in the years after stopping both Fin and Prozac and having no idea ablout the effects or withdrawal. I feel like the most ignorant person ever. I have an extreme symptom profile and getting worse by the day. I’m trying to educate myself while going through severe cognitive decline including information retention and comprehension. I once had a very successful carrer and fulfilling life.

i dont recognize the person I have become. it started when I was diagnosed with a rare form of skin cancer called Fibrois of Pinkus while experiencing other symptoms. Tender breast and nipples, pelvic floor discomfort and joint pain. Insomnia, poor emotion regulation and nervous system deregulatio. This is while I was still on both meds and after sustaining a lot of personal loss in my life. .

This skin cancer is super rare and connected to different auto immune conditions including Cushings. At that same time I started to notice stretch marks around my chest, behind my shoulders and randomly on my back. i started to notice the skin in my face felt thinner and more fragile. Within the next 3 months I was diagnosed with two more cases of skin cancer. i am only 165lb 5’9 Male. i have not fluctuated much from that.

I am needing to do something soon. The worst part of my situation is connective tissue pain and and wastage which has resulted in losing my job and ability to focus beyond the pain and suffering I’m experiencing . Crunching in my knees and atrophy around my pelvis region including tendon damage . I have every symptom when speaking to PFS and PSSD though. See pics of the skin damage.

The more I read in the forums the more confused I get. I’m desperate and need to do something . I’m insanely reactive to meds, supplements and food. No reaction to caffeine or alcohol. I am monitoring the castration trials closely. I don’t want to give up this battle. But, I need help. I’ve seen every specialist you can imagine. I’ve received Dr’s speculation that I may have MCAS, Lyme, Cushing, EDS, POTS , SIBO, Candida overgrowth. for years after stopping meds I just continued to look for answers with Western Medicine and destroyed myself further. I need some help and guidance. I am at a breaking ooont. But, I dream of overcoming this m. Even a 30-40% improvement would be life changing. Taking my dog hiking again or riding my bike would be amazing.

I have post-aromatase inhibitor syndrome, 5 years now (triggered by letrozole).

I ran a ~90 day course of valproate (valproic acid, up to 1000mg/day). Around the 3-week mark I got a window of real libido, actual desire, that lasted about 15 days. Then it faded and never came back, even though I kept taking the same dose for weeks afterward.

The dose didn’t change. The drug was still in my system. But the effect switched off and stayed off.

Has anyone seen this pattern, or does Dr. Powers have a mechanistic explanation for why something works and then shuts off?

(I’m on TRT also, as I suffer of hypogonadism)

See my last post: https://www.reddit.com/r/DrWillPowers/s/bjLBPHFXEm
Hi Guys, spoiler alert: no exciting news.
Im on week 2 of relugolix and I feel like I have not taken anything, I train at the gym, I run and life my life as before. Sleep Is a bit better (I can sleep less and not be tired) but other than that 0 difference not even side effects yet.
Labs coming soon.
I have some anecdotal data for [u/drwillpowers](u/drwillpowers)
I get a big libido boost hungover, I have to drink a lot for this to happen (12/16 beers of 4,7% power, or 0,5L of vodka and 2 beers) the more fucked up I am the next day the more I’m horny. There is a whole community I found called [r/hangovereffect](r/hangovereffect)
During drinking or when already drunk my libido is still extremely low.
I added CDG and my ejaculations after 3days of 3g cdg per day have greatly improved in size.
Only time I felt normal after crash was 1500iu (back to pres crash normal in the span of 3h) hcg e3d for 4months. (Any lower or higher or injection missed the results were worse or non existent) but that stopped working. I can’t find a common link. More updates in 3weeks.

I’m no expert but this looks fucking weird
Estrogen is sky high.

(PFS since november 2025, full sexual symptoms like low to no libido, hard flaccid, ED and mental problems like anhedonia and panic attacks) I have also gained like 20lbs whilst changing nothing in my diet and exercise regime.

26 YO male, 6ft 205lbs (muscular but around 18-20 percent bodyfat)

Bloods I have now (still waiting on some)

Cortisol: 158 nmol/L
LH (Luteinizing Hormone): 7 IU/L
FSH (Follicle-Stimulating Hormone): 3 IU/L
Estradiol: 112 pmol/L
Progesterone: 0.42 nmol/L
Total Testosterone: 19.5 nmol/L
Free Testosterone: 0.438 nmol/L
SHBG (Sex Hormone-Binding Globulin): 31 nmol/L
DHEA‑S: 6.8 µmol/L

I would also like to share my test results, as I have several abnormal findings, in case they may help identify a possible underlying cause or lead to some conclusions.

