Over the past 12 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 63 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.

- 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 age of 40 who use finasteride for alopecia are at risk for suicide if they develop persistent sexual adverse effects and insomnia. Physicians need more awareness regarding the decrease of PSA due to 5ARIs of 50% after 6 to 12 months use which can mask high-grade prostate cancer. They should restrict the 5ARIs to patients with a prostate volume of >40 ml according the EAU guideline 2023. Therapeutic innovation is urgently needed that might cure or relieve this wide range of health risks.
Leliefeld, H.H.J., Debruyne, F.M.J. & Reisman, Y: IJIR, 2023, Sept. 11 https://doi.org/10.1038/s41443-023-00759-5. [International Journal of Impotence Research]
- Exploring Rat Corpus Cavernosum Alterations Induced by Finasteride Treatment and Withdrawal
Data 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 the levels of its first product, DHT. Therefore, our observations indicated that a subchronic treatment with this drug, in addition to what we previously reported in plasma, also locally decreases the levels of DHT.
Melcangi RC, Diviccaro S, Herian M, Cioffi L, Audano M, Mitro N, Caruso D, Giatti S: Aug. 24, 2023 https://doi.org/10.1111/andr.13515 [Andrology]
- Beliefs and counseling practices among dermatologists regarding sexual and other adverse effects of finasteride
Despite 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 MS, Sanz J, Lin D, Tan N, Dommasch E, IJIR, 2023, Aug. 4. https://doi.org/10.1038/s41443-023-00750-0. [International Journal of Impotence Research]
- Neuropsychiatric Reactions to Finasteride: Nocebo or True Effect?
Brezis M, J Basic Clin Pharma. 2023;14(1):220-222. [Journal of Basic and Clinical Pharmacy]
- Vascular, Neurologic and Hormonal Abnormalities in Men with Persistent Sexual Dysfunction After Discontinuation of Finasteride
Carlisle M, Uloko M, Yee A, Goldstein S, Goldstein I: J. Urol., 2022. https://doi.org/10.1097/JU.0000000000002592.07 [The Journal of Urology]
- Gut Inflammation Induced by Finasteride Withdrawal: Therapeutic Effect of Allopregnanolone in Adult Male Rats
Diviccaro, S; Giatti, S; Cioffi, L; Falvo, E; Herian, M; Caruso, D; Melcangi, RC. Gut Inflammation Induced by Finasteride Withdrawal: Therapeutic Effect of Allopregnanolone in Adult Male Rats. Biomolecules 2022, 12, 1567. https://doi.org/10.3390/biom12111567 [Biomolecules]
- Global online interest in finasteride sexual side effects
Asanad, K., Sholklapper, T., Samplaski, M.K. et al. Global online interest in finasteride sexual side effects. Int J Impot Res (2022). https://doi.org/10.1038/s41443-022-00612-1 [International Journal of Impotence Research]
- Diagnostic criteria for enduring sexual dysfunction after treatment with antidepressants, finasteride and isotretinoin
Healy D, Bahrick A, Bak M, Barbato A, Calabrò RS, et al. doi: 10.3233/JRS-210023. 2021 Oct 26. [International Journal of Risk & Safety in Medicine]
- How routine pharmacovigilance failed to identify finasteride’s persistent sexual side effects
- Differential Gene Expression in Post-Finasteride Syndrome Patients
- 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-Target
- The potential involvement of cholinergic system in finasteride induced cognitive dysfunction
- Investigation of Suicidality and Psychological Adverse Events in Patients Treated With Finasteride
- Alterations of gut microbiota composition in post-finasteride patients: a pilot study
- Repeated finasteride administration induces depression-like behavior in adult male rats
- Allopregnanolone, the Neuromodulator Turned Therapeutic Agent: Thank You, Next?
- Macular Abnormalities Associated With 5α-Reductase Inhibitor
- 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 alopecia
- 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
- Finasteride and Suicide: A Postmarketing Case Series
- Post-finasteride syndrome: a surmountable challenge for clinicians
- Post-finasteride syndrome: An emerging clinical problem
- 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.
- 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.
- 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.
- The post-finasteride syndrome: clinical manifestation of drug-induced epigenetics due to endocrine disruption.
- 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.
- Emotional consequences of finasteride: fool’s gold.
- 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.
- 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.
- 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.
- 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.
- 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?
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- Effects of 5-alpha reductase inhibitors on erectile function, sexual desire and ejaculation.
- Persistent sexual side effects of finasteride: could they be permanent?
- 5α-reductases in human physiology: an unfolding story.
- 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.
- Adverse side effects of 5α-reductase inhibitors therapy: persistent diminished libido and erectile dysfunction and depression in a subset of patients.