and it's about post-fenesterite syndrome, specifically penile shrinkage and retraction. Would you try HCG and Plumid first or jump into TRT to help with that? This is the TRT and Hormone Optimization YouTube channel.
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I know you hate finasteride, and I know it's a very, very popular drug in urology at the first sign of BPH. It kills me. And I'm not an expert in post-finasteride syndrome. And just this year, I've seen maybe three guys that have had this issue. And it's made me look into it more, but there's not a lot of good data on it.
The penile shrinkage thing, I mean, to me, it's just a lack of that, you know, penile health that you get from blocking the DHT. The interesting thing is, though, a lot of these guys with PFS, when they've come off, their DHT levels serum are fine, right? So it's, you know, we think, well, then it's not an issue, but I don't know what their penile DHT levels are. I think from what I've seen, or someone was outside, jump into Clomid and HCG, it doesn't work. I mean, unless it's a young guy, right?
That's, that's reasonable to try a kickstart and all that, but realizing it's a kickstart, try to read, you know, if their testosterone is low and a lot, usually they are. I see these guys and their testosterone is more than 400 or something like that. They're symptomatic. But the best symptom resolution that I've seen is with testosterone.
It just is. And then you do have the fertility concerns because these guys are young. But I've heard these stories. I've looked at the PFS forums, you know, which are a freaking dumpster fire of growth science. And everybody's talking about taking proviron because they want to take all these DHT derivatives when it's like, I don't think DHT is the issue.
The main issue with. an asteroid are the neurosteroids that are blocked from blocking 5-alpha reductase. It's not just the DHT.
That's what they feel like crap. The penile shrinkage, I don't know. I'm not being flippant about it.
I think some of that's in the head sometimes. You do get a little bit of maybe decreased girth or something like that. That's where, again, something like getting them on a daily Cialis just to restore their confidence and their blood flow down there, I think helps.
Getting them on testosterone, that helps with the tissue health. and then we figure out the fertility side of things. It's a big problem.
I mean, I don't see it a lot. I've had a few guys, one came to see me and then he ended up, I think, talking to Dr. Mark Gordon about his protocol, which I think is Clomid. He didn't like that.
So then he went to Mayo Clinic and he said they were just not helpful at all. Isn't Gordon the one that said that applying creams to the penis will increase size? Yeah, I think so.
So yeah. I'm not going to get into that. So we all have our own opinions about things. You know, I mean, you got to try. These guys are desperate and I get it right.
They're young guys and they're desperate. They've lost their sex drive. They feel like their penis is shrinking.
But what I've seen, the worst of them is that they overthink it. They just get online and they start diving into these forums and they're getting mixed signals. And so they just want to try everything at once. And I think it's going to get better, you know, within a matter of a few days or weeks.
And it's not. They've got to ride it out. You might, I mean, it's a big deal, but you've got to be patient and you can't flip out about it.
And you can't overstress yourself by reading forums and bad advice because you're never going to feel better. And this applies to testosterone replacement guys as well. You can't constantly be checking differing forums that are completely opposed to each other. And then you're confused all the time.
And so you're tweaking your protocol all the time. You're never going to be better. It doesn't matter what you do.
You're going to constantly be, you're basically a hypochondriac at that point. So. That's what I do see with some of the PFS guys, because a lot of them are young, you know, and they start maybe getting a little male pattern baldness in college age, right? And they're 21 or 22, and they take Propecia, and it causes some major issues.
So I hate 5-L for ductase inhibitors. Hate them. Hate them. I'm not a fan of most enzymatic inhibitors, unless the priority of the intervention supersedes how you feel temporarily.
I mean, No one can say chemotherapy is good for you, but we're trying to save a life. So putting someone on an inhibitor of a natural physiological process long term, just to say. And that's honestly still a concern of mine with Cialis, right? It is. That's what it is.
It's blocking a pathway. I haven't seen it change the way people feel, but is there a health detriment somewhere hidden that we don't, maybe? I mean, right now it doesn't look like it, but that may change, you know?
To me, it was worth it. for the benefits and the supposed, you know, endothelial health benefits. I mean, that may change in 10 years. It may come out and say it's freaking toxic. And I mean, but cause I agree it's you're, you're, you're blocking something the body does for a reason.
It's a big difference than statins. It's the most accurate statins. I agree.
Toxic, horrible. It's just bad medicine. It's just bad thinking.
And that's just, I mean, that's a whole different topic, right? But that's how researchers and everybody's just looking to make more drugs to do things that they don't even know that they're addressing the cause. Actually, they aren't addressing the cause of the issues.
They usually, they misinterpret effects that they find as causes. And so that, because they got to make a drug, right? So.
They may be seeing markers of things that tell you something's going on in the body, and then they try to make a drug to kill that marker. It's like the marker's there to help you. It's to tell you something's going on underneath.
It's just moronic. It drives me crazy. It really does.
Masking symptoms is the worst way to treat anything. Yeah, that's Western medicine. I mean, it is.
I hate to say that. I mean, I'm an allopathic doctor, but I'm not of that mindset anymore. I mean, every patient I see, when I see their medicine list, they come in from their primary care. And they're on 20 freaking things that are just masking symptoms.
Symptoms are important. Symptoms are telling you there's something wrong underneath. You need to find the cause.
And we don't do that. We just give them drugs. It's like the guys with the liver disease that have an SHBG of 120. And their first question is, what can I take to lower my SHBG?
Exactly. It's the same. It's like guys I see, right, with an elevated PSA. And they want to know what they can take to lower their PSA.
I'm like, the PSA is not hurting you. The PSA is a marker. We need to find out if it's a problem or if it's just your PSA, right?
It doesn't matter. But urologists do this crap all the time. We've got to put you on finasteride, get that PSA down. What? What?
It just kills me. It really does. It's a horrible way of thinking about things, and I just don't jive with that. Hey, thanks for watching. And now click on one of these thumbnails to learn a ton more about TRT and hormone optimization.