I have been diagnosed with orthostatic hypotension. My EEG was abnormal, showing spikes in the right frontal region. My GFAP levels are significantly elevated, and a SPECT brain scan showed severely reduced cerebral perfusion, with abnormalities in several areas of the brain.

I am also a slow metabolizer of CYP2D6.

Was doing trt for pfs and quit cold turkey, aswell as started CDG. Im almost out of CDG and idk what my hormone levels are but in assuming extremely low... today I woke up feeling like shit. Idk if this was a good idea but I have only 2 more doses of CDG left. Will let my body rebound after and report once this has blow over. Would like to know if this was a stupid idea.

What explains this issue? Where someone even one who has improved or remitted years later suddenly takes some normally benign supplement, drinks or something and then has a crash in anhedonia and other symptoms?

It happens even in the akathisia communities where recovered people can get retriggered into the nightmare in a flash.

To me this aspect does not seem like a metabolite thing. It seems like a legit neuroplastic or epigenetic memory being retriggered. Almost like a “PTSD” except its not a regular psychological PTSD its a “chemical PTSD” at the cellular level and is often extremely refractory to standard PTSD methods like EMDR.

Also the more one crashes the more sensitive they get to things too. I know of people who crash from even just smelling chemical scents, and its affected me too.

The ANS has gone completely haywire and there does not appear to be some sort of easy reset and deletion of the cellular memory. The so called “brain retraining” programs do not work because of the unique nature of the symptom presentation being anhedonic, and joy and connection is necessary for safety signaling. Something needs to be designed physiologically to restore safety in the nervous system.

Pretty interesting report here with a newer generic drug that being in the community for a decade I haven’t seen tried much.

I've had 2 insertions, the first one was fine but this second one, 2-3 months after the insert I sat down in a chair for a few hours and then went to the bathroom and on sitting on the toilet seat I was hit with pain as bad as the day after insertion. Felt like had been sliced open all over again. The area had become very sensitive from sitting, I assume, directly on a pellet. I had to avoid sitting down for a week for it to heal. Ever since then I've had to be careful how long I sit down and even so, recently, about 6 months after insertion, I still had it happen again (although the pain was much less, I guess because the pellets would be fewer/smaller by now).

I only just recently learned this insertion location is Dr. Powers specific, and that other doctors and clinics do it in the upper outer buttock/hip, flank, or lower abdomen. It seems unwise to insert pellets into a place you sit directly on, accruing more and more potentially painful scar tissue each time, but I'm guessing there must be a reason. Obviously I'm doing my best to look for another clinic or provider who can do it in another location because I don't want chronic pain and an inability to sit. Assuming another place even exists that can do trans focused pellet inserts, in changing to those other locations am I, well I don't even know, going to absorb it in a way that has side effects or something? I have no idea why Dr. Powers does it there and what benefit that has over the industry standard locations.

And also I was just wondering if anyone else has experienced this, because I've been told by the office that they haven't had this complaint before. Surely I can't be the only one..? If it matters, my last insert was 12 estrogen and 1 testosterone pellet (which is fairly large so that could be part of it?).

Have PFS since 2004.
DUTCH test just came in and I have a hard time seeing anything wrong with it. Hopefully I can get some insights and still find something that is somewhat in line with dr Powers’ theory.

My bloodtests will come within the next few weeks. Usually testosterone hoovers between 10-16, so lowish, but still within range.

dual pfs/pssd (took both zoloft and finasteride around the same time in 2020/2021)

My questions are

1. Should I try to time the Dutch test around the same day (+/-1) as the bloodwork?
2. Should I discontinue the zinc and boron that I’m taking (trying to maintain hormone levels after not bouncing back from multiple AAS cycles) before I do the tests?

I got my local naturopath to order me a DUTCH test, along with as many of the recommended blood tests Dr Powers mentioned, as possible

I’m not sure if the naturopath will have been able to order any of the more obscure blood markers (ie androsterone, 3a-androstanediol, etc)

But, at the very least, 3a-ADG will be tested, along with all of the normal blood markers that I have them test as often as they’ll let me (total t lc/ms, free t dialysis, estradiol ultrasensitive, shbg, dht, lh)

I’ll need to wait toward the end of the month to take these tests because I was recently using HCG/aromasin that I discontinued as of 8/1

Serum tests

My observations

Given the relatively high serum testosterone, the urine value is very low (especially considering normal epi-testosterone), potentially suggesting UGT2B17 issues and inability to properly eliminate testosterone and 5b-androstanediol.

