Finasteride and Hematospermia - to stop or not to stop taking finasteride

Men's health
1

In 2015, I had a very enlarged prostate and a high PSA. Through medications, things returned to almost normal. I'm 53 and in decent health with no other health issues or medications. I should also note that I live in Cambodia and have limited access to high-quality care other than going to Bangkok.

Last  September, I started having hematospermia (blood in semen; very bloody). The Cambodian urologist prescribed a few medications, but nothing seemed to work. I eventually read an article about Proscar and that it can be effective for treating hematospermia.

I started Pronor 5 mg (generic finasteride) in late December. After 2 months, the hematospermia cleared up. My semen has been "clean" since early March. I am still taking Pronor.

The side effects have been a very low libido, difficulty in getting an erection, very small ejaculation and, I think, an increased sense of apathy and lack of enthusiasm to do anything.

I emailed my other urologist in Bangkok (more skilled than Cambodia) and he said that I could stop taking the Pronor, though I haven't been back to him for an exam.

My worries with stopping the Pronor is that the enlarged prostate will come back and I may, again, have increased problems with needing to urinate frequently and during the night and the blood in the semen, like before. 

And, will the side effects I'm having now, go away? 

I suppose that there is no way of knowing other than stopping to see what happens. Presumably, everyone reacts differently to having side effects and stopping medications

I'd appreciate any thoughts and best options by others.

Thanks

Andrew

2

I don't know about hematospermia but it doesn't sound logical that the enlarged prostate is the only reason - finasteride can have long term affects, I think you should stop and see what happens - prostate will probably get bigger again and it might take time for libido to come back but maybe hematospermia was due to another reason - maybe someone else here knows more. Good luck!

3

I have also been considering cutting back on finasteride.  Hope you get a lot of replies.  Anyone who has complete success is probably not monitoring these forums though.

4

You probably know it takes a while for finasteride to work. Stopping it is the same. After stopping it, it takes 6 months to a year to clear it from your system. I asked if it was ok to just stop it. Was told yes. No taper needed as it stays in your system a while.

5

For myself,  My plan is to cut back to 1ea. 5mg finasteride tablet every three days.  If I detect some hesitation or blockage, will increase to two tablets every 3 days and, if needed, can renew flowmax med until finasteride again takes control.  Has anyone tried such a plan?

     

6

I just stopped both. They didn't help anyways. Had surgery. Figured why take them if they don't work. Dealing with cost and side effects for no benefits. Seen posts from others that they helped alot. My brother has been taking them for years( finasteride and flomax) and they work for him.

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Andrew.  I used to take avodart and doxazosin.  After having a TURP done, I stopped both medications and all I do now is CIC. The selfcathing is the best!  I suggest that you do the same, given your young age as compared to me being 68 years old.  If you are only 53 years old, by doing CIC, I believe you can save your bladder from getting worn out by having a bladder, that doesn't empty completely.  By doing the CIC, your bladder, will have a chance to regain it's elasticity.

I wish I knew about self-catherization.  I would have done it long ago.  It's the best feeling to have an empty bladder, and not having to think about "where's the next restroom."

 

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Andrew, you make no mention of having had a PSA test carried out.  I would be concerned that the presence of blood in your semen could be indicative of something sinister.

If you have had a PSA a test carried out as well as a DRE and you have been told that nothing sinister lurks within, then please ignore the above.

The only advice I can offer on how to proceed is limited to continue with the Finasteride on the basis that it is designed as a  long term treatment rather than as and when required.  When you stop blocking the uptake of Dihydrotestosterone (DHT), your prosate will begin to enlarge again and with that will come all the symptoms i.e. nocturia, frequency and retenton which will inevitably lead to other issues such as increase in UTIs, bladder stones and even kidney damage in cases of severe retention.

One last thought, have you given any thought to a natural  DHT blocker such as Saw Palmetto?  I used it for over 8 years when my prostate began to enlarge and was very effective for all except the last year when I had to begin taking Dutasteride when the enlargement began to have some setious consequences for me and even then it slowed it down only slightly and only surgery in the form of a HoLEP finally resolved all my problems.

At your age I would hope you are a long way from surgery but please in te meantime don't consider that as your symptoms have cleared up all is well, stay with the androgen blockers and with luck you will have at least a decade of relief before the inevitable and unstoppable evil of old age has more of an affect on your prostate and your other bits and pieces.

