Post-Finasteride Syndrome

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Current research has left the medical field in astonishment.

Worrying about a medication utilized by an abundant quantity of men has unveiled an increasing amount of distressing reactions.

Research on the topic is ongoing, but it has been proposed that the drug finasteride (Proscar), usually prescribed for treating prostate problems and male pattern baldness, affects areas of the brain associated with long-term memory and emotional reactions.

What is Finasteride?

Finasteride blocks the 5-alpha-reductase enzyme, avoiding its ability to turn testosterone into DHT. Finasteride can be taken in the form of tablets or applied topically.

Finasteride Uses

A medication called Finasteride is an effective treatment for the symptoms of BPH (benign prostatic hyperplasia), such as frequent urination, urinary retention, and difficulty passing urine.

It is possible to combat hair loss in males through a measure that keeps the body from creating the hormone in the area of the head that blocks hair development.

How does Finasteride work?

So, how does finasteride work?

The extent and magnitude of prostate enlargement are largely influenced by the amount of DHT present. There are two kinds of 5 alpha-reductase; type 1 is present in tissues like the liver or skin, and type 2 is the most common type seen in the prostate.

This enzyme is essential for the usual growth of the prostate, as well as its enlarged development over time. Finasteride functions as a blocker of the type 2 5α-reductase enzyme.

It appears that Finasteride does reduce the size of the prostate, suggesting that it has some positive effects. Research has suggested that there may be a decrease in the amount of prostate-specific antigen PSA in males in certain cases.

The greatest advantages are seen in men who have prostates larger than 40 g. It provides around 20% more relief than what was present a year ago by shrinking the prostate.

Research indicates that the drug Finasteride Propecia lessens the amount of intraprostatic DHT by nearly 92%. Despite worries about the enormous cutback, people who are in favor of it and Merck have argued that Finasteride (Propecia) does not decrease the DHT levels to the extent where it would be the equivalent of chemical castration.

The reason behind this is that the type 1 isoenzyme found in the skin and liver changes the amount of testosterone circulating in the body into DHT. It can be argued that out of all the medicines studied, Finasteride could have the most severe sexual results.

What Are the Side Effects of Finasteride?

Flomax can not just alter the brain but also can have various negative effects. These side effects include:

  • erectile dysfunction/ sexual dysfunction
  • loss of libido, penile shrinkage
  • insomnia
  • muscle atrophy
  • depression
  • lack of mental concentration

Post-Finasteride Syndrome: Established Facts

  • Finasteride represented a major breakthrough in the treatment of male pattern hair loss, based on an understanding of the underlying pathophysiology and observations on the respective genetic defect of 5-alpha-reductase.
  • Clinical studies have demonstrated both a high efficacy of treatment and a very favorable safety profile, establishing the drug as first-line treatment of male pattern hair loss.
  • More recently, post-finasteride syndrome (PFS) has been claimed to occur in men who have taken oral finasteride to treat either hair loss or benign prostatic hyperplasia. The condition is characterized by sexual dysfunction, somatic symptoms, and psychological disorders that persist after cessation of fi­nasteride treatment.

Novel Insights

  • We present the first case of PFS in our 20-year prescription practice of oral finasteride for the treatment of male pattern baldness, with circumstantial evidence that PFS may represent a delusional disorder of the somatic type, possibly on a background of a histrionic personality disorder and with the potential of a mass psychogenic illness due to its media coverage.
  • PFS demonstrates analogies to controversial “mystery syndromes” as amalgam illness, multiple chemical sensitivity, Morgellons disease, and Koro: the symptoms cannot be adequately explained biologically, and the frequency of consultations for the respective condition parallels the media coverage, which points to a high degree of suggestibility.
  • PFS has obviously become a problem that has to be dealt with, preferentially, not on a nonprofessional public platform. There are no predictive factors for the risk of development of the PFS. Nevertheless, it would seem appropriate to ascertain a history of preexisting mental health issues, such as depression or histrionic personality disorder, with a strict selection of patients before starting treatment with fi­nasteride. Also, the management of PFS should be focused on the underlying psychopathological disorder.

