Threshold dynamic: hypermasculinization up to a point, then receptor-signaling burnout

Answering a commenter who asked whether the model works in reverse — they were not notably masculine before finasteride/dutasteride — Powers describes a threshold dynamic: patients with only the DHT-metabolism pathway available can present highly masculinized, creating a selection bias toward seeking hair-loss drugs; lower-testosterone patients can masculinize on the drug via DHT leakage, up to a point. Past that point, levels spike high enough to "burn out" receptor signaling. This threshold, he says, explains the commonly reported onset pattern of a few days of heightened libido and hypermasculinity followed by collapse. He adds that the theory fits every outlier he has seen — windows from random interventions, onset on cessation — backed by genome and lab data, while conceding that no theory is ever fully correct.