Over the past 14 years, researchers at leading institutions—from Harvard Medical School to Northwestern University Feinberg School of Medicine to Baylor College of Medicine to the George Washington University School of Medicine and Health Sciences—have published clinical studies and statistical analyses on PFS in leading journals, including JAAD, JAMA Dermatology, The Journal of Clinical Endocrinology & Metabolism, PeerJ, Pharmacotherapy and American Journal of Men’s Health. To date, the PFS Foundation has aggregated 74 such papers on our Medical Literature page. Going forward, we will continue to review such literature and house it here for the edification of clinicians, researchers, patients and their family members, regulatory officials, and members of the media.
If you know of additional PFS-related medical literature that you would like us to consider housing on our website, please email pertinent links/names to proberts@pfsfoundation.org.
- Isolated Depressive Disorders and Suicidality with Finasteride Use for Androgenetic Alopecia: A Call for Enhanced VigilanceWhile adverse psychiatric drug reactions, including depressive symptoms and suicidality, are often reported in conjunction with sexual dysfunction, this study highlights the severity of depressive effects associated with finasteride, particularly the risk of suicidality even in the absence of associated sexual dysfunction or psychiatric history. The persistence of depressive symptoms sometimes beyond 20 months post-discontinuation,… Read more: Isolated Depressive Disorders and Suicidality with Finasteride Use for Androgenetic Alopecia: A Call for Enhanced Vigilance
- Failing Public Health Again? Analytical Review of Depression and Suicidality From FinasterideFinasteride…has long been suspected of causing severe neuropsychiatric reactions, including depression, anxiety, and suicidality… Concerns about depression from finasteride were raised in several studies as early as 2002. Between the years 2017 and 2023, 4 independent analyses of adverse event reporting systems and 4 studies using data mining of healthcare records indicated a significant increase… Read more: Failing Public Health Again? Analytical Review of Depression and Suicidality From Finasteride
- Finasteride Use: Evaluation of Depression and Suicide RiskMultiple clinical studies suggest that oral finasteride treatment may increase the risk of neuropsychiatric side effects. A systematic review found that the odds of developing depressive symptoms were significantly higher in oral finasteride users compared to non-users, with an odds ratio of 2.14. The pooled rates of depressive symptoms were higher with oral finasteride at… Read more: Finasteride Use: Evaluation of Depression and Suicide Risk
- Association between Finasteride with Subjective Memory Deficits: A Study from the NHANES and FAERS DatabasesConvergent evidence from both epidemiological studies and pharmacovigilance surveillance suggests a potential association between finasteride administration and cognitive dysfunction, particularly in memory-related domains. These findings underscore the need for comprehensive risk communication strategies regarding potential neurocognitive adverse effects during clinical consultations and for establishing routine cognitive monitoring protocols for patients undergoing prolonged finasteride therapy. Zhang… Read more: Association between Finasteride with Subjective Memory Deficits: A Study from the NHANES and FAERS Databases
- Post-Finasteride Syndrome: A True Clinical Entity?PFS represents a complex and multifaceted entity, challenging clinicians and researchers alike in its diagnosis, management, and understanding. This complexity necessitates a multidisciplinary approach, integrating insights from urology, psychiatry, and pharmacology to effectively address the diverse manifestations of PFS. It is crucial to acknowledge that the responsibility for managing and identifying PFS extends beyond urologists,… Read more: Post-Finasteride Syndrome: A True Clinical Entity?
- Anxiety-, and depression-like behavior following short-term finasteride administration is associated with impaired synaptic plasticity and cognitive behavior in male ratsInterestingly, we observed that finasteride impairs hippocampal-dependent spatial memory but not prefrontal cortex-dependent recognition memory… This study suggests that finasteride administration induced anxiety-, and depression-like behavior and impaired hippocampal dependent learning and synaptic plasticity and provides insight that neurosteroids play an important role in mood and cognition. Sasibhushana RB, Shankaranarayana Rao BS, Srikumar BN: April… Read more: Anxiety-, and depression-like behavior following short-term finasteride administration is associated with impaired synaptic plasticity and cognitive behavior in male rats
- Analysis of the finasteride treatment and its withdrawal in the rat hypothalamus and hippocampus at whole-transcriptome levelData here obtained by RNA sequencing showed that chronic treatment (i.e., for 20 days) with finasteride affects the expression of hypothalamic and hippocampal rat genes. As we reported, the most affected brain area is the hypothalamus, with 15 genes downregulated and 171 genes upregulated. Among the downregulated genes, we will here discuss those that, based… Read more: Analysis of the finasteride treatment and its withdrawal in the rat hypothalamus and hippocampus at whole-transcriptome level
