Hi there everyone!

(I hope this doesn't violate any rules on here, but I'm only asking a question about Finasteride use, not about doses or where it is obtained, etc etc.  )

My question is this: On hairloss forums, many men talk about the post-finasteride syndrome and how it effectively destroys them as a male, not just in gynomastia and reduced sex drive but stuff like nerve damage and brain damage/fog. Now I fully understand why an otherwise happy cis male would see any reduction of sex drive and an increase in gynomastia as a bad thing. It's obvious as to why they'd see that as a negative side effect. And it's obvious why a devoted crossdresser or MTF would see that as more of a positive.

But.... I've never seen on crossdresser or MTF forums any mention of the side effects such as nerve, tissue damage, brain damage, skin damage etc that is reported as a side effect as seen on the predominantly male hairloss forums. Which makes me wonder why this is the case, or whether its just not reported on here.

Has anyone who is MTF trans or is a crossdresser (or even who is an FTM) taken finasteride and experienced the more serious side effects mentioned above (as opposed to the usual ones such as gynomastia, etc)?

I ask as while I feel am on most definitely on the trans spectrum in the trans-femme area - I am still effectively a crossdresser socially and physicality because I'm holding down a straight relationship with a cis-girl and am very much seen as a fairy typical male guy at work and everywhere else these days (because of how I look now), so because of this, I am wary of rocking the boat (hence why I still haven't tried HRT even after six years of therapy). I have, however started taking finasteride again so I can give one last go out at saving my hair.

There's definitely evidence medically and anecdotally that the drug can and often does cause profound changes in the male body, either over a long time or a short time depending on the person. I do think its a case of when rather then if changes will occur while taking it, even if the severity and type of changes vary greatly. I'm always looking at updated accounts and news on how this drug works as, while things like gynomastia or loss of muscle wouldn't be much of an issue despite my currently being in the closet about being trans - potential nerve damage, ED and brain issues definitely would be a problem.

Thanks for reading.

Hi Stella,

I've been on dutasteride for 4 years.  After the first year I went on spiro too for a year.  Then for the next 2 years I've just been on dutasteride and low dose E.    I had zero side effects the first year.  With the spiro I got a bit of erectile dysfunction.  With the low dose E, it's hard to say.  I have had some breast growth but I would say that has much more to do with the E.  Not much erectile dysfunction.

I have some brain fog, but I attribute a lot of that to my dysphoria and stress.

I wonder how many people on these hair forums have other issues that could be causing them trouble.   The North American diet is pretty horrendous for most.  There's lots of people who still smoke.    I'm not defending finasteride or dutasteride, they obviously have side effects for some people but maybe some of the comments on these forums may not  really be related to the medication.   I also wonder how many fall victim to the power of suggestion from others.

Sorry I couldn't give you a more exact answer.
Take care,
Paige

Hi Paige, thanks for answering :-)

No, your answer is a very helpful one. I do wonder about their responses and whether a lot of it could be suggestion and psychosomatic. It's interesting being on the hairloss forums and then on forums like this, because there's a complete flip reversal of how people see themselves. On those sites finasteride and dutasteride kill being a man off stone dead and leaves people zombies, but on here when people use it only seems have comparatively mild effects on stifling biological male function and I've never one person talk about nerve damage while being on an AA like finasteride. It's almost like finasteride reacts very differently with a trans or crossdressing person that it does with a happy cis-male.

I expect in reality that it's a bit of both, though. I know that on Fin when I first went on it years ago (when I was 26/27) my bladder seemed to shrink and the urge to pee was and still is stronger now when I need to go then how it was before Fin. It's not an issue at all, it's just a slight change that I noticed which I am 90% sure was Fin.

What exactly is brain fog like? Because I have always had a shockingly bad short term memory since I was a kid, and I get confused easily, or rather I have trouble translating my understanding of something into making my body carry out the task to actually do it - there's like a resistance in my brain, a delay and well...a fog...that slows down the process. Though I doubt that's actually the same type of fog that yourself or others are talking about?

Testosterone is a sort of precursor chemical that can be reduced to DiHydriTestosterone (DHT) or oxidized to Estradiol.

