Finasteride doesn’t only block 5AR, it also blocks the PNMT enzyme; Antidepressants also affect it
Was watching Prof. Melcangi’s interview with SIDEfxHUB and he mentions this. This would explain the sexual disfunction cause this enzyme is very important for it. And this enzyme is also affected in PSSD, which can explain the nearly identical sexual issues in both syndromes.
In Addition to Blocking 5α-R, Finasteride Inhibits Adrenaline Production, Possibly Inducing Sexual and Psychological Side Effects, New Research Suggests:
Post-Finasteride Syndrome And Post-Ssri Sexual Dysfunction: Two Clinical Conditions Apparently Distant, But Very Close:
https://www.sciencedirect.com/science/article/pii/S0091302223000626
Had no idea about this. Google about how to boost this enzyme:
"Phenylethanolamine N-methyltransferase (PNMT) activity can be boosted biologically through exposure to physiological stress, adequate levels of the cofactor S-adenosylmethionine (SAM), and stimulation by glucocorticoids (cortisol/corticosterone).
How PNMT is Regulated and Supported
Glucocorticoids: High levels of cortisol or corticosterone from the adrenal cortex naturally induce and maintain PNMT gene expression and enzyme activity in the adrenal medulla. [1, 2]
Stress Stimuli: Acute or repeated physiological stressors (such as immobilization stress or cold exposure) significantly upregulate PNMT gene expression and elevate adrenaline synthesis. [1, 2]
Cofactor Availability: SAM (S-adenosylmethionine) acts as the essential methyl donor for PNMT to convert norepinephrine into epinephrine; it also helps stabilize the enzyme structure and extend its half-life. [1, 2, 3]"
I used SAM-e in the past after developing PFS for joints and depression but wasn’t for long. Didn’t have any crash nor improvement and didn’t find anything about SAM-e here but on Propecia Help there’s a post about PSSD induced by SAM-e.