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Welcome to J Francois Eid, MD - Directly answering member questions in the "Medical Professionals" section below the Treatment boards.
https://www.peyroniesforum.net/index.php/topic,17819.0.html

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Author Topic: Peyronie's and total Erectile Dysfunction due to finasteride - I need advice.  (Read 865 times)

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lacpaz

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Nice to meet you guys. My problems started after taking finasteride for two months. From the start of treatment I started to develop medium grade Erectile Dysfunction that prevented me from having strong erections when I masturbated. Because of this I stopped the treatment.

However the symptoms have been gradually worsening since I stopped treatment. The urologist recommended taladafil 5mg daily and it improved my erections for the first month. However I have continued to get worse after the initial months. The changes I have noticed:

- Hard flaccid almost 24h.
- Almost Total Erectile Dysfunction.
- Very important loss of thickness at the base.
- TERRIBLE pain, 24 hours a day both in flaccid state (in the last month just when the Erectile Dysfunction has become severe even with the use of taladafil is when it seems to hurt a little less).
- Penile skin tightening and veins appearing.
- My PC muscles feel weak and I have to strain to make the penis "wider".
- Penis feels very inelastic.
- Loss of nocturnal erections.
- I barely respond to taladafil 5mg

I have had hormone tests (all good) and a doppler this summer where I saw a peyronie's initiation. After stimulation with injection I had an 80% erection rate. However, since the summer I have not stopped getting worse and worse until reaching almost total Erectile Dysfunction and a very important loss of thickness.

After reading all the information in the forum I have thought about buying a medical grade VED. And I have a series of doubts

1- Would it be advisable if I still have pain to use the VED with the OLD MEN protocol? My idea would be to regain some thickness and allow the tissue to improve.
2- In my case which protocol could help more because of the pain and the almost total Erectile Dysfunction?
4- Any remedy for hard flaccid?
5- Are shock waves effective?
2- Could I use heat therapy or would it be counterproductive?

On the other hand I plan to add pentoxiflin, arginine, ALCAR and Q10 to my oral regimen.

Thank you in advance.
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palo15

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So it sounds like you did get a Peyroines diagnosis, so that’s a start. Many men come here without a Peyroines diagnosis and just assume it’s Peyroines but don’t know, and no one here can diagnose you. So, always start with a diagnosis, because otherwise you are just guessing what’s wrong.

Shockwave therapy has not been shown to be effective. I doubt heat therapy would be counterproductive but it wouldn’t improve anything. You can try the oral therapies and see if they help, but there really is no EMA or FDA approved oral therapies for Peyroines. Pentoxifyllin was studied and there were some studies that it outperformed placebo, but the effects were never so dramatic to win approval. You can try those other remedies too, but I wouldn’t hold out much hope.

Xiapex is the only EMA and FDA approved medication, but it’s an injectable, is quite expensive and not available everywhere. That with traction is effective by softening the plaque. Surgeries are available to cut the plaque and replace it with a filler like alloderm, but I’d be really careful choosing the surgeon. This really requires a Peyroines specialist to do. I wouldn’t trust the average urologist. This is a very vascular, highly complex and delicate area of your anatomy and you don’t want just any surgeon fooling around down there. Certainly try non-surgical approaches first, and look into Xiapex injections. They are not nearly as invasive as a surgery and some men have felt fully cured by just that treatment alone. Good luck.
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Wilson

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Dear Friends, I apologize to distract some people here out of this topic, but could someone explains what finastride means? As far as I understand, it is some “dangerous” clinical pills for hair loss treatment, which causing dangerous consequences including peyronie? Am I right? I guess, some people also want to know more details about it? By the way, one more questions please, could someone explain me what ”kegel” means and what is “hard-flaccid” means? Please, don’t debate nor dispute with each other. Just explain it in a short text, if you want, or PM me. Apologize again. Thanks in advance.
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Young and regularly thinking about this issue
Peyronie's without curvature since April 2012 due to injury
Almost constant discomfort and Loss of penile sensation
Still fighting - trying to find a top famous specialist

palo15

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Hi Wilson,

There’s a drug called Proscar, which is prescribed for middle aged men (usually) for an enlarged prostate, a very common and benign condition. It shrinks the prostate by interfering with the production of certain male hormones which cause the prostate enlargement. It’s not supposed to have bad side effects, like Erectile Dysfunction, or presumably no one would prescribe it or it would never have gotten approval. But, like a lot of drugs, it later came under scrutiny. Take the usual dose of Proscar, whatever that is, and cut it in half and you’ve got what is called Finasteride. It was discovered early on that Proscar, by blocking certain male hormones, also reduced male pattern baldness.  It was theorized that Finasteride would also do the same. This was studied and shown to also have this effect. Male pattern baldness (which is not what this forum is about) is caused by genetically sensitive hair follicles on the top of the head (never on the sides, like over the ears) which are hit by male hormones and this causes the hair loss on top. You need both the genetically sensitive hair follicles on top of the head and the male hormones for the hair to fall out. Some men don’t have the genetically weaker hair follicles so their hair never falls out and they live their whole lives with a full head of hair, in spite of the hormones. Those who have the weaker hair follicles lose that hair at some point and to some extent (it’s highly variable). Finasteride came into use in the late 90s to treat, usually with hair transplants, male pattern baldness. But, around 2010 controversy arose over use of Finasteride with some saying it caused Erectile Dysfunction, even after men stopped taking it. There were lawsuits over this. Rather than calling the drug “dangerous” it’s probably better just to call its use highly controversial, even though it is still on the market. But, I have not heard of any studies linking Finasteride use to Peyroines. So, I’d rather doubt it’s relevance to the issues in this board. Kegel is a pelvic floor exercise and I’ll have to defer to others if they have more specifics on it and in what a “hard flaccid” is.
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lacpaz

