. I'm  stopping the finesteride. Been on over a year. I'll take my chances.

Hi Michael,

I took finasteride for 10 months and went to my urologist for cystoscopy and other tests. He told me the next time he sees me is for a TURP, so I asked about the finasteride and he casually replied to stop taking it as it doesn't seem to have improved things. That was the moment I realised I was dealing with a t--t, so I went back to my own researching and I feel I am getting better because I no longer suffer the agonies of incontinence (urine) and my sex life returned, to which I thank my GP for putting me on testosterone. Life is fine right now; I can tolerate my situation, but I still keep researching. 

rdemyan,

So, you're taking an alpha blocker (alfuzosin) with a 5AR-inhibitor (dutasteride), correct?

How long have you been on that regimen?

I was on Finasteride years ago and experienced bad side effects: man boobs, loss of libido, no ejaculate whatsoever.  However, my prostate did not grow, my PSA went down to 1.1, and I peed pretty well and slept through the night.

As I've gotten older - and off Finasteride for 7-8 years - my prostate has more than doubled in size, my stream is much weaker and I need Flomax to pee.  Seems the Flomax is wrecking havoc on sex drive but my wife and I haven't slept together in a long, long time and I wouldn't commit adultery with a gun to my head - so even though I miss intimacy, the sexual side effects of Flomax aren't devastating.

My urologist is world-renown and he refers me to the PCPT (comprehensive study, about 20 years ago) that implicated Finasteride in G7+ cancer.  For that reason, he's not putting me on Finasteride given my strong family history of PCa.

I figure there's not much difference between Avodart and Proscar.

I do know other uro's who prescribe 5AR-reductase inhibitors w/ no reservations and no concerns about increasing % risk of high Gleason cancer.

Last question:  did your doc order for you Cialis AND Flomax?  I don't follow if he did, as I always thought a guy takes one or the other, not both.

Michael

1) Yes, I am taking both.  Have been on dutasteride for about a month.  I took Flomax for about three weeks and then switched to alfuzosin almost 3 weeks ago.

2) I don't know for sure, but I suspect the man boobs might be due to increasing estrogen.  I've been taking increased amounts of quercetin as I read that this helps keep estrogen in check.  I'll be looking for other natural supplements to take.

3) While on dutasteride and Flomax, I had zero sex drive.  So the low dose cialis was supposed to help with that as well as BPH.  It did both, but side effects were too much.  Also, I hate taking pills, so I didn't mind stopping it.

4) Not surprised you haven't heard of alfuzosin.  I had to do the research on it to get my USA uro to prescribe it.  The Flomax was worsening my tinnitus.  Alfuzosin might have some effect, but my tinnitus is much better.  My GP here in the states has BPH.  He didn't know about alfuzosin.  I told him and he said he is going to switch.  It seems to be more popular in Europe.  I always check out what the Europeans are doing, because some of the drug companies here have a stranglehold on medications to the point where doctors aren't even familiar with alternatives.

5) Avodart prevents an additional "pathway" from causing prostate grown; whereas Proscar only stops one pathway.  At least that is my understanding. Recommend you google it for more info.

I'm really glad I found alfuzosin.  Sex drive is better; I'm  peeing better, Post Void Residual is lower, and there seems to be less concern with alfuzosin with respect to floppy iris syndrome.  I would say though that I'm just a tad bit more subject to dizziness, but I suspect I'll get used to that.   Congestion seems to be a bit less on alfuzosin when compared with Flomax.

Alfuzosin does work similarly to Flomax.  I strongly recommend that you google these medications to learn more.

Cheers.

Wow redemyan,

You gave me a lot to look into and I appreciate it.

I'm going to research further.  Flomax has given me a stuffy head for years.  Can't remember the last time I could breathe "freely."  What a price to pay (along with the sexual side effects) to be able to pee.

The Finasteride blocks conversion of testosterone to DHT (di-hydro testosterone).  DHT is the culprit in both male pattern baldness and prostate enlargement.  I don't know why Finasteride would cause estrogen to increase as it does not decrease T levels (which would increase estrogen to testosterone ratio) but instead slows down the T --> DHT process.

But something is causing the gynecomastia. 

I was able to ejaculate while on Flomax but now there is nothing.  My wife and I have had a rough marriage and so there was never much sex, going back > 15 years.  I hate to "relieve myself" but I'd do it every 30-90 days to "flush things out."  I wonder if waiting three months many times was too long and that caused some of my prostatitis issues.

But I was able to produce a little semen while on Flomax.  Now, there is nothing.  And I wonder how I can "flush out" the prostate since there is no ejaculate.

