What is Post-Finasteride Syndrome?

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If you have heard of Finasteride before, you may or may not know about post-finasteride syndrome (PFS). Whether you are taking or considering Finasteride to treat male pattern baldness (male androgenetic alopecia) or benign prostatic hyperplasia, it is crucial to be aware of this devastating and life-altering condition so that you can spot it early. Many users are unaware of PFS and experience persistent side effects once they stop using Finasteride.

In this blog, we discuss whether post-finasteride syndrome is real, what causes it, the variety of symptoms, how to treat it and how it can be prevented.

 

Table of Contents

Is Post-Finasteride Syndrome Real?

Post-finasteride syndrome is a condition that is characterised by a range of persistent symptoms that occur after a course of Finasteride has stopped. Not all Finasteride users will be affected by PFS because it is a very rare condition. One study estimates over 1,000 men experience PFS worldwide. [1] This is a relatively low number of cases, considering there are millions of Finasteride users worldwide.

While there are ongoing debates about the existence of post-finasteride syndrome, only a few studies have shown evidence of the condition. More research is needed to understand it in further detail. 

How Do You Tell If You Have Post-Finasteride Syndrome? 

You can tell if you have post-finasteride syndrome if you experience any of the following common symptoms after discontinuing the use of Finasteride [2]:

Physical

  • Muscle wastage and twitching
  • Gynecomastia (breast tissue swelling)
  • Fatigue
  • Dry eyes and skin
  • Metabolic changes
  • Digestion problems
  • Tooth and gum problems
  • Bone problems

Sexual 

  • Erectile dysfunction
  • Loss of libido and sexual desire
  • Penile and testicular changes
  • Ejaculatory disorders
  • Pleasureless orgasm

Neurological

  • Depression
  • Brain fog
  • Anxiety
  • Dizziness
  • Insomnia (difficulty falling/staying asleep)
  • Memory impairment
  • Tinnitus (ringing in the ear)
  • Blurred vision
  • Suicidal thoughts
  • Anhedonia (inability to experience pleasure)

Some of these symptoms are similar to the side effects of Finasteride such as loss of libido and erectile dysfunction. However, on-drug side effects are not classified as PFS symptoms.

In a post-finasteride syndrome survey completed by the PFS network, 427 submissions were received. Results showed over 50% of the respondents used Finasteride for 200 days or less and reported a variety of symptoms including muscle cramps, twitching, thin skin, fatigue and muscle weakness. [3]

What Causes Post-Finasteride Syndrome?

The exact cause of post-finasteride syndrome is not fully clear. However, it is believed to be related to the way Finasteride impacts the body’s production of a hormone called dihydrotestosterone (DHT). Finasteride is an active ingredient used to treat male pattern baldness and it works by reducing an enzyme that is responsible for converting testosterone into dihydrotestosterone (DHT). Finasteride 1mg is the recommended daily dosage for treating male pattern baldness. While it provides clinically proven hair growth results, it may impact the body’s hormonal levels, causing symptoms of PFS.

Other research suggests that genes may play a role in post-finasteride syndrome. In a study of the clinical characteristics and genetic variants in post-finasteride syndrome patients, 3 males aged between 20 and 30 years with a PFS duration of 1 to 3 years were enrolled. The male patients were reported to suffer from erectile dysfunction, anxiety, feelings of isolation, and insomnia. After analysing their clinical and genetic information, variants in genes were detected and these genes showed potential risk genes. [4]

How Long Can Post-Finasteride Syndrome Last?

There is no research yet that indicates exactly how long post-finasteride syndrome can last. Individuals with PFS can experience persistent symptoms for weeks, months, or even years after stopping a course of Finasteride.

What is the Treatment for Post-Finasteride Syndrome?

As of yet, there is no approved or evidence-based treatment for post-finasteride syndrome. [5]  

In the meantime, symptoms of PFS can be relieved by maintaining a healthy lifestyle, getting regular exercise, as well as limiting alcohol and caffeinated drinks. For depression and anxiety-related symptoms, speaking with a therapist can help improve mental health and well-being.

How to Prevent Post-Finasteride Syndrome?

If you have recently discontinued the use of Finasteride, it’s important to keep track of any unusual symptoms and consult with your healthcare provider if you feel worried or concerned. As mentioned before, post-finasteride syndrome is a very rare condition so it wouldn’t affect the majority of Finasteride users, even long-term users. 

If you want to avoid the risk of developing PFS, there are Finasteride alternatives available for male pattern baldness such as Minoxidil. However, Finasteride is an FDA-approved and UK-licensed medication and results from alternatives may not be as effective. 

Is Finasteride Safe to Take?

In general, Finasteride is a safe and well-tolerated medication for men with male pattern baldness. Despite this, all prescription medications come with potential side effects. Finasteride may cause decreased sex drive or erectile dysfunction (affecting 1 in 100 people). [6]

Luckily, common side effects of Finasteride typically decrease after a while. If you are struggling with male pattern baldness and considering Finasteride, please speak to your healthcare provider about the potential side effects and post-finasteride syndrome. 

Sources

  1. International Journal of Trichology. (2018). A Comment on the Post-Finasteride Syndrome. Retrieved on 23rd August 2024, from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6369643/
  2. PFS Network. (n.d). Common symptoms of Post-Finasteride Syndrome. Retrieved on 23rd August 2024, from: https://www.pfsnetwork.org/symptoms
  3. MHRA. (2024). Safety review of Finasteride. Retrieved on 23rd August, from: https://assets.publishing.service.gov.uk/media/6630abd087bdbae4ab19adc9/Finasteride_PAR_Accessible.pdf
  4. Translational Andrology and Urology. (2022). Case report: a study of the clinical characteristics and genetic variants of Post-Finasteride syndrome patients. Retrieved on 23rd August 2024, from: https://pubmed.ncbi.nlm.nih.gov/36386264/
  5. Fertil Steril. (2020). Post-Finasteride syndrome: a surmountable challenge for clinicians. Retrieved on 23rd August 2024, from: https://pubmed.ncbi.nlm.nih.gov/32033719/
  6. NHS. (n.d.). Side effects of Finasteride. Retrieved on 23rd August 2024, from: https://www.nhs.uk/medicines/finasteride/side-effects-of-finasteride/

Whilst all of our content is written and reviewed by healthcare professionals, it is not intended to be substituted for or used as medical advice. If you have any questions or concerns about your health, please speak to your doctor.