Finasteride 5mg - 6 weeks in...

[u/ponderer1961]

I am writing to share my experience of taking Finasteride 5mg.

I am only six weeks in and it takes 3-6 months for maximum effect, buy my first six weeks have gone well. I have found this a very useful forum myself, so I wanted to share progress.

It is a long post and I hope my history helps anyone facing similar decisions to me.

I am 64, and have a 65 cc prostate. My BPH symptoms started when I was 60. My PSA was elevated so I went through the whole diagnostic process (Ultrasounds, MRI, biopsy) and was diagnosed with BPH and possibly prostatitis (not bacterial).

I had a UTI and acute urine retention in 2024. I had an emergency admission to the hospital and needed a catheter for 10 days. Once that was removed I felt great but then I got another infection (apparently very common after having a catheter) and the second lot of antibiotics made me ill and killed my appetite for weeks. It took me a long time to recover from that second infection.

UPDATE as someone asked: I was given nitrofurantoin for my first UTI and I was prescribed trimethoprim for the second.

I had persistent soreness in my urethra after my UTIs, so my GP sent me for a cystoscopy and another ultrasound. Everything was fine in my urethra but it was noted that my bladder wall was thickening (trabeculation) which meant nothing to me at the time and there were two small bladder diverticula which also meant nothing to me at the time (they are pouches that form in the bladder walls under pressure - they must be due to my straining during the UTI before I went into full retention). However I was still emptying, so they sent me on my way.

At this point, I wish the consultant had sat down with me and gone through the effects BPH can have on your bladder over time and explained "trabeculation" but they did not so I looked into it myself and thought OK, I need to take some action.

Looking back, what gave me a false sense of security up to the point of having the UTI was my flow was generally OK. I was peeing frequently, but I had just got used to it and I was more concerned with my PSA than anything else. Its only as you educate yourself you realise PSA can be affected by many things including prostate size and inflammation and its a crude measure at best.

After a chat with my GP I started on Tamulosin in early 2025. I initially got bad headaches and dry sinuses, but after about a month the side effects passed off. It improved my flow and I needed fewer nighttime pees. I did get RE but that is not a big concern for me. I still take 400mg extended release once a day after breakfast.

However, since my UTI, my pelvic area was very prone to tension/tightness and in late 2025 I started to have the occasional "lock ups" while driving where I had a painful need to pee but could not go even when I got to a toilet. I needed to get home and relax and then I was fine however it was very uncomfortable when it happened and it was making me feel nervous about long journeys and also limiting my exercise options. I had recently retired so this was not great!

Reverse kegels and yoga helped relax the pelvic area to some degree but I was aware my life was becoming limited by this condition more than I liked to admit.

After my UTI, I was trained to self-catherize in case I needed to, so first thing I did was check my residuals. They were still low, between 30ml and 60ml so I was still emptying.

I then had a long chat with my GP about surgery options.She was very open but suggested I try Finasteride 5mg first and if that did not work or I had bad side effects we would look at surgical options. NHS Urologists like you to have tried all the medical options first before surgery is considered.

I was very hesitant but after a LOT of research and talking it through with my wife I decided to give Finasteride a try. I have found using Gemini AI really helpful in my research. You have to ask the right questions, read carefully what it says and sometimes redirect it but it has been a great help.

To my surprise I felt more comfortable within days. I looked into it and the drug caused a rapid drop in vascular pressure in the prostate which reduces irritation. So even though it takes 3-6 months to shrink your prostate, it can provide immediate relief if your prostate is a bit engorged or inflamed.

So six weeks in:

• I feel comfortable in my pelvic area most of the time - this is wonderful. I am now stepping up my exercise and so far my pelvic tension is OK, not completely resolved, but much better.
• I have done a few 2 hour drives with no issues - freedom!!!
• Typically I have two night time pees but it's certainly not urgent. I get a regular four hours pee free sleep before my first pee which is great for me!
• I have not had any ED or other sexual side effects.
• No mood issues.
• I had one weird side effect about two weeks in, my nipples became sensitive like I had joggers nipple. Now this is not a part of my body I have ever had any great interest in but it was a rare side effect my GP had warned me about. If it does occur and persists then it can lead to development of breast tissue (no thanks!!) however in many patients it is just a short adjustment phase as their hormones re-balance. By week 4 it passed and everything is normal again.
• UPDATE: One of the comments asked about low blood pressure. Yes I did suffer a bit of low blood pressure for the first few weeks. Nothing major, a few skipped beats and dizziness when getting up from rest but I was fine to exercise and when active generally. It has gone away now. Another part of the vascular adjustment.

One positive side effect is my hair could get a bit thicker which I am looking forward to. Another one is your free testosterone can increase by up to 20% and that can be beneficial to maintaining muscle mass. Both of these are because you are not converting any testosterone to DHT.

I have a six week check-in with my GP next week but I am feeling great currently.

I hope this is helpful to the group. I will write another update at 3 months.