- Post-Finasteride Syndrome And Post-SSRI Sexual Dysfunction: Two Clinical Conditions Apparently Distant, But Very ClosePost-finasteride syndrome and post-SSRI sexual dysfunction, are two poorly explored clinical conditions in which men treated for androgenetic alopecia with finasteride or for depression with SSRI antidepressants show persistent side effects despite drug suspension (e.g., sexual dysfunction, psychological complaints, sleep disorders). Because of some similarities in the symptoms, common pathological mechanisms are proposed here. Indeed,… Read more: Post-Finasteride Syndrome And Post-SSRI Sexual Dysfunction: Two Clinical Conditions Apparently Distant, But Very Close
- Comparative effects of finasteride and minoxidil on the male reproductive organs: A systematic review of in vitro and in vivo evidenceIn our systematic review, we have assessed and compared for the first time the impact of two important medicaments, finasteride and minoxidil, both used to treat alopecia, on male reproduction. Two reproductive organs of adult murine models, testis and epididymis, in addition to testis/epididymis-related cells, were focused on this investigation. We can conclude that finasteride… Read more: Comparative effects of finasteride and minoxidil on the male reproductive organs: A systematic review of in vitro and in vivo evidence
- The Post-Finasteride Syndrome: Possible Etiological Mechanisms and Symptoms[I]t is utmost important to identify individuals with a previous history of depression, sexual dysfunction or infertility who may be more susceptible for the various side effects. The risks should than be discussed with the patient and weighed out against the benefits of the use of 5ARIs as mentioned in the introduction. Men under the… Read more: The Post-Finasteride Syndrome: Possible Etiological Mechanisms and Symptoms
- Exploring Rat Corpus Cavernosum Alterations Induced by Finasteride Treatment and WithdrawalData here reported indicate that the subchronic treatment with finasteride is able to directly affect the enzyme 5α-R type II in the rat corpus cavernosum and consequently the conversion of T into DHT. Indeed, we reported a decrease in its protein expression, associated with rise in the levels of its substrate and a decrease in… Read more: Exploring Rat Corpus Cavernosum Alterations Induced by Finasteride Treatment and Withdrawal
- Beliefs and counseling practices among dermatologists regarding sexual and other adverse effects of finasterideDespite multiple randomized controlled trials and meta-analyses documenting an increased rate of adverse sexual events in men treated with finasteride for either androgenic alopecia or benign prostatic hypertrophy, 29% of dermatologists thought that this was unlikely and 20% were uncertain. Fewer than a quarter believed that finasteride could cause depression or lower sperm counts. Irwig… Read more: Beliefs and counseling practices among dermatologists regarding sexual and other adverse effects of finasteride
- Neuropsychiatric Reactions to Finasteride: Nocebo or True Effect?Reports to the FDA of neuropsychiatric events for finasteride in comparison to control medications show disproportionate safety signals for finasteride with a striking increase in suicides. Increased reporting could relate to enhanced awareness and not to a nocebo effect. In pharmacovigilance surveys, the actual rate of serious adverse effects on mood from finasteride in some… Read more: Neuropsychiatric Reactions to Finasteride: Nocebo or True Effect?
- US Food and Drug Administration Warning Regarding Finasteride and Suicidal Ideation: What Should Urologists Know?Most of the current evidence is from the dermatology field and suggests that 5-ARI users experience a higher rate of depressive symptoms… Urologists prescribing 5-ARIs should be aware of the recent addition of suicide and [suicidal ideation] risk to the list of side effects. A mental health screen should be performed and appropriate resources provided… Read more: US Food and Drug Administration Warning Regarding Finasteride and Suicidal Ideation: What Should Urologists Know?
- Vascular, Neurologic and Hormonal Abnormalities in Men with Persistent Sexual Dysfunction After Discontinuation of FinasteridePersistent sexual side effects have been repeatedly reported in men after discontinuation of (DC) Finasteride (FIN), including ED, orgasmic dysfunction and/or genital anhedonia/anesthesia. Khera et al (2020) reported persistent physical sequelae including penile vascular changes in 25 men after DC FIN. The purpose of this study is to replicate Khera’s research findings in a larger… Read more: Vascular, Neurologic and Hormonal Abnormalities in Men with Persistent Sexual Dysfunction After Discontinuation of Finasteride
- Gut Inflammation Induced by Finasteride Withdrawal: Therapeutic Effect of Allopregnanolone in Adult Male Rats[P]revious observations in PFS patients and an experimental model showed alterations in gut microbiota populations, suggesting an inflammatory environment. To confirm this hypothesis, we…explored the effect of chronic treatment with finasteride…and its withdrawal…on the levels of steroids, neurotransmitters, pro-inflammatory cytokines and gut permeability markers in the colon of adult male rat. The obtained data demonstrate… Read more: Gut Inflammation Induced by Finasteride Withdrawal: Therapeutic Effect of Allopregnanolone in Adult Male Rats
- Global online interest in finasteride sexual side effectsPrior literature has suggested that finasteride may negatively impact men’s sexual health. In 2011, the Food and Drug Administration (FDA) provided a warning on finasteride drug labels to incorporate sexual side effects such as reduced libido and erectile dysfunction. We aimed to evaluate global online interest in finasteride sexual side effects, their penetrance and variation,… Read more: Global online interest in finasteride sexual side effects
