Re: Cis male experienced insane side effects from…
u/drwillpowers
r/DrWillPowers2026-04-17T00:12:45Z
Dr Will Powers’ own statements and theorizing
Mentions treatments or doses — not guidance
Summary (paraphrased)
Replying to a cis male who experienced severe 5ARI side effects without developing PFS, Powers tells him his epigenetic system is "rewritable" (DVD-RW) rather than stuck (DVD-R), and suggests most people with PFS share the same side-effect genes — the difference is getting stuck. He reads the commenter's picture as a neurosteroid-failure subtype: an enzyme disorder in pregnenolone/progesterone metabolism in which 5ARI removes allopregnanolone and disrupts the brain's GABA system, raising pain perception — and suggests pregnenolone or low-dose progesterone might suit that subtype.
Key points (paraphrased)
- DVD-RW (recoverable) vs DVD-R (stuck): the differentiator between side effects and PFS.
- Most PFS patients are theorized to share the side-effect genes; stuckness is the extra step.
- Neurosteroid-failure subtype: pregnenolone/progesterone enzyme disorder; allopregnanolone loss disrupts GABA, raising pain.
- Subtype-specific hint: pregnenolone or low-dose progesterone for this picture.
Why it’s in the corpus
The DVD-R metaphor's cleanest statement and the clearest articulation of the neurosteroid-failure vs metabolite-trapping subtype split, with subtype-specific treatment logic.
Context — the post Powers was replying toVerbatim third-party text, shown for context only — not Powers’ statement. Usernames removed.ShowHide
Powers' comment replies to the original post by [username removed], a cis male reporting severe side effects (dissociation, focus loss, worsened sciatica, dry eyes, prostatitis) from oral/topical dutasteride and finasteride without developing PFS, asking about hormonal options for hair loss.
(Parent context recovered from the r.genit.al mirror on 2026-10-09; Powers' comment text itself is from John's user-provided export.)
Some fields on this page come from the release’s Markdown edition, which carries text the JSON edition omits.
Related records
- Video
Rethinking Reductase: The Case for Progesterone and DHT Balance in Men
unidentified presenter (Wellness By Design Project; not confirmed as Powers) · The Wellness By Design Project · 11:32 (692s)
5α/5β reductase biochemistry; allopregnanolone depletion in PFS; progesterone modulation
YT-17MNS2Z6kV02026-02-16PFSCore corpus - Powers · Reddit post
Has anyone here taken finasteride or dutasteride and gotten post finasteride syndrome (PFS) from them? I have a theory as to why this seems to happen in transgender women more than cis men
u/drwillpowers · r/asktransgender
Powers proposed that PFS stems from deficient allopregnanolone, a neurosteroid produced downstream of 5-alpha-reductase via the AKR1C enzyme family. He hypothesized that only people carrying decreased-function variants in AKR1C genes develop the syndrome when…
DWP-0012020PFSCore corpus - Video
Healthcare of the Transgender Patient (Powers Method)
William J. Powers, D.O. · Chen Merami · 2:03:27 (7407s)
background pharmacology: 5ARI neurosteroid depletion, rectal progesterone protocol, androgen blockade
YT-3g52vlv5YWo2024PFSCore corpus