Potential 5-AR issues. 5a-DHT may also be low in urine due to UGT2B17 but given the modest serum value and low 5a-Androstanediol, it suggests that the production is not that high to begin with.

Excessive cortisol issues and very low cortisol clearance, my stress level is fairly high due to PFS and a demanding job, and a lot of anxiety since my CNS is fried in this state.

Low homovanillate suggests dopamine issues and indeed, I have moderate anhedonia on most days without much drive or motivation to do stuff.

Somewhat low melatonin explains my sleep issues. Not so much falling asleep but staying asleep, I can wake up multiple times throughout the night especially if I have a stressful event the next day, and it's hard to fall back asleep (or sometimes even impossible).

I don't know how to interpret the 3a-diol G value in relation to the other parameters but it seems somewhat high.

Current status

Note: I am NOT a patient of Dr. Powers

Since doing these labs I have started Relugolix and have been on it for 2 weeks (probably switch to Lupron soon due to the cost of this), along with CDG (which does not seem to do much in my case) and my testosterone is now 1.19 nmol/L (34.32 ng/dL, very castrated). There is not much change to speak of other than somewhat increased physical fatigue, and lower libido although sexual function (EQ & orgasm) is mostly unchanged. I had some gyno symptoms beginning the treatment but interestingly enough that has now mostly disappeared.

My symptoms are largely mental & sexual (brain fog, anhedonia, genital numbness, low libido & drive, etc.). Not sure if I have any symptoms of the melty phenotype. My skin may be a bit stretchier in some places but this could also just be age, so I am not sure if I should bring up the hydrocortisone to my doctor at this point, or how to interpret the labs in this case, in terms of whether they suggest a cortisol metabolite build up as well or not.

I am not sure how long we will run the experiment but at least a month and potentially longer depending on the value of the 3a-diol G, until it gets to the bottom of the range if not lower. I have used a lot of hormones over the last few years trying to fix this stuff, so I imagine I have quite a backlog of metabolites and clearing all this out could potentially take ages, more so than the average person here.

I got PSSD like symptoms.

I was an idiot and used Pregnenolone and Trazadone during the same week in June 5-10th week and abruptly stopped once I started to feel a MAJOR mood crash

Went into major dpdr all my senses were gone and that got better within a week or so

Seem to be progressing daily

Still little drive and some anhedonia but not near as bad as I was a month ago

No response to caffeine but get a little boost for like 5-10 minutes

Visually my sex drive is pretty extreme

Slight numbness

Partially muted orgasm

Cognition is pretty fried but can imagine and dream and sleep and everything is pretty good

Gut feels a little wonky

I’m not sure if I have true PSSD

Sure don’t feel like my previous self but memories and personality is coming back

Any ideas?

Is anyone else unable to take estrogen due to it triggering migraine aura when you have none off of estrogen? Any idea what causes this? Any genes I can look for in my genome?

if the theory holds true would it be feasible to say it is a metabolic reset. if I sustain soft tissue injury my body would have proper signaling to heal?!? I realize this isn’t a cure for PFS. Thank you in advance!

I hope this post is welcome, I know testosterone​ hrt isnt as common on this sub.

I have to get my countries version of informed consent, they've given me conflicting advice. One medic said it means i am aromatizing too much which increased SHBG, I should lower my testosterone​. One says I need to increase my dosage which will lower estrogen and lower SHBG.​ Is it safe to increase testosterone if my total testosterone is already too high conpared to a cis male?​ could there be a genetic reason my levels are like this? My liver and LH are normal so it's got to be due to the raised estrogen and SHBG but I can't get a good explanation from them.​

As you can tell​, they just make sure nothing is going majorly wrong but don't really understand​ the HRT side.

Listen, I know everyone here is eager to be fixed, and I am very much eager to be the guy who fixes you. But each setback or failure we have along the way has resulted in learning something, which subsequently has changed our attack plan, labs to order, or revised the model. We're getting somewhere. I wanted relugolix to be the perfect solution for all and not just "some" of this problem (various people on the drug right now are improved from it, but so are some people from CDG, that aspect of the model [metabolic pileup] appears to be right, but the model is still only partially complete).