- Diagnostic criteria for enduring sexual dysfunction after treatment with antidepressants, finasteride and isotretinoinA set of enduring conditions have been reported in the literature involving persistent sexual dysfunction after discontinuation of serotonin reuptake inhibiting antidepressants, 5 alpha-reductase inhibitors and isotretinoin. OBJECTIVE: To develop diagnostic criteria for post-SSRI sexual dysfunction (PSSD), persistent genital arousal disorder (PGAD) following serotonin reuptake inhibitors, post-finasteride syndrome (PFS) and post-retinoid sexual dysfunction (PRSD). METHODS:… Read more: Diagnostic criteria for enduring sexual dysfunction after treatment with antidepressants, finasteride and isotretinoin
- How routine pharmacovigilance failed to identify finasteride’s persistent sexual side effectsWhen confronted with data that their product could cause persistent erectile dysfunction, the Risk Management Safety Team at Merck, in 2009, had the opportunity to take further action to sort out the issue. Realizing that many adverse event reports lacked adequate information, the team could have recommended conducting additional rigorous prospective studies on finasteride to… Read more: How routine pharmacovigilance failed to identify finasteride’s persistent sexual side effects
- Differential Gene Expression in Post-Finasteride Syndrome PatientsThis study is the first to consider gene expression differences in men with PFS in explaining the etiology of this condition. Given gene expression per se is not mechanistic and does not imply causality, experiments with downstream processes of protein expression and activity should be undertaken to provide mechanistic data and clarify the results of… Read more: Differential Gene Expression in Post-Finasteride Syndrome Patients
- Risk of Depression Associated With Finasteride TreatmentCrude pooled rates of depressive symptoms with versus without finasteride were 3.33% versus 2.54%; random-effects meta-analysis yielded an odds ratio of 2.14. In addition, risk of suicidal ideation or behavior was greater with versus without finasteride (21.2% vs 14.0%), and risk of sustained sexual dysfunction was high (60.1%). The findings support a growing impression that… Read more: Risk of Depression Associated With Finasteride Treatment
- Three-Dimensional Proteome-Wide Scale Screening for the 5‑Alpha Reductase Inhibitor Finasteride: Identification of a Novel Off-TargetData presented here indicate that the 5α-R inhibitor FIN is also able to interact with PNMT. This concept is supported by 3D proteome wide-scale screening, by docking and MD simulations, by an in vitro biochemical assay, and in vivo analysis. We believe that the present findings may help in explaining the various side effects reported… Read more: Three-Dimensional Proteome-Wide Scale Screening for the 5‑Alpha Reductase Inhibitor Finasteride: Identification of a Novel Off-Target
- The potential involvement of cholinergic system in finasteride induced cognitive dysfunctionFinasteride (100 mg/Kg, s.c.) administration decreased the percent correct choice during the retention trial of the RAM task. This was paralleled by an increase in the number of total number of errors and reference memory errors. In the social interaction test, finasteride (100 mg/Kg, s.c.) administration decreased the time spent with the rat compared to… Read more: The potential involvement of cholinergic system in finasteride induced cognitive dysfunction
- Investigation of Suicidality and Psychological Adverse Events in Patients Treated With FinasterideIn this pharmacovigilance case-noncase study, significant RORs of suicidality and psychological adverse events were associated with finasteride use in patients younger than 45 years who used finasteride for alopecia. The sensitivity analyses suggest that these disproportional signals of adverse events may be due to stimulated reporting and/or younger patients being more vulnerable to finasteride’s adverse… Read more: Investigation of Suicidality and Psychological Adverse Events in Patients Treated With Finasteride
- Alterations of gut microbiota composition in post-finasteride patients: a pilot studySexual dysfunction, psychological and cognitive complaints, muscular problems, and physical alterations symptoms were reported in more than half of the PFS patients at the moment of sample collection. The quality sequence check revealed a low library depth for two fecal samples. Therefore, the gut microbiota analyses were conducted on 21 patients. The α-diversity was significantly… Read more: Alterations of gut microbiota composition in post-finasteride patients: a pilot study
- Repeated finasteride administration induces depression-like behavior in adult male ratsThis study provides the evidence that an animal model of finasteride-induced depression is feasible to investigate the cellular and molecular mechanisms, and the pharmacology underlying the neuropsychiatric effects of finasteride. Further, these results provide insights into the potential involvement of neurosteroids in depression and will lead to the development of novel therapeutics for its treatment.… Read more: Repeated finasteride administration induces depression-like behavior in adult male rats
- Allopregnanolone, the Neuromodulator Turned Therapeutic Agent: Thank You, Next?Pharmacological treatments, including finasteride and oral contraceptives, that inhibit 5α-RI, which results in a blood and brain allopregnanolone decrease also affect subunit expression of GABAA receptor and are associated with mood symptoms and suicide and are part of post-finasteride syndrome. Post-finasteride syndrome, in addition to depression, anxiety and cognitive deficits also induces sexually-related side effects,… Read more: Allopregnanolone, the Neuromodulator Turned Therapeutic Agent: Thank You, Next?