Good luck.

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Doesn't CIC make your penis sore? It does for me. Just a little, but libido down.

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The fastest, doing CIC, for me was 3 seconds from point of entry to penetrating the bladder. It was kind of a game for me, to see how fast I could do it.  This one time I did it, I started bleeding, not really bad, but bleeding none the less.  I thought to myself, that's enough for speed...this is foolish! Now I go really slowly. I take my time, and make sure there is no pain or the slightest discomfort.  So my answer to your a question, is that I have no pain at all.  My suggestion to you is to go really slow.  If you feel any kind of pain, however slight, just stop, wait a few seconds or more, then proceed again.  Good luck!

11

Hi,

Thanks for the reply. In 2015, my PSA was through the roof (over 40). When the hematospermia started last September 2016, my PSA was over 7, but as I went back for follow-up exams it kept dropping. The last test is was about 4. The TRUS was basically normal (some cysts) and the cancer antigen was negative.

I'd like to try something more natural like the saw palmetto, but I'm not sure if I can simply switch to it with the finasteride still in my system. Plus, I can't get it here unless someone ships a supply to me.

Living in Cambodia and not having access to a reliable doctor, consultation and health insurance is a problem. I sent my urologist in Thailand my records/tests from the hematospermia. He seems like a competent doctor. When I emailed him that the hematospermia stopped, he told me that I could stop the finasteride. 

It seems that I can continue on it, and have the side effects of low libido, little ejaculation and general malaise. Or, stop and wait for it to clear my system and see if the other problems come back (enlarged prostate, urinary problems, hematospermia). Not a great choice.

Thanks again for the reply

12

"I suppose that there is no way of knowing other than stopping to see what happens."  My friend, you have apparently answered your own question.  If you are going to take a hiatus from finasteride, do keep in mind that 5-alpha-reductase inhibitors have an extremely long half life.  That is why, if you'll read other posts in this thread, a lot of guys are now taking these drugs (finasteride and dutasteride) intermittently, and with equally efficacious results.  It's going to be a balancing act with you, if you do decide to take a break, and here's what I mean by that;  the hematospermia may eventually recede over time ... but the BPH may eventually exacerbate over time.  Finally, it a simple bias I have.  Whatever else is going on with you may not be related at all to the drugs you're taking.  Wishing you the best.

 

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Hi andrew,

How did you manage to bring your PSA down from over 40 in 2015 to 7 in 2016 ? Hank

14

Hi,

The 2015 episode was a super-enlarged prostate and I couldn't urinate. It seemed it was due to an infection. I was prescribed some antibiotics and other medicines and the problem cleared up. The PSA dropped to less than 10 within a few months. Things basically returned to normal for more than a year until the hematospermia last September. Even with the hematospermia, my PSA was 7 and kept dropping, but it is still above normal.

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Your PSA level of 4 before Finasteride is only slightly out of range for your age (50-59: PSA 0.0-3.5). With Finasteride, it should be lower now. Hank

16

Finasteride can cause false PSA readings. They use that rule of thumb to cut your reading in half when on it. I personally don't trust this. To me it's like a guess. I don't believe it could be the same for everyone.

17

I altered my schedule to be one finasteride tablet taken two-days-on; one-day-off cycle, (total of  two tablets taken for every three day period).  Theory is that it shouldn't require as much overall to maintain as it did to shrink the prostate.   Will report result in maybe 6 months or, if I make another adjustment, sooner.  

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Hi Vibes,

How long have you been taking finasteride ? Has it helped you much ? Also, do you experience any side effects that andrew does ? I am considering taking it to see if i can improve on my hesitancy. Hank

19

I've been of fernasteride for about 1 year. I think it has helped. I was also taking tamsulosin for most of that time. I peed pretty good when on those drugs except for peeing at night. When I got up to go it would just dribble out. Also sex  was imposible. I recently switched to daily cialis which seems to have bettere flow at night. Helps wiuth erections but fenasteride still makes problems. I think I may tweek the time I take cialis maybe it will give better erections at a time when I'm most likely going to have sex

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Been on finasteride for about 18 months.  It took about a year for it to have enough effect to get off Flomax. No problems at all peeing now. Yes, I have side effects but not as bad as flomax.  That's why I'm trying to sclale back on dosage.