Finasteride is a funny medication. It blocks an enzyme that normally reduces testosterone to the very active hormone DiHydriTestosterone (DHT).

With this conversion path blocked, in some men the level of another enzyme called aromatase, produced in shin and some fat cells, may oxidize the extra testosterone into estradiol.

Yup, finasteride MAY produce a weak HRT regimen on a few people! 

Consider how WE feel before we start HRT, and how much better we feel once we are on HRT and our bodies and minds settle into the new chemistry. Cisgender men are on the right chemistry for their bodies already. The drop in DHT and possible rise in Estradiol can induce a state not too different than what we experience before we start HRT, that internal discomfort from a biochemical mismatch.

Their bodies experience less of the active DHT form of testosterone, an androgen and neurotransmitter. They may get a rise in estrogen compounds. The androgen drop can lead to MAST cell growth, or more breast tissue. It can also produce thinner skin.   The drop in DHT and rise in estrogens in the brain may be perceived as a brain "fog".

I was on finasteride for years before I came out, and the "side effects" likely helped me get by for quite a while before I started HRT.


Sent from my iPhone using Tapatalk

Just a throw away comment, but many trans women would accept the negatives of finasteride as positives - regardless of the actual health effects,

I started having panic attacks in the middle of the night - they'd wake me up from a deep sleep. Not a pleasant experience! After doing some research, I got off spiro and fin and am now controlling T and E on oral E and bioidentical progesterone alone. The panic attacks are gone and I'm feeling great!


Sent from my iPhone using Tapatalk

From what I have seen, many members here both MTF and FTM use Finasteride and have had no difficulty with it. For a small number of people it can cause serious side effects and if you experience any physical or mental symptoms out of the normal, you should discuss this with your doctor and get off it as soon as possible. Symptoms can include weird mental feelings and weakness or exhaustion. If you stop early you will minimize the damage and hopefully be able to reverse it. If you remain on the drug after experiencing symptoms it may not be possible to reverse the effects.

So far I haven't seen any reports of problems on this site however I have been able to google people with problems elsewhere. It's possible they were self medicating or the sample size was so large that it included people with other problems that Finasteride caused complications.

It is not easy to find accurate side effect profiles without going to medical subscription websites such as Micromedex.

For those of us who have this access, the rates of sexual dysfunction in men depend on the dose taken. For the low dose hair loss Finasteride, expect 1 to 2 % will have some form of problem. For the higher dose prostate Finasteride, the rate is a bit higher, about 4 or 5%, but this may be due to the prostate issues with or without Finasteride.

Does this mean that 95% of us will have no problem with Finasteride? While the medical literature is fact based, we are taking Finasteride as part of a cross hormone therapy regimen. There are really very few of us to do a large study on and most of the data we have are based on men without transgender issues.

The bottom line is this, most of the time no problem, but sometimes there will be an issue. Also, since we are all individuals, drugs effect each of us differently. Science can make good predictions about a large group of people based on good statistics, but any one persons results are variable. All we can say with some certainty, is what is most likely to happen. No guarantees.

https://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0010302/?report=details#side_effects 

This site provides some additional information.   Note that the dosage for hair loss is about 20% of what it is for BPH. 

I have been on Finasteride for about four years for BPH.  Initially it helped with flow start and I didn't get up much at night but erections became more difficult and and semen levels definitely went down.  I had not begun to identify as trans at that point and went off for about 6 months.  I did have some gynomastia but it was not pronounced at that point.  When I went back on I was in a very different frame of mind and the side effects didn't bother me at that point.  I have some marked gynomastia, erections are infrequent and not sufficient for penetration most of the time, it is harder to reach orgasm.

I attribute the mind fog to stress from work and exhaustion.  It is more of a "I just want to curl up and sleep" which may also be some depression working in there too.

I have taken some herbal estrogen replacements and with the Finasteride there is more breast development (obviously desired).  I believe that my body is quite sensitive (primed) for estrogen and the amount of herb that I have been taking has been very low dose, partially because I am concerned about the possible side effects of introducing estrogen.  (Read the recent report from Kaiser Health about HRT in trans women)

I didn't find anything about neuro effects of Finasteride.