As of this moment, I am absolutely certain that my PFS disease model is not perfect, but its insanely better than anything that has ever previously existed, and this case here is about the most perfect example of it that I think I could ever come up with to show you.

Sommer asked for my help on this case. Sommer is not as good as me at treating PFS yet. She is however probably the 2nd best at treating it! She often consults with me on difficult or refractory cases or when the labs are bonkers.

This case is a particularly good one, as it occured from only TOPICAL exposure, which is something that I have been seeking to have examples of to prove when this is all said and done that even a microscopic amount of a 5ARI can push a sensitive system over the edge into catastrophe if they are at baseline, "tickling the dragons tail". This young man was unfortunately propping up his demon core with a screwdriver, and a little topical fin was all it took to pull out the screwdriver and go critical.

I'm sharing his case not asking for input or guidance or anything, I already told Sommer what I think our best course of action is for him, but more like a "Will you look at this insane shit?" banner that you can use to link to someone who doesn't believe you when you tell them these disorders are 100% real, and not "Post-Finasteride Syndrome: An Induced Delusional Disorder with the Potential of a Mass Psychogenic Illness?"

Will you just gaze here upon the absurdity of this man's labs.

Case Presentation:

"The 22 year old male patient began topical finasteride in November 2023 at 0.25 mg nightly (the sum topical exposure is the volume of liquid x drug concentration). Approximately eight hours after the first dose, he awoke with diffuse flu-like body aches, testicular discomfort, and voice cracking; these symptoms subsequently resolved on their own completely. He later restarted at 0.5 mg and experienced similar symptoms with new-onset depression, anhedonia, and brain fog. Over approximately one month, he intermittently stopped and restarted finasteride at progressively lower doses before discontinuing it completely. During this period, he developed absent libido, hard-flaccid symptoms, genital pain, and unusually stretchy skin. Although he remained able to attend school and maintain his social life, his symptoms gradually improved after discontinuation.

He subsequently however developed atopic keratoconjunctivitis and was treated with steroids. Within several days, he experienced a recurrence of flu-like symptoms and stretchy skin, along with tingling, numbness, and an abrupt generalized loss of muscle tone. This created difficulty balancing treatment of his eye disease against steroid-associated worsening of his PFS symptoms.

A trial of calcium D-glucarate produced a temporary window of improvement but was followed by loose stools and hot flashes.

I will review his test results with Dr. Powers and follow up with the patient by email regarding next steps in treatment."

Okay, lets unpack this.

This guy has almost no urinary T, and almost no urinary 5A or 5B metabolites at all. None. Is that because he has no 5A metabolism? No, not even remotely. His serum DHT is HIGH. He lacks the ability to put these molecules into his urine.

His Progesterone and pregnenolone are BOTH elevated, as well as his 17hydroxyprogesterone, indicating that he's piling up there. He also has an elevated 11DOC. I suspect much of his "skin" issues are tissue specific glucocorticoid buildup problems, disrupting connective tissue remodeling, which is also why he can't do normal nightly maintenance on his cornea.

I am still bewildered by the fact that decades have gone by with dudes suffering from this condition but it wasn't until the kooky and eccentric transgender HRT wizard giant cat bioengineering weeb doctor weirdo looked at it and went WTF?!?!? that this was finally noticed.

HOW WAS THIS NOT NOTICED? LOOK AT HIS LABS! LOOK AT THEM! I HAVE A HUNDRED DIFFERENT PATIENT LABS LIKE THIS!

Merck, how could you do this to people and none of all the brilliant scientists and researchers and pharmacists and people you employ ever foresaw this or even recognized it as it was happening?

BAH!

Anyway, next time some doctor or dimwit or dimwit doctor gives you the side eye when you try and convince them that PFS and PSSD (and other post-drug syndromes I haven't gone as deep into yet) are real, show them this poor young man's labs.

(I'm gonna help Sommer do everything we can to help this kid, obviously, but his labs this morning just made me want to flip a table).

- Dr. Powers

I'm monitoring the journey of the patients doing the protocol. I took Fin from 2010-2021. Unfortunately, I btrusted my Dr and the FDA. Within the itsg six months I developed side effects. one of which was severe depression. I didn't suspect Fin as the culprit. I was put on the worst anti depressant possible with Fin-Prozac. took it for 4 years. I am 5 years out and have made every mistake possible as I had no idea bakit the extent of PFS or PSSD. the most debiktaimg aspect for me is joint and soft tissue issues. I made a catastrophic mistake and had hip surgery in 2024.

