Treatments?

Post Finasteride Syndrome Treatment

Unfortunately there is still no treatment that has managed to reverse all the symptoms of Post-Finasteride Syndrome. However, it is possible to improve your health and minimize some of the side effects to improve quality of life. It is possible to achieve Post Finasteride Syndrome recovery. In this section, we will display methods that can bring relief to some symptoms. These are medications, diet and lifestyle changes that helped some patients. 

Index: 
1. General guidelines
2. Natural supplements that can help 
3. What blood tests to do? 
4. My doctor says it is psychological, what to do? 
5. Medicines that can help in some cases 
6. Natural methods that can bring relief, symptom by symptom  

1. General Guidelines
Here are some general guidelines, searched in the forums in English, which may help who is suffering from Post-Finasteride Syndrome:
a) Avoid caffeine .

If possible, remove the substance from your diet. Insomnia is a common trait of those who suffer  from finasteride persistent side effects. Having a better sleep, your body will release more growth hormone, which can help in recovery. Sleep well! Caffeine also worsens the state of anxiety in these patients, and this may have consequences on the ability to focus, memory and general well-being.

b) Do regular aerobic exercise, but don't over exercise.

Exercise is a great ally against depression and may bring momentary relief of some symptoms of Post-Finasteride Syndrome. In addition, physical activity also increases production of growth hormone. However, in many accounts researched in Propeciahelp.com, patients report that excessive exercise worsened their general states. If you feel bad in the days following the exercise, slow down, until you reach the intensity that improves your well being, but doesn't make you feel worse the next day.

c) Improve your diet.

Include most vegetables and fruits in your diet salad. At this time of recovery you need to expose your body to a maximum of vitamins and nutrients. Avoid processed foods that are rich in preservatives and artificial substances. It is also advisable to reduce the amount of fat in the diet. Some patients benefit in energy and feel their metabolisms are faster when they cut of dairy from the diet. 

d) Avoid the use of medication for some time, if possible .

Several patients in Propeciahelp describe they now react differently than before to some drugs. If it is possible to avoid the use of medicines during this phase it will be beneficial. There are many natural ways to treat a headache or heartburn, without requiring you to take a drug, for example. The intention, in the recovery phase, is not to overload the liver.

e) Most antidepressants cause sexual side effects, avoid them!

Look for natural alternatives to cope with depression, such as exercise and activities that improve your well-being. There are reports of patients with PFS that were treated with SSRI-type antidepressants and this has worsened the sexual side effects they had from finasteride. 

f) Avoid alcohol.

Alcohol is toxic to the liver and its digestion and elimination demands a lot of body energy. At this time of recovery, you need to save your body energy, and create a healthy routine. In this routine, your body will improve slowly, day by day. But you need to have discipline and should not interrupt the recovery cycle.

g) Think  positive.

Place in your mind that you will return to the level of health you had before taking finasteride. Positive thinking and discipline are fundamental to improve your health right now.

h) Simplify your life for a while.

Avoid stress and situations that change your mood.

i) Observe your reactions and write a journal.

Observe your reactions to food, physical activity and sex interest, mood, etc ... It is essential to know yourself well during this period, so you can create a routine and avoid foods or activities that make you feel worse.

j) There is NO proven case that Testosterone Replacement Therapy has solved the persistent sexual problems caused Finasteride . Do not accept this suggestion from any physician if you suffer from Post-Finasteride Syndrome. There are many stories in Propeciahelp of patients who were treated with testosterone gel (which is converted to DHT in contact with skin), or testosterone injections and treatment did not cause any sexual improvement in them. And in many cases made it worse.

So be careful! The administration of exogenous testosterone (not produced by the body), cause the reduction of testes and disruption of testosterone production in the body . A man who  initiates treatment with testosterone replacement therapy needs to do this for life. For men in andropause it may be a great treatment and can restore sexual function. It is also a great treatment for man who lost his testicles due to an accident or disease. But it is not the recommended procedure for fighting the persistent sexual side effects from Finasteride.