- Macular Abnormalities Associated With 5α-Reductase InhibitorAmong 31 male patients with foveal cavitation, 5-ARI was used for 10 of 14 patients (71.4%) with macular abnormalities of unknown origin and for 2 of 17 patients (11.8%) with macular abnormalities of well-known specific origin… Optical coherence tomography imaging showed a disease spectrum ranging from tiny foveal cavitation to an impending macular hole. Of… Read more: Macular Abnormalities Associated With 5α-Reductase Inhibitor
- An evaluation of the federal adverse events reporting system data on adverse effects of 5‑alpha reductase inhibitorsPost-finasteride syndrome (PFS) has been described as physical, neurological, or psychiatric side effects which persist for three or more months after discontinuing the medication, affecting approximately 900,000–1.5 million men. In 2015, the National Institute of Health (NIH) added PFS to their list of genetic and rare disease… Analysis of FAERS data suggests [adverse events] of… Read more: An evaluation of the federal adverse events reporting system data on adverse effects of 5‑alpha reductase inhibitors
- Penile vascular abnormalities in young men with persistent side effects after finasteride use for the treatment of androgenic alopeciaWhile the sexual side effects of 5ARIs are well known, there may be persistent genitourinary, physical, psycho-cognitive, anti-androgenic and penile vascular changes after 5ARI discontinuation. Use of 5ARIs for treatment of AGA may lead to persistent sexual, genitourinary, physical, psycho-cognitive, and anti-androgenic sequelae even after cessation of 5ARI therapy… Two subjects (8%) committed suicide during… Read more: Penile vascular abnormalities in young men with persistent side effects after finasteride use for the treatment of androgenic alopecia
- Health Risks Associated with Long-Term Finasteride and Dutasteride Use: It’s Time to Sound the AlarmHere we advance the concept that blockade of the 5α-R enzymatic activities by such irreversible inhibitors results in a state of new form of androgen deficiency, independent of circulating T levels. This new form of androgen deficiency has not been recognized before, simply, it is thought that as long as T levels are in the… Read more: Health Risks Associated with Long-Term Finasteride and Dutasteride Use: It’s Time to Sound the Alarm
- Prolonged use of finasteride-induced gonadal sex steroids alterations, DNA damage and menstrual bleeding in women[F]inasteride is associated with common adverse health effects in women with long-term treatment for androgenetic alopecia such as; irregular menstrual cycle, aromatase disorder, high cholesterol, heavy menstrual bleeding and induced DNA damage…Finally, the study recommended that finasteride should not be administrated as treatment for androgenetic alopecia in women. Albasher G, Bin-Jumah M, Alfarraj S, et… Read more: Prolonged use of finasteride-induced gonadal sex steroids alterations, DNA damage and menstrual bleeding in women
- Finasteride and Suicide: A Postmarketing Case SeriesIn this postmarketing case series of 6 former finasteride users who committed suicide, all reported insomnia and persistent sexual dysfunction after medication discontinuation. The most prominent psychiatric symptoms were depression, anxiety, panic attacks, feelings of isolation and “brain fog.” Some of the most debilitating symptoms were insomnia and fatigue. Apart from 1 case who had… Read more: Finasteride and Suicide: A Postmarketing Case Series
- Post-finasteride syndrome: a surmountable challenge for cliniciansIt is not surprising that almost all studies published to date do report increased sexual adverse effects. However, even when such sexual adverse events were reported, many argued that the numbers of subjects afflicted are small and propagated the falsehood that the adverse effects do resolve with continued treatment. This is unfortunately a willful blindness… Read more: Post-finasteride syndrome: a surmountable challenge for clinicians
- Post-finasteride syndrome: An emerging clinical problem[T]hese data indicate the urgent need for high quality clinical trials, with long-term follow up, specifically addressing sexual function and mood disorders. In addition, it is imperative to study in detail the molecular mechanisms that cause this condition, trying to identify a possible genetic predisposition, in order to limit the burden of PFS. Finally, therapeutic… Read more: Post-finasteride syndrome: An emerging clinical problem
- The Steroidogenesis Inhibitor Finasteride Reduces the Response to Both Stressful and Rewarding Stimuli[W]e tested the effects of [finasteride (FIN)] in a battery of tests aimed at capturing complementary aspects of mood regulation and stress reactivity in rats. FIN reduced exploratory, incentive, prosocial, and risk-taking behavior; furthermore, it decreased stress coping, as revealed by increased immobility in the forced-swim test (FST). This last effect was also observed in… Read more: The Steroidogenesis Inhibitor Finasteride Reduces the Response to Both Stressful and Rewarding Stimuli
- Altered methylation pattern of the SRD5A2 gene in cerebrospinal fluid of post-finasteride patients: a pilot study.Recent findings in rat models confirmed that altered epigenetic processes, consisting in abnormal DNA methyltransferase protein levels and increased global DNA methylation levels, are linked to anxiety- and depression-like behaviour. Our finding of high levels of methylated SRD5A2 in CNS cells of a normotensive hydrocephalus individual, displaying an epigenetic status at odds with all other… Read more: Altered methylation pattern of the SRD5A2 gene in cerebrospinal fluid of post-finasteride patients: a pilot study.