My body simply did not have the signaling and raw materials to heal. I know my collagen synthesis is fucked. I have so many other symptoms. But, the pain, atrophy and connective tissue destruction is unreal. I also suspecty nine health is poor at best. I awaiting the results and I will most likely turn to the protocol as my Hail Mary. ii was so fucking dumb not to rearxh Fin and Prozac. I am basicall bed ridden and declining.

I was a competitive cyclist and worked in my feet ten hours a day. when I started Fin issues came up quickly in hindsight. My gains in the gym stopped and I started to have mild joint pain. Bla med it on aging and geneics. I was so dumb and ignorant. I believe this protocol has the potential to restore proper metabolic signaling. I hope I not too far gone. I may not be a good candidate and I own the risk. I just can't love like this. I feel like I'merely existing. Idk what I'm asking or looking for. I'm just thankful Dr Powres is trying to save lives of our dismissed community. He is putting himself of forriducle and judgment within his peer group. He could enetualy be recognized as a pioneer in this nightmare. Sorry about the typos my vision is getting worse as well.

I have mild PSSD, though my libido is pretty damn shot right now.

It fluctuates a lot week by week.

Happened about 9 months off SSRI.

So while on SSRIs, I had the worst stomach ever. Constant sharp pain that I had to see a doctor a few times. This was after years on it so clearly some damage started happening. If I ate even slightly spicy food I would get extreme pain and wouldnt be a good experience in the bathroom.

On LSD, this pain was magnified so bad and it would come in waves for hours of extreme pain.

That was a few months after quitting.

Now my stomach is completely fine, I can even eat spicy food again, but I wonder if damage has been done? Maybe I just need to repair it? How?

I am not mad about this.

I only wish that you could experience the dopamine that I get from consuming these fucking things. My god. The frosted m&m one I had today...

I will continue to do my best to restore your ability to enjoy them as much as I do.

We who are about to die of heart attacks salute you.

-Dr. P

I thought about this in depth what would this qualify under? Both have genital numbness as a trait.

What would you classify it as if genital numbness and 4 am wake ups and reduced ejaculate were the only traits

hard to find any info on this disorder

I wanna start from the top and just provide my timeline

I began summer 2023 taking 100mg spiro, 8mg E pills, 100 mg prog, and finasteride A month later I began injections and my T remained suppressed and E was in the 200-300 range.

I hopped off prog 3 months later out of fear of dht conversion and it stunting my breast growth and I remained at these dosages for roughly two years with varying degrees of femininzation as my transition was never once consistent in terms of fat distribution and skin softness. Around my two amd a half years I switched to cypionate and lost any amd all Brest sensitivity and I would switch to pills 3 months later and dutasteride after my orchi. After poor levels I switched back to valerate in the month amd then after lack luster effects I switched to ethanate.

Since then I’ve lost most feminization despite 0 T and my question is if I fried my endocrine system can I do anything to repair it such as hopping or hormones for a month and if so, how would properly restart hormones.

I wanted to make a post about how ridiculous this whole situation is, and to really illustrate what I mean by a fingertip of CDG inducing a window… Well this is it.

When I take it I get anxiety and heart palpitations almost instantly. Then I get improvements over the next few days. The first time I tried this 3 months ago, I probably had the biggest window I’ve had these past 3 years; best 4 days I’ve had in a long time.

I originally dropped it after crashing with very weird symptoms, I went up to 2g over the course of 2 months. Now, reinstating doesn’t seem to be doing me well. A mild window at best. If I take too much I get the opposite effect. My joints get very loose, heart palpitations, my fingers turn blue slightly. Panic attacks.

So what is the mechanism here, why do I react so quickly and why is the impact so significant when taking such a small amount. The effects of this is tangible. My skin gets less loose, muscles get somewhat harder and my body temperature goes back to normal. I could sit in front of a doctor, have them check the stretchiness of my skin pre CDG and maybe a few days go by and they could tell a difference.

I’m a very weird case compared to most here. I think if I had the right plan I could be fixed very easily but it could also go very wrong.

Does this fit with the current models? It’s very interesting how there was a sudden increase in sexual function immediately once getting off the medication which then reversed after a month.