Re: Why "X treatment crashed me bro" is counterintuitive to the reality of these conditions, and that which makes you feel a little bad may be in reality, what you need to recover. I think I have figured out the true nature of the low libido/anhedonia/substance resistance in PFS/PSSD and how to fix it.

Powers explained his use of indomethacin as the only available "hammer" for lowering THDOC, while noting he lacks good alternatives — one patient with a single kidney cannot take NSAIDs, diazepam inhibits THDOC synthesis but is itself a GABA-A agonist, dexamethasone suppresses ACTH-driven adrenal DOC synthesis but is suboptimal, and medroxyprogesterone (which inhibits THDOC in rats) suppresses male libido. He acknowledged he could be wrong about the mechanism, having no CSF tap to prove it — only Melcangi's data, which he says supports his theory — plus other plausible indomethacin mechanisms (COX/prostaglandin, AKR1C3/11-oxygenated-androgen, or FAAH/endocannabinoid effects). He argued the biochemistry was unsolved because it is complicated: not one mutation but a combination of multiple rare mutations that together reduce androgen metabolism and excretion capacity, which is why GWAS studies failed — most people simply lack enough of them. He said the true pattern was that every patient had some lab value that made no sense relative to the others, a pattern he could recognize from 16 years of reading transgender-medicine labs. On the suppression trial itself, he described patients regaining androgenic signs (body odor, acne) within a week of starting — absurd under traditional thinking — and interpreted it as astronomical intracellular androgen pile-up that serum values fail to reflect, such that falling serum levels clear the metabolite backlog and pass through a genuinely functional signaling level on the way down. He closed by framing the remaining questions as whether the system fully resets or needs a maintenance modifier, and by noting that hundreds of patients sequencing their own genomes and collaborating represents something unprecedented in modern medicine.