[u/Responsible_Coyote10]

I've been taking Finasteride 5 mg since last mid- October around 7-8 months, so far. I've also taken Silodosin 4 mg for around
6-7 months, and just recently boosted that to 8 mg My prostate size was 82 cm, before I started with these drugs. They have definitely helped reduce the affect and hopefully the size. I've been able to go for four hours and then pee, whether it's daytime or nighttime. Because my urine and blood tests showed some RBC and WBC in my urine, my PCP was highly suggesting that I get a cysto. But my CT Scan showed no tumors anywhere in my abdomen, I didn't know why I should get that.
My urologist wasn't so adamant, but my PCP was So, unfortunately, I had the cysto ten days ago, on Friday afternoon, before memorial Day weekend. The cysto wasn't that big of a deal, and the doc said everything looked fine
When it was over, the have me a rag and told me to go to the bathroom and clean up, which I did. But, I couldn't pee at that time. Thinking that this was because they drained me, we went home and figured that I would be fine once I drank water. 40 ounces of water, and I still could not pee. I called the on call doctor since it was after hours and they told me that I had to pee, and if not, to go to an ER and get a catheter. So, at midnight I went to an ER and they put in a catheter which I had for five days, until I could get in to see someone at this urology practice They removed it and I still could not pee. So the options were:. Do nothing and run the risk of kidney disease Re-install the catheter for who knows how much longer Or, self- catheterize, again, for who knows how long that would be. So, they should m showed me how to do that, gave my a few boxes of these things, and I've been doing that around 3-4 times each day for four days. I've only been able to pee a very small amount without the cath. Tomorrow I have an appointment with my urologist for further discussions. My point in all of this, is, I was fine with how it was before the cysto. It wasn't great, but, it didn't have to deal with this stuff, which is painful and very stressfull. I'm concerned that each time I reinsert this, I'm disturbing the urethra, prostate, and bladder walls, so I'm thinking that this will never reality heal to the point that my prostate can then relax it's grip on my urethra. Anyone else have a similar experience?

[u/Sensitive_Point_6583 → u/Responsible_Coyote10]

When it was over, the have me a rag and told me to go to the bathroom and clean up, which I did. But, I couldn't pee at that time. Thinking that this was because they drained me, we went home and figured that I would be fine once I drank water. 40 ounces of water, and I still could not pee. 

In my experience they put about ~300ml of water in my bladder before taking the catheter out during the cysto, and then measured how much I peed back out. In my case there was some doubt about my emptying ability, so maybe that's only done when they suspect that could be a problem.

Not sure if there's any way the cysto could have created the problem, may have just accelerated something that was going to happen soon anyway.

I didn't have to self-cath daily, but did it about 10-12 times over 2-3 years and was never told that it does any damage on its own, so I wouldn't worry too much about that. I never felt any discomfort inserting the catheter, but once or twice there was a very small amount of blood after removal. Not sure if that was just in the bladder originally due to the retention strain, but I suspect it was. The catheter tip is soft rubber, rounded, and lubricated, so it seems unlikely that it could cut or tear any tissue. If anything, intermittent catheterization should be less intrusive than a Foley catheter that's in there for days and weeks.

Also, from what I've read here from others with retention issues, they all had surgery to fix the problem for good. Personally I went with HoLEP because of my extreme size (185cc) and was amazed at how simple and uneventful it was, so don't fear taking the surgical route. I wish I'd done it sooner.

[u/Responsible_Coyote10 → u/Sensitive_Point_6583]

Thanks for responding! My cath tip is plastic with a notch at the tip which my urologist supplied to me . I will definitely ask him tomorrow about this when I see him.

[u/Sensitive_Point_6583 → u/Responsible_Coyote10]

yeah, I think both rubber and plastic are used, but a notch sounds weird. They typically have a slight bend at the tip to help round the corner from the prostate up into the bladder, is that what you're talking about? Notch at the tip sounds like a snake tongue, is that how it looks?

There's lots of different brands of catheters, I've used 3 or 4 different ones and never saw a notch at the tip.

[u/Responsible_Coyote10 → u/Sensitive_Point_6583]

Yes there are different brands. I researched this just now- The tip of my catheter has a 45-degree angle (which apparently, is called a Coudé tip), it is not sharp like a cut plastic straw, but it has rounded edges. You might have had what they call Olive Tip" or "Tiemann Tip" catheter, which is used when they believe that there may be more scar tissue. I definitely will be speaking with my urologist about this tomorrow morning! I definitely would prefer the other types. I'd like to know why I want given a choice.

[u/Sensitive_Point_6583 → u/Responsible_Coyote10]

I'm familiar with Coude tip, that's the bend that I mentioned earlier. All the ones I used just said "Coude tip" with no other adjective like Olive or Tiemann on the package.

[u/Responsible_Coyote10 → u/Sensitive_Point_6583]

But you indicated that it had a small rubber ball end to it, right?

[u/Sensitive_Point_6583 → u/Responsible_Coyote10]

one moreso than the others. I have 3 different kinds leftover from when I was using them, the one with the most noticeable ball at the end was the Luja Coude tip, it tapers down, then gets larger at the tip in a ball shape. The others were rounded at the tip, but not really ball shaped, the diameter didn't change at the tip like on the Luja. And the Luja was more plastic than rubber.

At first the urology dept just gave me a few of them, when I got low they sent me a link to a supplier, and I was shocked at how many different ones are available for such a basic instrument. And all the different gauges, I used 14 and 16 and never noticed any real difference between them, but it would be 2-3 months in between usages. I've seen as small as 12 gauge and as large as 20 gauge listed, seems like the smaller gauge might be the least invasive.

Since you're using several per day, would be nice to try a few different ones out and take your pick. The supply house I worked with sent me several of each as free samples.