- Sexual dysfunction in men taking systemic dermatologic medication: A systematic review.Although there is some evidence against sexual dysfunction occurring in patients taking 5 mg and 10 mg of finasteride, most studies describe relatively common adverse effects of decreased libido, impotence, and ejaculation disorders… We identified 5 studies that did not support the increased rates of sexual dysfunction in men taking 1 mg finasteride for androgenic… Read more: Sexual dysfunction in men taking systemic dermatologic medication: A systematic review.
- Finasteride-Induced Inhibition of 5α-Reductase Type 2 Could Lead to Kidney Damage—Animal, Experimental Study.Conclusions 1. The finasteride treatment of adult male rats led to a decrease in androgen receptor expression and its cellular translocation within the kidney cortex. 2. The pathomorphological changes (glomerulosclerosis, tubulosclerosis, dysplastic glomeruli, and tubules with lumen dilatation) in rats’ kidneys with disturbed steroid hormone imbalance were associated with the diminished expression of intracellular junctional… Read more: Finasteride-Induced Inhibition of 5α-Reductase Type 2 Could Lead to Kidney Damage—Animal, Experimental Study.
- Incidence of type 2 diabetes mellitus in men receiving steroid 5α-reductase inhibitors: population based cohort study.Conclusions: The risk of developing new onset type 2 diabetes appears to be higher in men with benign prostatic hyperplasia exposed to 5α-reductase inhibitors than in men receiving tamsulosin, but did not differ between men receiving dutasteride and those receiving finasteride. Additional monitoring might be required for men starting these drugs, particularly in those with… Read more: Incidence of type 2 diabetes mellitus in men receiving steroid 5α-reductase inhibitors: population based cohort study.
- Treatment of male rats with finasteride, an inhibitor of 5alpha-reductase enzyme, induces long-lasting effects on depressive-like behavior, hippocampal neurogenesis, neuroinflammation and gut microbiota composition.Our findings indicate that finasteride treatment causes several alterations in the hippocampus that are detected at the end of the treatment… coincide with the apparition of depressive-like behavior, suggesting that long term effects of finasteride treatment on neurogenesis and neuroinflammation may participate in the enduring effects of the drug on depressive-like behavior, which are detected… Read more: Treatment of male rats with finasteride, an inhibitor of 5alpha-reductase enzyme, induces long-lasting effects on depressive-like behavior, hippocampal neurogenesis, neuroinflammation and gut microbiota composition.
- The post-finasteride syndrome: clinical manifestation of drug-induced epigenetics due to endocrine disruption.Finasteride treatment impairs biosynthesis and function of neurosteroids, which are critical regulators of central (CNS) as well as peripheral nervous system functions and modulate a host of neurotransmitter receptors, such as gamma amino butyric acid receptors. Thus, finasteride-induced neuroendocrine disruption of biosynthesis of critical signaling molecules results in pathophysiological states, which contribute to inhibition of… Read more: The post-finasteride syndrome: clinical manifestation of drug-induced epigenetics due to endocrine disruption.
- Post-finasteride syndrome: a review of current literature.The persistent symptoms reported by men after treatment of BPH or AGA with 5α-reductase inhibitors have been increasingly studied over the past decade. However, many of the studies investigated PFS using surveys of patients seeking treatment for PFS or from PFS-specific online forums, exposing the results to potential selection and recall bias. Further, there is… Read more: Post-finasteride syndrome: a review of current literature.
- Finasteride is associated with a higher odds of obstructive sleep apnea (OSA): results from the US FDA Adverse Events Reporting System.Finasteride, which crosses the blood-brain barrier, therefore lowers overall androgen activity. A decrease in androgen levels has been associated with [obstructive sleep apnea] and lower sleep efficiency in some studies. The odds of OSA with finasteride for any indication versus OSA with all other medication in FAERS used for any indication revealed…1,490 all other AE… Read more: Finasteride is associated with a higher odds of obstructive sleep apnea (OSA): results from the US FDA Adverse Events Reporting System.
- Emotional consequences of finasteride: fool’s gold.Users of finasteride…report serious physical and emotional adverse effects, collectively known as post-finasteride syndrome… Limited research exists exploring the psychological corollaries of post-finasteride syndrome and preexisting Axis I and Axis II mental health conditions… An important finding in this study was that almost 57% (n = 97) of men reported a psychiatric diagnosis and 28%… Read more: Emotional consequences of finasteride: fool’s gold.
- Neuroactive steroid levels and psychiatric and andrological features in post-finasteride patients.The levels of some neuroactive steroids analyzed in CSF of PFS patients were significantly different versus those in healthy controls. In particular, the levels of PREG, as well as of its further metabolites, PROG and DHP, were significantly decreased in CSF of PFS patients. PFS patients show altered levels of important physiological regulators of brain… Read more: Neuroactive steroid levels and psychiatric and andrological features in post-finasteride patients.
