To be more precise about Finasteride, it reduce the production of dihydrotestosterone (DHT) by inhibiting the enzyme that produce it. DHT if made of course from T and act as an antiandrogenic. DHT is mostly responsible for secondary sexual characteristics as body hair, volume of prostate, consequently volume of seminal fluids. On the other hand it reduce the fall of scalp hair which is nice to avoid baldness. This last goal can be achieve with 1mg a day while 5mg day is you to reduce problem of enlarge prostate. For myself the 1mg a day did a good job for hair loss, with less leg hair, with the ones remaining being much thinner. Seminal fluids are greatly reduce too, to two drops (being vasectomized too) but no ED after two years. But who care when there is no penetrative sex.

WheelyFixed wrote: Thu Oct 30, 2025 4:03 am You might try looking at Finasteride or Spiranolactone as those have on-label uses other than T-reduction, but have ED as a sided effect...

I can only warn against Finasteride. For years, it was touted as a cure not only for hair loss and enlarged prostate, but also for preventing prostate cancer. However, there are several indications that the drug may prevent harmless cancer (which may not even be cancer at all), but may cause higher-grade cancer. All I'm saying is that the drug is controversial, at the very least, because it directly interferes with the testosterone-dihydrotestosterone regulatory cycle and has significant side effects.

Thanks for letting us know about the controversial side of Finasteride Castor.

WheelyFixed

It's a good comment made par Castor.
My urologist told me about that, as for my age the probability of prostate cancer is about 1%. With finasteride it can double or triple to 2 to 3% chance. Which is not high per say.
It's true also that there is many studies and some controversy about the consequences of using finasteride and here I found some relevant article for those who could find and interest in the subject.
I think the pdf of those article are accessible for everyone, no need to be link to a university or professional scientific career.

https://academic.oup.com/jnci/article-a ... ogin=false

https://www.nejm.org/doi/full/10.1056/NEJMoa030660

https://journals.lww.com/md-journal/ful ... __A.8.aspx

https://aacrjournals.org/cancerpreventi ... sk-of-High

Thanks for those links wanasoso2. Interesting reads though possibly good insomnia treatments... My non-MD take on them seemed to be that it was somewhat of a mixed bag, that taking Finasteride seemed to reduce the overall risk of getting ANY prostate cancer. However if you did get PCa, it was more likely to be a serious case...

So definitely a trade off on the risks.

WheelyFixed

Finasteride was originally developed to treat benign prostatic hyperplasia and marketed under the trade name of Proscar. BPH is a significant enough medical condition of restricting urinary flow that warranted any slight increase in cancer risk since the the treatment would be by a urologist who would be monitoring. One of the side effects of the Proscar treatment was decreased hair loss from male pattern baldness. After extensive clinical trials Proscar was rebranded at a lower dosage and marketed as Propecia. The original interest in this area started in the mid 1970's with clinical trials in the 80's and approval by FDA in the 90's. It has been around and in use for quite a while. Use for BPH, benefit far outweighs risk. For the treatment of male pattern baldness, does vanity outweigh even slight risk? As I develop a small bald spot I'm still weighing that one

Of more interest is what I learned from my urologist. Once I was in my 50's my yearly physical by PCP included the digital prostate exam as well as PSA blood test. When I moved to a new area 10 years ago I learned that primary care docs here only use PSA to gauge prostate health. If you want a physical check you must see a urologist, which I do. The urologist stated that PSA can miss some of the more aggressive forms of prostate cancer in it's initial development but that can be detected better with the digital exam. So as usual if you ask 3 doctors a question you get back 6 different opinions.

Since my surgery I have been on an estrogen and later a combined with a progesterone. Not really looking to transition, just be more myself. I found I have lower energy and some muscle loss so my gynecologist recommended I go on a very low dose of topical testosterone. I did but now I fill partially amd have some unwanted hair growth. It’s a trade off she told me…not much you can do…I I don’t want to fill but yet want more energy. Any one else have this experience. I have urgious to play, but no desire. Does that make sense? I love that feeling…it’s calming.

I've been on Estrogen since a month after my first Lupron shot. Other than growing more breast than I like (but am OK with) no obvious feminizing, and the boobs don't show if I have a shirt on. However I have lost considerable muscle mass.

My T levels since that first shot have been 'non-detectable' which is what they say if below the minimum the test can pick up. I've been mildly concerned about this since it is less than what 'natural' eunuchs or cis-females have.

I was looking at Deca-Durobolin as it was described in the Eunuch Friends Wiki since it claimed to give a lot of the benefits of T in terms of bone health, muscles, etc. without pushing libido. However it appears that it is not available in the US according to my doc. Instead my TG doc recently suggested that I try doing very low dose T gel or injections, and see what that did for me. I'm currently fighting with the insurance to get it covered.

WheelyFixed

WheelyFixed wrote: Mon Mar 09, 2026 11:01 am my TG doc recently suggested that I try doing very low dose T gel or injections, and see what that did for me. I'm currently fighting with the insurance to get it covered.

WheelyFixed

I am currently taking T-gel and I am quite satisfied with the effects. The advantage is I can control dosage every day. The regular dosage is 2 pumps a day. But after talking to my endocrinologist, I experimented down to 1 pump a day, and after 6 months, cut down to the current dose of about 1/2 pump a day. At this low dose, I don't get much libido, no erections, my penis remains nice and small (at less than 50% of its original size. However, it seems adequate to maintain my bone health. If anything, my bone density seems to have improved a bit in the past couple of years.

My endocrinologist got insurance coverage for my T-gel because my T level without any TRT was very low, and bone density scan indicates that I have osteopenia. (Note that evidently there are T-gel and then there are androgel. Some is covered and some not. The endocrinologist had to work with insurance company to identify the one they are willing to cover. But eventually, I have gotten approval for T-gel and have been using it for about 8 years now.)

The good news is that I've now been approved, and the T-gel is supposed to be delivered tomorrow. It's supposed to be the lowest strength (IIRC, 12.5mg / pump) and we are going to start w/ 1 pump every other day. I go back again in a few months to get a level check and talk about how it's working for me...

Glad to hear you are getting good results as that is a good sign for me...

Not sure exactly what convinced the insurance to approve it, but their denial said that I had failed to meet the FDA requirement of chronically low T levels... When I called them on the phone (on a Saturday) I asked the agent if they were aware that I had over three years of undetectable levels and wasn't that enough? I sent the Doc a message via the EHR portal about them denying it and filing the appeal on Sunday. I'm not sure how much record checking they did but I got a message back from the doc very early on Monday saying they'd approved it... I didn't mention that I was a eunuch, but it is in my medical record...

WheelyFixed