I am 75 years old, and currently on Finasteride. I was married twice, and raised 5 children. I am no longer in any kind of romantic relationship with a woman and don't have any desire to be again. I have to get me blood work done this week. Then in 2 weeks I see my doctor. Depending on what my PSA numbers are I will start a discussion with my doctor about options. Removal of prostate, castration, more medications, etc., etc.. If my PSA numbers are going up I will ask the doctor about options as I would prefer castration rather than taking medications for years, especially if the medications are not keeping PSA numbers down. I had a couple family members die from prostate cancer and if I can avoid that, then to me castration would be worth it. Will have to see what doctor says. Just my thoughts and accepting reality that as men get old often get prostate cancer is common and if there is a way to prevent it then it would be worth it.

Would having your prostate removed instead be another option? Castration without some amount of testosterone can become debilitating.

10yeareunuch (imported) wrote: Thu Sep 14, 2023 4:20 am Would having your prostate removed instead be another option? Castration without some amount of testosterone can become debilitating.

Estrogen / estradiol is also an option - It is risky to go "hormone free" per my doc, but you can handle the health risks associated w/ getting with EITHER T or E... Given the PSA concern E would probably be better. In at least some cases, I've heard of testosterone suppression being done simply w/ a large enough dose of E...

Biggest downside risk of E is feminization, especially growing breasts. However how much is age related, and @ 75 is probably not likely to be a "HUGE" problem... (@ 65, I've gotten big enough that I'm conscious of them looking down while naked, but they don't seem to be as noticeable when I put even a T-shirt on, and I've never had ANY comment about them)

That said, it is best to avoid ORAL E pills, and use either patches or injections instead, the needed dose is much lower and it is easier on the liver.

WheelyCurious

What does the Finasteride do? I only know of it because some guys losing their hair take it. I am bald and don't care (for me), but what are the side effects generally? I know some guys that are very upset about their hair loss. Why was it prescribed for you, and how does it work?

I wish the best for you through this.

From: https://www.drugs.com/mtm/finasteride.html

Finasteride is used alone or with other medication to treat symptoms of benign prostatic hyperplasia (BPH) in men with enlarged prostate.

Finasteride is also used to treat male pattern hair loss in men.

Lots of other links - that was just the first one that popped up... Basically it is a relatively mild anti-androgen / T suppressing drug, which may lead to shrinking prostates that have gotten enlarged as a reaction to Testosterone, often causing (among other things) problems w/ urination like weak stream, trouble starting, needing to go often because of not emptying, etc...

Since male pattern baldness is also caused by T, suppressing it MAY result in some level of hair regrowth... (One could ask if growing hair is worth the other effects of lowering T, but...)

WheelyCurious

Interesting. Guys treated for hair loss may be in for something they did not expect. Glad to know about this.

I am happy that I am happy bald.

CFI10000 (imported) wrote: Thu Sep 14, 2023 12:36 pm Interesting. Guys treated for hair loss may be in for something they did not expect. Glad to know about this.

I am happy that I am happy bald.

True, although the anti-androgen effects and high chance of 'function' reduction are pretty explicitly spelled out as a known side effect, so I'd expect any decent doctor to be pretty clear about warning patients of that risk....

As I just mentioned in another thread, there are an amazingly large number of the 'first line' drugs for very popular ailments that are on lists posted here of things w/ at least some anti-androgenic effects, and which I know were NEVER mentioned to me....

WheelyCurious

Yes and I will see what the doctor says in regard to options and recommendations.

Although Finasteride does reduce one’s PSA score, it may hide one’s true indication of having prostate cancer. It does, however, reduce prostate size, promotes hair growth, lowers libido and the ability to maintain an erection.

Taking estrogen will cause significant breast growth.

In 2019 my PSA went from a normal 1.5 to 9. By 2020 it was up to 12. In 2021 I had a prostate biopsy and a CTscan, both of which were negative for cancer. At my last screening in spring 2023 my PSA had gone back down to 5.7 without medication. I would only suggest surgery as a last resort. I'll be 66 in Nov 2023. So yes consult your doctor concerning options but don't be in too big of a rush for non-reversible surgery. Good luck.