- Persistent erectile dysfunction in men exposed to the 5α-reductase inhibitors, finasteride, or dutasteride.Our chief objective was to assess whether longer duration of 5α-RI exposure increases risk of [persistent erectile dysfunction], independent of age and other known risk factors… Among men with 5α-RI exposure, 167 of 11,909 (1.4%) developed PED… Of 530 men with new ED, 167 (31.5%) had new PED. Men without prostate disease who combined NSAID… Read more: Persistent erectile dysfunction in men exposed to the 5α-reductase inhibitors, finasteride, or dutasteride.
- Androgen Receptor (AR) Gene (CAG)n and (GGN)n Length Polymorphisms and Symptoms in Young Males With Long-Lasting Adverse Effects After Finasteride Use Against Androgenic AlopeciaThis study showed that short and/or long (CAG)n and (GGN)n repeats had different frequencies according to symptoms reported by patients with PFS, likely reflecting the vast array of genes modulated by the AR. This study showed a U-curvilinear profile of (CAG)n repeats for skin dryness symptoms, where the two extremes exhibited a worse condition than… Read more: Androgen Receptor (AR) Gene (CAG)n and (GGN)n Length Polymorphisms and Symptoms in Young Males With Long-Lasting Adverse Effects After Finasteride Use Against Androgenic Alopecia
- Exploring the neural mechanisms of finasteride: a proteomic analysis in the nucleus accumbens.Recent evidence has shown that [finasteride], albeit generally well tolerated, can induce untoward psychological effects in a subset of patients; furthermore, this drug may have therapeutic efficacy for a number of different neuropsychiatric conditions, ranging from Tourette syndrome to schizophrenia. In rat models of these conditions, FIN has been shown to block the effects of… Read more: Exploring the neural mechanisms of finasteride: a proteomic analysis in the nucleus accumbens.
- Characteristics of men who report persistent sexual symptoms after finasteride use for hair loss.Symptomatic finasteride users had “significantly lower International Index of Erectile Function composite score” and “significantly lower scores for each of its domains of erectile function, sexual desire, orgasmic function, intercourse satisfaction, and overall satisfaction”… There exists “a significant positive correlation between a subset of Beck Depression Inventory scores related to negative attitude and blood oxygen… Read more: Characteristics of men who report persistent sexual symptoms after finasteride use for hair loss.
- An observational retrospective evaluation of 79 young men with long-term adverse effects after use of finasteride against androgenetic alopecia.Concern regarding adverse effects of finasteride is increasing. We aimed to determine the type and frequency of symptoms in men having long-term sexual and non-sexual side effects after finasteride treatment (a condition recently called post-finasteride syndrome, PFS).… Out of 79 participants…the most frequent sexual symptoms referred were a loss of penis sensitivity (87.3%), decreased ejaculatory… Read more: An observational retrospective evaluation of 79 young men with long-term adverse effects after use of finasteride against androgenetic alopecia.
- Effects of subchronic finasteride treatment and withdrawal on neuroactive steroid levels and their receptors in the male rat brain.The effects in the brain of finasteride…have been poorly explored. Therefore, the effects of a subchronic treatment of finasteride…and the consequences of its withdrawal on neuroactive steroid levels in plasma, cerebrospinal fluid and some brain regions…have been evaluated in male rats. After subchronic treatment…the following effects were detected: (i) depending on the compartment considered, alteration… Read more: Effects of subchronic finasteride treatment and withdrawal on neuroactive steroid levels and their receptors in the male rat brain.
- Persistent sexual and nonsexual adverse effects of finasteride in younger men.Conclusions: Persistent adverse effects of finasteride in younger men include erectile dysfunction, low libido, lack of orgasms, depression, and decreased alcohol consumption. One study has found lower levels of several neurosteroids in this population. Out of the various persistent side effects, erectile dysfunction and decreased alcohol consumption have been the most studied in animal models.… Read more: Persistent sexual and nonsexual adverse effects of finasteride in younger men.
- Finasteride, not tamsulosin, increases severity of erectile dysfunction and decreases testosterone levels in men with benign prostatic hyperplasia.Conclusions: This study showed that long-term 5α-RIs therapy but not tamsulosin in men with BPH is associated with continued worsening of ED, which does not resolve with continuing treatment, contrary to previous claims. Most importantly, it appears that 5α-RIs therapy but not tamsulosin results in a reduction of T levels and increased AMS score as… Read more: Finasteride, not tamsulosin, increases severity of erectile dysfunction and decreases testosterone levels in men with benign prostatic hyperplasia.
- Adverse effects of 5α-reductase inhibitors: what do we know, don’t know, and need to know?Recent preclinical and clinical findings indicate that 5α-R inhibitors evoke not only beneficial but also adverse effects. Future studies should investigate the biochemical and physiological mechanisms that underlie the persistence of the adverse sexual side effects to determine why a subset of patients is afflicted with such persistence or irreversible adverse effects. Also, a better… Read more: Adverse effects of 5α-reductase inhibitors: what do we know, don’t know, and need to know?