2. Natural supplements that can help
If you decide to try a natural supplement, start with the lowest dose (or even less than that) to see how you will react. Then increase the dose if needed.
Peruvian Maca (Lepidium meyenii)  - Peruvian Maca is a cruciferous plant native to the Andean region of Peru. It is sold as natural supplement and has a stimulating action on libido. Some forum members  from Propecia Help have tried the supplement and reported some improvement. 
Tribulus Terrestris - It is a supplement made ​​from a herb that has been used as a sexual stimulant for centuries - to increase sex drive and performance and to treat impotence. It acts by stimulating the production of LH hormone in the Pituitary (It is common for Post-Finasteride Syndrome patients to show low levels of LH). LH is the hormone that induces production of testosterone in the testes. Tribulus Terrestris is sold as a supplement and can improve libido and erection. Worth a try. 

3. What blood tests do? 
Total Testosterone 
Free Testosterone 
3 Alpha Androstenediol Glucuronide 
DHT 
Estradiol (E2) 
Prolactin 
LH 
FSH 
ACTH 
TSH 
T3 
T4 
Vitamin D 
Cortisol 
Liver tests

4. My doctor says it is psychological, what to do? 
Argue that there are medical studies published about this problem in reputable scientific journals. If necessary, take copies of the studies published here on the site. Argue that many patients had altered levels of sex hormones from the use of finasteride, and so you need to do these tests. The 3 Alpha Androstenediol  Glucuronide is a byproduct of DHT, and is the best indication that you may have developed PFS. It is converted by 5 alpha reductase, the same enzyme that Finasteride blocks. Argue  that DHT testing is not very accurate, but 3 Alpha Androstenediol Glucoronide test is reliable, so you will be able to measure your 5 alpha reductase activity by doing this test. If necessary, switch to another doctor.

5. Medicines that can help in some cases 
Caution: Any medication must be prescribed by a doctor. Do not take medications without medical supervision.

Alprazolam or Bromazepam - ​​If you have stopped finasteride recently, and feel that your metabolism is in a state of chronic anxiety (insomnia, poor sleep, panic attacks, irritability, mood swings, extreme anxiety, restlessness, difficult concentration - a set of symptoms known as post-finasteride crash), the use of one of these medications can help. Finasteride blocks the conversion of progesterone to allopregnanolone, which  has a calming effect in the brain. Allopregnanolone acts by modulating a neurotransmitter called GABA-A. Therefore, the use of finasteride can affect the level of GABA-A in brain. Since these drugs act on GABA replacement, they are beneficial to these patients. Furthermore, by acting on the anxiety and improving sleep quality, the use of one of these drugs will help reverse another problem common in some men with Post-Finasteride Syndrome. Many complain their penises display a much smaller size and more rigid consistency when flacid than before finasteride (known as shrinkage in Propeciahelp forum). It is a dramatic change and usually patients who are in this state after finasteride usage also present lack of nocturnal erections and smaller erections. It is important to break this cycle, because if a man is not having nocturnal erections for a long time, this can lead to structure problems in the penis. When one of these medication is used to treat the post-finasteride crash, penis returns to normal size and consistency when flacid. The quality of sleep is restored, so this will also favour the reestablishment of normal nocturnal erections. It is really important to stop the crash symptoms and these medications work well in the matter.
It should be used for a short period (few months) and only if necessary, under the supervision of a psychiatrist. The withdrawal has to be gradual. 

Clomid - (Clomiphene citrate)  - It can help men who have had a dramatic drop in testosterone production and present a profile of hypogonadism (total testosterone levels below the minimum of the scale). The problem of living with a very low level of testosterone is that the patient tends to develop a series of problems such as osteoporosis, heart problems, diabetes, among others  (see more about hypogonadism on the "importance of DHT" page).  Clomiphene Citrate stimulates the production of FSH in the pituitary gland and it also raises the level of LH hormone, which is the hormone that induces testes to secrete more testosterone. This method was developed to treat athlete bodybuilders who abused the use of testosterone and it affected the body's own production.
It should be used under medical supervision  and is only indicated for patients who have testosterone levels below the minimum scale. Many patients were able to "rewire" the pituitary-testes axis, secrete higher amounts of testosterone, and avoided having to do testosterone replacement therapy for life (which is a complex treatment). 