It has been said that men who have ingested finasteride orally to deal with baldness or benign prostatic hyperplasia may suffer from post-finasteride syndrome (PFS). The condition is identified by features such as sexual troubles, physical symptoms, and psychological problems that do not go away after somebody stops taking finasteride, even though their age, amount taken, and why it was taken are not relevant. As of yet, medical professionals have not acknowledged this condition, although people with PFS experience very similar symptoms. People suffering from this condition might experience a decrease in sex drive, difficulty in achieving an erection, a decrease in the size of the penis, a reduction in sensitivity, enlargement of male breasts, the wasting away of muscle, difficulty concentrating, extremely dry skin, and depression.

In 1992, the US Food and Drug Administration (FDA) gave the go-ahead for the use of 5 mg oral finasteride to treat benign prostate hyperplasia, and four years later, in 1997, the same organization gave approval for the use of 1 mg oral finasteride for treating male pattern baldness. Despite finasteride having been used for a considerable length of time and on a global scale, Post-Finasteride Syndrome has only recently gained attention from the media. PFS has been suggested based on accounts from medical professionals who are not skin specialists, studies covering neurology and endocrinology, and studies with a lack of control and a high level of choice biasing. Additionally, it is evidently acknowledged that a significant nocebo effect can affect people after they find out about the potential side effects of finasteride. In the end, 2012 saw the rise of a health advocacy organization titled the Post-Finasteride Syndrome Foundation. The purpose of this foundation was to financially support research looking into the characteristics, biological processes and treatments of PFS, while increasing public knowledge/awareness of the condition.

The exact number of people dealing with the consequences of PFS is impossible to determine, but researchers believe it could be as high as 1,000 men all over the world. This calculation is based on the amount of members signed up on the online community

A 2010 Cochrane review indicated that in comparison to a placebo, men taking finasteride are more likely to experience difficulties with impotence, erectile dysfunction, decreased libido, and ejaculation in the first 12 months of treatment. However, these rates were similar to that of the placebo after two to four years and normally reduced over time. Professor Trüeb, at the Center for Dermatology and Hair Diseases, has prescribed oral finasteride regularly over a lengthy period of time, providing successful treatment of male pattern baldness.

Case Report

A Caucasian male in his mid-twenties who was originally seen at the age of 20 sought treatment for male pattern baldness at Hamilton-Norwood scale III vertex, using a 5% solution of minoxidil applied to the area twice daily. Later, a 10% solution of minoxidil sulfate was applied to the area once daily for four years without any successful results. After looking up the possible side effects of taking 1 mg of finasteride by mouth, it was determined that the 24-year-old should begin a treatment plan that combined that with topical minoxidil sulfate. After utilizing a combination of 1 mg of oral finasteride and 10% topical minoxidil sulfate therapy for 7 months, the outcome was still unfulfilling, prompting the swapping of finasteride to 0.5 mg of oral dutasteride. The patient taking finasteride did not mention any ill-effects. Dutasteride was concluded after a period of one month because of testicular discomfort. When the use of dutasteride was stopped, the discomfort in the testicles quickly vanished. After stopping taking finasteride and dutasteride for a total of 8 months, 4 months later the patient informed of having difficulties with getting an erection, coldness in the penis, testicular discomfort, less semen during ejaculation, and reduced interest in sex. At the moment, the amount of dihydrotestosterone in the serum was reduced, but eventually returned to normal. No further endocrinological abnormalities were found.

From Day One of the patient’s and his mom’s usage of finasteride and dutasteride, they have routinely e-mailed their apprehensions, as well as inquired regarding the safety of the medications and raised issues with the permanent sexual side effects listed on the labels. It is important to note the timing of the patient’s eventual complaint of PFS in relation to a news broadcast about the condition, wherein a person reported the effects only arising after discontinuing their oral finasteride use to address pattern baldness. The patient also admitted to consulting respective Internet fora.

When the patient stated they thought they had PFS, they were asked to come in for an appointment to look into the problem. Prior to consulting with the urologists, the man had already sought out their opinion to find the root of his reported symptoms, but the urologists were unable to detect any type of organic or endocrine abnormality. The patient seemed to be very sure of having PFS, despite any attempts to provide evidence to the contrary. They seemed unable to find any humor in the situation, and were highly sensitive to any criticism about their worry. Any effort to dispute his judgement brought about an intense emotional response, accompanied by discontentment and animosity. He showed a great deal of self-importance, and the mood surrounding his opinion was very tense. He stated that he had never experienced depression in the past and was not currently going through a period of depression.