- The impact of the 5α-reductase inhibitors (5α-RIs) on male sexual function and psychological well-being.5α-Reductase inhibitors (5α-RIs) such as finasteride and dutasteride have proven useful in the clinical management of lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH) and also in the treatment of androgenetic alopecia (AGA). However, these drugs have serious and, in some patients, persistent or irreversible sexual side effects. These agents interfere with… Read more: The impact of the 5α-reductase inhibitors (5α-RIs) on male sexual function and psychological well-being.
- Persistent sexual dysfunction and suicidal ideation in young men treated with low-dose finasteride: a pharmacovigilance study.Overview of Sexual Dysfunction (SD) and Suicidal Ideation (SI) Reports: A total of 15,518 adverse event reports were submitted [to the FDA] for low-dose finasteride between 1998 and 2013, corresponding to 4910 reports submitted for men aged 18–45 years. Persistent SD and SI adverse events accounted for 11.8% (577 reports) and 7.9% (39 reports), respectively,… Read more: Persistent sexual dysfunction and suicidal ideation in young men treated with low-dose finasteride: a pharmacovigilance study.
- Adverse event reporting in clinical trials of finasteride for androgenic alopecia: a meta-analysis.Results: Of 34 clinical trials, none had adequate safety reporting, 19 were partially adequate, 12 were inadequate, and 3 reported no adverse events. Funnel plots were asymmetric with a bias toward lower odds ratio for sexual adverse effects, suggesting systematic underdetection. No reports assessed the adequacy of blinding, 18 (53%) disclosed conflicts of interest, and… Read more: Adverse event reporting in clinical trials of finasteride for androgenic alopecia: a meta-analysis.
- Safety concerns regarding 5α reductase inhibitors for the treatment of androgenetic alopecia.Recent postmarketing reports and a US Food and Drug Administration analysis have documented uncommon persistent sexual and nonsexual side-effects in a subset of younger men who have taken finasteride 1 mg for androgenic alopecia. While the mechanisms of the sexual side-effects in humans is incompletely understood, one study found lower cerebrospinal fluid concentrations of dihydrotestosterone,… Read more: Safety concerns regarding 5α reductase inhibitors for the treatment of androgenetic alopecia.
- Persistent sexual, emotional, and cognitive impairment post-finasteride: a survey of men reporting symptoms.Finasteride is a synthetic 5-α reductase inhibitor, which prevents the conversion of testosterone to dihydrotestosterone and has been used for more than 20 years in the treatment of male pattern hair loss. Randomized, controlled trials have associated finasteride with both reversible and persistent adverse effects. In this pilot study, we sought to characterize sexual and… Read more: Persistent sexual, emotional, and cognitive impairment post-finasteride: a survey of men reporting symptoms.
- Androgen levels and semen parameters among former users of finasteride with persistent sexual adverse effects.Recent postmarketing studies and the [FDA] have found that finasteride, 1 mg, for androgenic alopecia has been associated with persistent sexual and nonsexual adverse effects. The present study was designed to assess whether otherwise healthy former users of finasteride with persistent sexual adverse effects have a higher prevalence of low serum androgens and spermatogenic deficits.…… Read more: Androgen levels and semen parameters among former users of finasteride with persistent sexual adverse effects.
- Immunohistochemical evaluation of androgen receptor and nerve structure density in human prepuce from patients with persistent sexual side effects after finasteride use for androgenetic alopecia.Finasteride is still one of the most common therapeutic drugs prescribed for AGA, a distinctive alopecia pattern involving hairline recession and vertex balding, a condition more frequent with increasing age… However, treatment of young subjects is of increasing concern due to accumulating evidence that daily use of oral finasteride has several severe adverse effects. Our… Read more: Immunohistochemical evaluation of androgen receptor and nerve structure density in human prepuce from patients with persistent sexual side effects after finasteride use for androgenetic alopecia.
- The dark side of 5α-reductase inhibitors’ therapy: sexual dysfunction, high gleason grade prostate cancer and depression.A substantial body of evidence exists which points to serious and potentially ill-health effects of [finasteride and dutasteride] therapy. These include loss or reduced libido, erectile dysfunction, orgasmic and ejaculatory dysfunction, development of high-grade PCa tumors, potential negative cardiovascular events, and depression. The side effects are potentially harmful in some individuals and in young men… Read more: The dark side of 5α-reductase inhibitors’ therapy: sexual dysfunction, high gleason grade prostate cancer and depression.
- Patients treated for male pattern hair with finasteride show, after discontinuation of the drug, altered levels of neuroactive steroids in cerebrospinal fluid and plasma.Observations performed in a subset of patients treated for male pattern hair loss indicate that persistent sexual side effects as well as anxious/depressive symptomatology have been reported even after discontinuation of finasteride treatment. Due to the capability of finasteride to block the metabolism of progesterone (PROG) and/or testosterone (T) we have evaluated, by liquid chromatography–tandemmass… Read more: Patients treated for male pattern hair with finasteride show, after discontinuation of the drug, altered levels of neuroactive steroids in cerebrospinal fluid and plasma.