Viagra, Levitra or Cialis - Some men with PFS benefit from these drugs to improve erection. Others do not get improvements, even using these drugs. A third group shows worsening of physical symptoms of PFS when using prescription drugs in general. If you decide to try, take note of your reactions to make sure that the medicine is not making matters worse. Start at the lowest possible dose and increase if necessary. It should also be used under prescription. 

6. Natural methods that can bring relief, symptom by symptom  
Anxiety - There are several natural options to combat anxiety before taking for a tranquilizer. chamomile tea, valerian tea, valerian pills, exercise, kava ​​tea (with moderation), among others. 
Depression - St. John's Wort, fish oil pills (fish oil), Omega 3, exercise. 
Headaches - In the case of Post-Finasteride Syndrome, headaches can have a few different causes. 
Pain in the center of the head - related to the pituitary region and dopamine deficiency. Some patients have this headache always after ejaculating. Eating foods rich in tyrosine brings temporary relief (cheese, butter, meat, fish, eggs, peanuts, hazelnut, chocolate). Tyrosine is an amino acid which may accelerate the secretion of dopamine. Caffeine can worsen the problem. 
Pain around the head - some patients who developed Post-Finasteride Syndrome report this type of pain. It is indicative of allergic reactions. It is more common in the months following the crash (post-finasteride crash - right after stopping finasteride treatment). Examine your diet and eliminate allergenic foods for a period (eg, nuts, seafood, and in some cases it is necessary to eliminate gluten for a while). 
Impotence and libido  - It may help in the improvement => Exercise and any effort in order to have a faster metabolism. One of the theories about the Post-Finasteride Syndrome is that the patients body has now a low level of free cortisol (see theories on the "post-finasteride syndrome" page). Thus, if the cortisol  available is not enough, it will affect the proper use of thyroid  hormones and the patient will  have hypothyroidism-like symptoms. How to speed up metabolism? 
There are methods that require a diet change for a few days or hours to induce the metabolism to speed up. A method that works with some former finasteride users is fasting for hours or a day (one should always compensate with plenty of fluid intake - coconut water, juices, etc. - medical supervision advised). Cutting carbs can also work. Some patients choose to eliminate milk and some fruit in the diet (milk digestion is slow and some fruits also slow your metabolism). Each body reacts differently and it's worth testing what works in each. It may seem strange that changes in diet can improve one's  sexual symptom, but the point here is to have a faster metabolism and thus force the body to leave the slow metabolism state that has been established after finasteride. 
Swelling - Some patients with Post-Finasteride Syndrome develop swelling and fluid retention. This symptom is related to a slower activity in the pituitary region in these men. As the level of LH and FSH in these patients are different, another hormone secreted in the same region may have had its secretion altered after finasteride. Vasopressin or antidiuretic hormone regulates many activities of the body including the elimination of water. To address the problem, the same methods of metabolism acceleration described in above item can be helpful. Another approach is the elimination of salt from the diet. 
Insomnia - Elimination of caffeine from the diet, exercise, lifestyle changes, valerian, passion fruit, tea, etc..
Penis shrinkage in flacid state - It may seem incredible for those who are unfamiliar with Post-Finasteride Syndrome, but many of these patients complain about how different their penises are in flacid state compared to how they were prior to Finasteride use. They complain that after they stopped Finasteride intake, their penises became much smaller when flacid and also its consistency is not as soft as it was. The cronic anxiety state caused by the post-finasteride crash, associated with the consequences of 5 alpha reductase inhibition lead to this penis shrinkage state. It makes it harder to obtain an erection and it may prevent the former finasteride user to have normal nocturnal erections when still in that state. The most effective way to deal with this problem is not natural, it is to stop the chronic anxiety symptoms, by taking a benzodiazepine tranquilizer for some time. Alprazolam and Bromazepam work well in the matter. See more on item 5.