THEORY - PAS and PFS - 5-Alpha Reductase Enzyme - Very Plausible/Currently seems to be the most likely cause of PAS

Jan 25, 2021
The only partial recovery I have found is from Mifepristone. Hang in there mate.
Thanks for your reply! Can i ask how long and how much dosage have you used that medicine? Which doctor should i go for taking this medicine?
And i want to say that i am taking 200 mg of Panax Ginseng daily, at first week i felt almost healed. I gained the pleasure and orgasm almost fully but in 2nd week it all became worse again... Maybe that can help for short duration.


New member
Feb 16, 2021
This thread is very interesting since I reported in the Acne forum * that my blood levels of (note: needs to be logged for you to see, otherwise it may show as removed):

* Post #1 / Post #2 / Post #3 / Post #4 / Post #5 / Post #6 / Post #7

- LH
- Free testosterone
- Estradiol
- Prolactin

Are all messed up probably due to my 2011 Accutane treatment that lasted months. As you can see, low estradiol for men means low libido (from what I understood, it can't be too high or too low - never one of the extremes!):

Low LH, FSH, DHT, all mean low libido, too. Prolactin in the 20's (should be half that for a man) is another sign of sexual dysfunction.

What I hypothesized is that adding these supplements:

- Peruvian MACA, Tribulus Terrestris, Fenugreek, Tongkat Ali, D-Aspartic Acid...

May perhaps make a difference by increasing both estrogen and testosterone levels. And perhaps also others like DHT, LH, FSH... and decreasing prolactin.

Also thinking of adding Panax ginseng.

Besides probably low libido due to Accutane use I also had (this was 100% confirmed) severe depression. The depression probably lasted for a few years, before it was gone forever. It has been said this was probably due to vitamin B12 depletion. My blood tests showed my B12 levels to be OK.

Link for the study (Decreased vitamin B 12 and folic acid concentrations in acne patients after isotretinoin therapy: A controlled study)

Low vitamin B12 accounts for this:

- Mental problems like depression, memory loss, or behavioral changes.

EDIT: in post #6 (see above) I added a few studies supporting these supplements as a good idea to boost libido/testosterone. I also asked a question about DHT: if Accutane supresses it, and high DHT equals having ACNE, then shouldn't that imply that "curing" acne means becoming impotent? At least for some...
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New member
Mar 11, 2018
A point against this theory is that DHT derived AAS increase libido in normal women. This means when given exogenously they are able to cross the BBB sufficiently to activate brain ARs. Thus, if decreased DHT production in the brain was the only issue, secondary to reduced 5AR activity, it could be remedied with a DHT derived AAS (like Anavar or Proviron). Unfortunately this isn't the case.
Dec 30, 2021
Isotretinoin as shown above is a 5 alpha reductase inhibitor. 5 alpha reductase inhibition leads to an antiandronergic effect. That means less testosteron is converted into Dihydrotestoseron. So we actually need an adrenergic agonist. There are lots of medication who are adrenergic agonists.
On the other hand less progesterone is converted into allopregnanolone. Less allopregnanone means more anxiety. So an option would be to take progesterone.

Regarding the theory that progesterone has an antiandrogeneric effect, this is not true. (Read under antiandrogenic effect