- Change in sexual function in men with lower urinary tract symptoms/benign prostatic hyperplasia associated with long-term treatment with doxazosin, finasteride and combined therapy.This study significantly extends understanding of the effects of long-term treatment with these drugs on sexual function in men with lower urinary tract symptoms associated with benign prostatic hyperplasia. Treatment with finasteride or combined therapy was associated with worsening sexual function while treatment with doxazosin alone was associated with minimal negative impact if any. Physicians… Read more: Change in sexual function in men with lower urinary tract symptoms/benign prostatic hyperplasia associated with long-term treatment with doxazosin, finasteride and combined therapy.
- Neuroactive steroid levels are modified in cerebrospinal fluid and plasma of post-finasteride patients showing persistent sexual side effects and anxious/depressive symptomatology.Introduction: Observations performed in a subset of subjects treated with finasteride (an inhibitor of the enzyme 5α-reductase) for male pattern hair loss seem to indicate that sexual dysfunction, as well as anxious/depressive symptomatology, may occur at the end of the treatment and continue after discontinuation. Aim: A possible hypothesis to explain depression symptoms after finasteride… Read more: Neuroactive steroid levels are modified in cerebrospinal fluid and plasma of post-finasteride patients showing persistent sexual side effects and anxious/depressive symptomatology.
- Decreased alcohol consumption among former male users of finasteride with persistent sexual side effects: a preliminary report.Background: There is a robust literature in rodents, but not in humans, on the interaction between finasteride and alcohol, particularly as it relates to neurosteroids. Finasteride has been shown to reduce alcohol intake and suppress alcohol preference in male mice. This study examines the role of finasteride in alcohol consumption in humans with male pattern… Read more: Decreased alcohol consumption among former male users of finasteride with persistent sexual side effects: a preliminary report.
- Effects of 5-alpha reductase inhibitors on erectile function, sexual desire and ejaculation.Clinical trials with 5ARI report prevalence rates of de novo erectile dysfunction of 5 – 9%. Decreased circulating dihydrotestosterone (DHT) resulting from 5ARI use is associated with diminished sexual desire and/or orgasm. The presence of adverse sexual effects is associated with decreased self-esteem, quality of life and ability to maintain an intimate relationship. Inhibition of… Read more: Effects of 5-alpha reductase inhibitors on erectile function, sexual desire and ejaculation.
- Persistent sexual side effects of finasteride: could they be permanent?In a group of 54 otherwise healthy former users of finasteride who developed persistent sexual side effects that lasted for at least 3 months, 96% continued to experience these effects when reassessed 9–16 months (mean 14 months) later, raising the possibility of permanent effects. To explain the long-term neurological effects of finasteride, it is possible… Read more: Persistent sexual side effects of finasteride: could they be permanent?
- 5α-reductases in human physiology: an unfolding story.5α-reductases are a family of isozymes that play a critical role in transformation not only of testosterone but also of progesterone, DOC, aldosterone, and cortisol into a host of neuro-active steroids that regulate a multitude of functions in human physiology… the neuro-active steroid hormones modulate a multitude of functions in human physiology encompassing regulation of… Read more: 5α-reductases in human physiology: an unfolding story.
- Depressive symptoms and suicidal thoughts among former users of finasteride with persistent sexual side effects.In a group of 61 otherwise healthy former users of finasteride who developed persistent sexual side effects, depressive symptoms were present and categorized as mild in 11% of users, moderate in 28% of users, and severe in 36% of users. Suicidal thoughts were present in 39% of former finasteride users, and an additional 5% chose… Read more: Depressive symptoms and suicidal thoughts among former users of finasteride with persistent sexual side effects.
- Persistent sexual side effects of finasteride for male pattern hair loss.A subset of otherwise healthy men taking finasteride for MPHL developed persistent sexual side effects in temporal association with the medication. Most men developed sexual dysfunction in multiple domains with 94% experiencing low libido, 92% experiencing erectile dysfunction, 92% experiencing decreased arousal, and 69% experiencing problems with orgasm…. The mean duration of the persistent sexual… Read more: Persistent sexual side effects of finasteride for male pattern hair loss.
- Adverse side effects of 5α-reductase inhibitors therapy: persistent diminished libido and erectile dysfunction and depression in a subset of patients.5a-RIs therapy, while improving urinary symptoms in patients with BPH and may prevent hair loss, produce significant adverse effects in some individuals including loss of libido, ED, ejaculatory dysfunction, and potential depression. They are serious enough to preclude them from pursuing such therapy…. The effects of these agents on vascular health should also be noted… Read more: Adverse side effects of 5α-reductase inhibitors therapy: persistent diminished libido and erectile dysfunction and depression in a subset of patients.