WARNING. These common meds might give you permanent sex. dysfunction

[Juicy3lf]

@Tragedy

What do you think of having 17-beta estradiol of 156 and SHBG of 68?

I would need the range because every lab is different. I'm assuming that the first is 15,6 therefore in range but maybe the second is above average?
I need more context to comment.

Range estradiol
41.4-159 pmol/L
156

Shbg
18.4-54.1nmol/L
68

Does that help?

[Tragedy]

Range estradiol
41.4-159 pmol/L
156

Shbg
18.4-54.1nmol/L
68

Does that help?

Yes, they are quite high. On their own, maybe they wouldn't be a problem, but if you're experiencing sexual symptoms (I remember you are), you gotta address them.

First thing, you should get more tests to see why they are high and check the status of other hormones.

You are clearly not obese, so let's rule out the most common reason. Another possibility could be inflammation (since you've had penis/nerve injuries in the past). The most common type is gut inflammation, known to cause high E2.

Nonetheless we are speculating, you need to do some detective work.

[GoodLookingNerd]

My test results finally came in:

17 beta estradiol (ECLIA method): 228 (41-158) pmol/l

Free test: 0.674 nmol/l

SHGB: 17.6 (18.3-54.1) nmol/l

DHT: 0.51 (0.31-2.16) nmol/l

So my DHT is pretty low but could be lower which checks out with my current hair loss situation.
My SHGB is low and my free test and estradiol are both high, especially estradiol.

From my understanding low SHGB usually does result in higher test and est levels which also checks out.

My estradiol is however about twice the normal amount. Could this be a concern? I dont have any symptoms such as gyno or ED. Keep in mind that I have already been on finasteride for 3 years

[GoodLookingNerd]

Second week on dutasteride 1mg/week, no noticeable changes so far

[Tragedy]

Could this be a concern?

Hey man, sorry if I didn't see your message, my life has been quite chaotic.

How is it going now?

So, basically because finasteride lowers DHT, your body ends up with more unused testosterone. This extra testosterone can then be converted into estradiol, therefore your body's hormone balance shifts towards estrogen, creating an estrogenic environment.

With more estrogen around, your body's estrogen receptors get more activated. Over time, too much activation can lead to these receptors becoming less sensitive (aka downregulation). This desensitization can mess with a lot of estrogen-dependent functions in your body, from mood regulation to sexual health, genital sensation and so on.

On the other side, with DHT levels dropping due to finasteride, your body tries to compensate by making androgen receptors more sensitive to the androgens still available (like testosterone). That's because testosterone is very less androgenic than DHT, so you need more. This body "fix" can therefore lead to androgens receptor dysregulation.

Also the low SHBG means more free hormones, including estrogen and testosterone, that will be free to go around and mess with your receptors, so it's two side of the same coin.

This whole picture is, to the best of my knowledge, how PFS symptoms start. That doesn't mean you will get PFS, it totally depends on your genetics and epigenetics, and none can predict who will win this disaster lottery. Nonetheless I would SLOWLY restore back your hormones within range, especially estrogens.

PS: I will remind again that LC-MS is the only really reliable method for measuring estradiol in men. Yet ECLIA is still and indication on what we were expecting.

[GoodLookingNerd]

@Tragedy No worries, thanks for elaborating. Im feeling good, no changes in mood or anything except maybe an even higher sex drive. Now that I understand the full picture it does sound concerning. Ill be sure to keep an eye on any red flags.
For lowering estrogen, would you advice taking something of an antiestrogenic nature, or taking on some root cause (too little DHT)?

[Tragedy]

@GoodLookingNerd you could both try to lower DHT more topically and less systemically, or try to limit estrogens conversion/binding with anti-estrogenic supplements.

maybe an even higher sex drive

Testosterone is the sex seeking hormone (proactively starting pursuing sex out of the blue) and Estradiol is the sexual arousal hormone (getting turned on physically once the sexual element is there). Obviously this is a simplification and it is also important their ratio, not just their absolute level.
Nonetheless is it indeed possible that estrogens make you more physically sensitive to sexual images and thoughts, if that is what you meant by higher sex drive.

[GoodLookingNerd]

@Tragedy Yeah that makes sense. Due to regulations Ive only been able to get capsuled Dutasteride (so not pure tablets) which also contains some kind of gel. Do you reckon its possible to make a DIY topical solution? From what Ive seen dutasteride particles are small enough to penetrate the skin but in a gel solution it may behave differently

[Tragedy]

Do you reckon its possible to make a DIY topical solution?

In principle yes, given you get a proper vehicle substance, but in practice its efficacy depends on the internal capsule composition, especially if dut is further embedded into microcapsules. This is a bit outside my expertise though, I would get the ingredients and ask someone in the chemical/pharmaceutical field