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Hi Wilson,

There’s a drug called Proscar, which is prescribed for middle aged men (usually) for an enlarged prostate, a very common and benign condition. It shrinks the prostate by interfering with the production of certain male hormones which cause the prostate enlargement. It’s not supposed to have bad side effects, like Erectile Dysfunction, or presumably no one would prescribe it or it would never have gotten approval. But, like a lot of drugs, it later came under scrutiny. Take the usual dose of Proscar, whatever that is, and cut it in half and you’ve got what is called Finasteride. It was discovered early on that Proscar, by blocking certain male hormones, also reduced male pattern baldness.  It was theorized that Finasteride would also do the same. This was studied and shown to also have this effect. Male pattern baldness (which is not what this forum is about) is caused by genetically sensitive hair follicles on the top of the head (never on the sides, like over the ears) which are hit by male hormones and this causes the hair loss on top. You need both the genetically sensitive hair follicles on top of the head and the male hormones for the hair to fall out. Some men don’t have the genetically weaker hair follicles so their hair never falls out and they live their whole lives with a full head of hair, in spite of the hormones. Those who have the weaker hair follicles lose that hair at some point and to some extent (it’s highly variable). Finasteride came into use in the late 90s to treat, usually with hair transplants, male pattern baldness. But, around 2010 controversy arose over use of Finasteride with some saying it caused Erectile Dysfunction, even after men stopped taking it. There were lawsuits over this. Rather than calling the drug “dangerous” it’s probably better just to call its use highly controversial, even though it is still on the market. But, I have not heard of any studies linking Finasteride use to Peyroines. So, I’d rather doubt it’s relevance to the issues in this board. Kegel is a pelvic floor exercise and I’ll have to defer to others if they have more specifics on it and in what a “hard flaccid” is.

I am not here to argue about this. I already have the diagnosis and I am looking for therapeutic options.

You can google to look up what hard flaccid is and below you have the relationship between finasteride and peyronie's. There are doctors who are very knowledgeable on the subject like Dr. Goldstein in the US. Finasteride inhibits DHT which is basic to maintaining a healthy penis.


https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7354335/
https://www.youtube.com/watch?v=kzb5PJBoawA&t=343s
https://forum.propeciahelp.com/t/pfs-peyronies/7340
https://forum.propeciahelp.com/t/does-the-peyronies-get-worse/3181
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Wilson

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Lacpaz, Sorry Man, I didn’t want attack your post. Just asked about finastride in details and others dangerous “things” in order to warn personal friends and others on future in advance. Sorry, Friend. All the Best.
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Young and regularly thinking about this issue
Peyronie's without curvature since April 2012 due to injury
Almost constant discomfort and Loss of penile sensation
Still fighting - trying to find a top famous specialist

Hawk

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    • Peyronie's Disease

It is essential that you read this very carefully https://www.peyroniesforum.net/index.php/topic,3180.0.html
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Prostatectomy 2004, radiation 2009, currently 70 yrs old
After pills, injections, VED - Dr Eid, Titan 22cm implant 8/7/18
Hawk - Updated 10/27/18 - Peyronies Society Forums

LuisFernandez

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I also developed Peyronie's while taking finasteride. I took it for two years. I had Erectile Dysfunction and was also masturbating 4x/day. I then hard hard anal sex which caused me an injury which led to acute Erectile Dysfunction and Peyronie's. Almost been 1 years since that event.

1. Yes VED is critical, OLD MAN protocol is good. Personally i used it about 30min per day. I don't recommend more than 5hg. I don't use a "medical grade" vacuum device. I have a DP-4000 with a couple of LeLuv cylinders, i love this device.

2. Cialis and daily VED usage. I personally take 10mg Cialis and was prescribed injections. After injections i actually experienced an improvement of erections and erection quality recently.

3. I experienced this for about a month after my injury. I recommend Cialis, light traction, light VED (you want to heal in an expanded state.) The key is to REDUCE inflammation. So, pentoxyfilline, vitamin-e (to be safe,) low inflammation diet.

4. I DO NOT recommend shockwave therapy and this will cause further micro injuries to the penis.

5. You can do heat therapy WHILE doing traction and VED, otherwise it's useless by itself. In fact during hard flaccid/inflammatory period you may want to avoid heat to reduce factors of inflammation.

Good luck.
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Injury in April 2020. Onset of Erectile Dysfunction.
Started RestoreX and VED 2 months after injury.
Taking 10mg daily cialis, pentox, coq10, vit-e.
Traction (+1 inch)/VED/PGE-1/DMSO+X
Recovering slowly. Be patient and diligent.
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