u/Mission-Election-563

Dear all,

In November/December 2024 I took Finasteride for a short period. I noticed changes after the very first dose and stopped quickly. Since then I've been dealing with classic PFS symptoms: penile numbness, difficulty getting and maintaining an erection, and near-complete loss of libido.

This week I got blood work done. Unfortunately I couldn't test everything due to cost.

My urologist says this looks like primary hypogonadism and wants to treat me with testosterone. I'm not sure that's the right call given the context.

Lab results:

Marker	Result	Reference range
Testosterone	3.65 µg/l	3.50–12.00
SHBG	56 nmol/l	18–54
Free Androgen Index (FAI)	22.74	35.00–92.60
LH	12.8 U/l	1.7–8.6
FSH	4.9 U/l	1.5–12.4
Progesterone	0.21 µg/l	< 0.15
DHT	70 ng/dl	30–85

Why I'm struggling to interpret these:

Based on Dr. Powers' theory (as I understand it so far), PFS involves a blockade of the 5α-reductase enzyme, which prevents the conversion of progesterone → 5α-DHP → allopregnanolone. The resulting neurosteroid deficiency (particularly allopregnanolone) is thought to drive many PFS symptoms via disruption of GABA-A receptor signaling.

However, my DHT is in the normal-high range (70 ng/dl), which suggests 5α-reductase is actually functioning? Yet progesterone is elevated, LH is significantly high, and free androgens are low.

I haven't been able to test allopregnanolone, pregnenolone, or free testosterone directly.

Has anyone seen a similar pattern? Does the elevated progesterone with normal DHT fit anything described here? And is testosterone treatment the right move, or could it suppress LH and mask what's actually going on?

Any input appreciated.

wolf in sheep's clothing done by @matt.roscoetattoos

PFS after short Finasteride use, labs don't clearly fit the pattern