I wish I could just get the prostate cut out.  Of course, I need a pathology report saying I have cancer and my biopsy was negative and my MRIs have not shown any lesions. 

Relying on drugs (which I hate too) is no way to live when the side effects are so pronounced.

I've taken quercitin in the past and will get back on it.

I've been using Serrapeptase for about 6 weeks.  It's helping a little with LUTS.  My knees and neck sure feel a lot better.  But I'd rather have painful joints and my prostate shrink than be able to run again and deal with BPH.  

Btw, have you experienced blurred vision with Cialis?  Flomax has done that to me. 

Thanks again.

Michael

 

I took serrapeptase years ago for a short while for something that I can't even remember.  I'll google it to see if it helps with LUTS. Thanks.

 forgot to mention (because it's better today), but I am having more blurry vision particularly in the left eye.  It has come and gone over the years (prior to the BPH pills), but now seems entrenched.  I'm having my eyes checked out this Friday.  So yeah, I am having more blurry vision.  Also, I think one of the rare side effects of Cialis is a sudden loss of vision, but I believe I also read that the potential is higher with high-dose Cialis as opposed to low-dose Cialis.

Sex life is better on alfuzosin, but not as good as with no pills. The Avodart has a hand in it as well.  On Alfuzosin, I haven't noticed significant RE, but its possible. Sometimes my urine is cloudy hours after sex, which I guess could be suspended ejaculate (I don't think it would dissolve totally in urine, but I'm not sure).

I'm not sure what your exact situation is, but if you're intending to stay on an alpha blocker, why not give alfuzosin a try.  You can always switch back or maybe try Rapaflo (which I believe is another alpha blocker more prevalent in Europe than the US) or.....

There’s a lot here on BPH medications over other treatments. I took alpha blockers (Prazosin or Flomaxtra (Tamsulosin) 4mg a day 2006 to 2015. Urologists had known since 1995 that an increased dosage would be required after 2 years but no research had been done so they wouldn’t increase my dose. There was also no research into ramifications of many years of these drugs post-prostatectomy.

Somehow they decided they could prescribe Duodart which included Dutasteride and 4mg of Flomaxtra together with the 4mg of Prazosin ie 8mg of alpha blockers. I have seen on this site 8 mg a day of alpha blockers being prescribed. So it’s all crazy. As previously mentioned here 5ARIs, Dutasteride and Finasteride had some suspicion of being involved with a higher risk of high grade PCa. I was MRI diagnosed 3+4 PCa and maybe wrongly chose radical prostatectomy in 2015. Numbers with similar progression possibly appears to be small and trial outcomes are said to be somewhat doubtful so no one in Australia wants PCa listed as a side effect. My BPH symptoms were not that bad and 6 or 8mg a day of Prazosin now seems the way they should have let me go. Prostatectomy recovery, initial kidney failure, rashes, fungal infections mistreated blockage, kidney stones, low testosterone polymyalgia rheumatica have all had their toll and incontinence goes on and on and on. They won’t treat the low testosterone due to return of PCa issues. They also don’t know the full function of the prostate or the bits lost with it. How hormones and immune system are affected. You feel different and it’s not just erection loss. Then grandkids give me a hard time about beating me “out of nappies” as well.

Men’s urinary adversities need a lot more research and data collection than is currently funded.  They don’t seem to know if Gleason 7s progress to 8s and 9s or just become a more aggressive 7. I can’t even find if prostate enlargements are the result of increased size or number of cells and if a difference could affect the Cancer issue. From what I see on these sites urinary treatments for BPH in particular are ridiculously different, there is no formal approach and we allow them to get away with this with that old “we are all different” excuse for this careless approach.

Barrie Heslop

Barrie,

Prostate enlargement (BPH) is due to increased number of normal prostate cells.  When 5-AR, an enzyme, converts testosterone to DHT, the DHT prevents apoptosis (normal cell die-off) from occurring.  The prostate continues to grow but the normal die-off of other cells does not take place and the gland grows larger and larger.   

One uro told me it's an entirely different mechanism than the proliferation of cancer cells, and that most men will develop one or the other, but not usually both.

Sounds like you have had BPH and cancer, correct?

You underwent an RP?  Were some of the things you've encountered complications from surgery?

You can find alternative medicine doctors who will argue that testosterone does not fuel prostate cancer.  The mainstream medical community would seem to argue otherwise.  I think, given the uncertainty, it would be best to proceed cautiously with testosterone supplementation with a history of cancer.   I have a family history of PCa, and I think my uro would not recommend T supplements because he'd see that as increased risk.

Michael