Why Does Finasteride Continue to Be Sold?

In spite of the proof, and until the medical discussion is worked through, Finasteride can still be purchased, and alert labels are put in certain countries as a caution versus the post-finasteride syndrome.

This product is marketed as an aid in treating the signs of BPH and male pattern baldness. IQVIA, a company that conducts health industry research, reports that in the United States, between April 2017 and April 2018, more than half a billion tablets containing the drug Finasteride were issued.

Merck, the maker and distributor of finasteride, have asserted that they do not accept that reputable research exists that affirms Post-Finasteride Syndrome. Merck vouches for the effectiveness and security of Propecia.

Though this was declared, over the period of 2011 to the present day there have been 1,400 plus legal cases brought against Merck in the US and Canada.

In addition, legal complaints have stated that long-term sexual issues, reduced mental function, and sadness have resulted. In 2012, the FDA made it compulsory for the organization to modify the stating on Propecia labels with regards to adverse effects from “short-term” to “perpetual (see irreversible).”

“Warning Labels Not Enough”

As a result of the latest Finasteride scandal, we reached out to prostate health expert and metabolic disease specialist Ben Ong for a breakdown of the latest research, and what other options men facing prostate disease have:

Since 2008, European nations have wanted stronger cautionary labels on finasteride product packaging. Yet even they were unaware that the repercussions were lasting.

The FDA only gave in to demands and implemented the warning labels in 2012. They did not mention that any of the issues such as erectile dysfunction, decreased sexual desire or any difficulties with sexual performance would be enduring.

Rumors within the organization suggest that the FDA might require Finasteride to be recalled based on the outcome of the court cases.

The potential deterioration of Post-Finasteride Syndrome is particularly alarming, and the dangerous implications and devastating outcomes with regards to men’s mental health should not be taken lightly.

Can Finasteride Cause Cancer?

Previous clinical trials show that Proscar prevents low-grade cancer. The majority of the exams, including extensive long-term assessments, present congruous outcomes. Those using the medication are more likely to exhibit higher levels of prostate cancer.

The discovery that Proscar may be related to highly advanced prostate cancer was first made in 2013 when the Prostate Cancer Prevention Trial (PCPT) was conducted.

The clinical trial indicated that Finasteride had an increase in the amount of more serious prostate cancers. It was observed that the chance of developing prostate cancer was lowered by 25% for those who took part in the study. In response, the FDA placed a black box warning on the drug.

However, this question remains controversial.

New Research

Recent studies have demonstrated that taking Finasteride can lower the probability of having prostate cancer. Additionally, there is no heightened danger of death from prostate cancer. At the Annual American Urological Association Meeting in San Francisco, a speaker shared this information.

For the Prostate Cancer Prevention Trial, scientists randomly divided 18,882 males into two groups; one receiving the medication Finasteride, and the other being given a placebo between 1993 and 1997. The intervention ended in 2003.

Thompson and his team of collaborators compared individuals from the Prostate Cancer Prevention Study with details in the National Death Index, which is maintained by the Centers for Disease Control and Prevention. They looked over the information of 300,000 individuals in an 18.4 year period on average.

In the study, 42 participants who took Finasteride passed away due to prostate cancer, whereas 56 of those who took the placebo died from the same cause.

The results of the most modern study suggest that Finasteride does not heighten the chance of having high-grade prostate cancer. It is essential to consider the significant changes finasteride may have on both mental and physical wellness.

How to Shrink Your Prostate Without Finasteride or Deadly Side Effects

We are giving our readers the exclusive chance to view one of Ben’s unique video presentations for a brief period of time in order to benefit men with prostate problems or those who are concerned about their prostate health.

It is usually only accessible to exclusive customers, so we strongly suggest you view this video before the opportunity is gone. If you are a male over 50, or are familiar with someone who is, it is especially important for you to be aware of prostate disease, BPH, or healthcare providers measuring your PSA levels.


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