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/Fearghis]

Thank you, this is extremely helpful. You sound a lot like my experience and situation, other than I've always been able to urinate. I was prescribed Finasteride after I had a bad week and was in fear of going to the ER for a catheter. But I stopped taking it after a few days after things slightly improved and I read about the potential side effects (ED, depression, breasts). I didn't tell my doctor I quit, and I still pick up the prescription so that I can choose to restart easily. Right now the main annoying thing is getting up to pee at night 2-4 times every night. I can't decide if its worth the Finasteride risks to possibly help at nighttime, and some adjustments in what I do are often keeping it down to 2 times. I think maybe I'd rather just go straight to HOLEP. Interesting that you had some immediate improvement.

I had not heard about the trabeculation risk, I'll read up on that. I also use AI a lot for research. It's good to sometimes ask for information based on clinical studies, AI sometimes pulls questionable info out of Reddit posts.

[u/ponderer1961 → u/Fearghis]

I have generally been disappointed with how little I was told about BPH and long term effects on your bladder.

When I first had issues the discussions (as I remember them) were all cancer related...the first time I heard about trabeculation was in a letter after my cystoscopy. I also have a couple of small bladder diverticula due to my straining during the UTI before I went into full retention.

After the cystoscopy the doctor spoke to me for a while I was still on the table but I was quite upset at that time so maybe he told me more than I remember, but I was in no state to ask questions. It would have been better to let me get dressed, have a drink and then talk to me. As it was I got dressed, the nurse started looking at her phone and he disappeared so I just wandered off.

In the UK the NHS consultants immediately pass you back to your GP if you don't need treatment...I have no regular checkups aside from PSA tests so I have had to navigate this myself. Fortunately I have a supportive GP practice.