Post-Finasteride syndrome (PFS) is an emerging area of clinical concern. This condition is characterised by Finasteride side effects that continue even after you stop taking the drug.
While there are plenty of anecdotal reports of persistent Finasteride symptoms, there’s currently limited research into the causes and even existence of post-Finasteride syndrome. It’s also extremely rare — one study suggests approximately 1,000 men worldwide have PFS symptoms .
So what do we know about PFS so far? In this article, you’ll learn:
- What post-Finasteride syndrome is (and whether it’s a real condition)
- How common PFS is and how long it lasts
- How to spot and treat post-Finasteride syndrome.
What is post-Finasteride syndrome?
Post-Finasteride syndrome is a condition in which side effects related to Finasteride use continue after you stop taking the drug. These side effects can include :
- Sexual dysfunction (including erectile dysfunction and low libido)
- Low mood (including depression and anxiety)
- Cognitive problems (such as brain fog).
In most cases, side effects cease when they stop taking Finasteride [3-4]. But there have been rare reports of ongoing symptoms despite stopping Finasteride — this is known as post-Finasteride syndrome .
Is post-Finasteride syndrome real?
Post-Finasteride syndrome is a relatively recent discovery. Only a few studies have explored the existence of the condition, so a lot more research is needed to establish if and why it occurs.
But the limited evidence indicates that post-Finasteride syndrome is a real condition with genuine symptoms . At the very least, it’s real enough that medical regulators in the UK and Sweden now require Finasteride product information leaflets to disclose the risks of long-term side effects, even if you stop taking Finasteride .
That said, some researchers have noted that many patients reporting PFS may be experiencing a nocebo effect. The nocebo effect is the opposite of a placebo effect. It happens when patients experience negative side effects from a treatment or medication due to their belief that it will cause harm. In this case, patients expect to experience ongoing problems after Finasteride use, which can trigger long-term side effects or lead to overreporting.
Some researchers believe the nocebo effect may affect many patients reporting PFS symptoms . Online interest in PFS soared after the FDA warned about sexual side effects related to Finasteride . So increased awareness of the problem may actually be making it worse.
Post-Finasteride syndrome symptoms
The most common symptoms of post-Finasteride syndrome are :
- Erectile dysfunction
- Low libido
- Difficulty achieving orgasm
- Reduced arousal
- Depression and low mood
- Brain fog
- Finasteride-related gynecomastia
Experiencing these adverse effects while taking Finasteride isn’t a symptom of PFS. PFS only occurs after you stop taking the drug.
What causes post-Finasteride syndrome?
The trigger for PFS is taking Finasteride. But the syndrome doesn’t affect all or even most Finasteride users. So what causes some people to experience it while others don’t?
Finasteride is designed to stop the 5-alpha reductase enzyme converting testosterone to dihydrotestosterone (DHT). But Finasteride may also affect the function of other steroids that occur naturally in your body [2, 8]. One study observed notably lower levels of the following steroids in PSF patients compared with healthy patients :
PSF patients also had higher levels of dehydroepiandrosterone, testosterone, and 3α-androstanediol. While it’s unclear exactly how these changes lead to PFS, Finasteride clearly has a much broader impact on the body than hair loss patients might realise.
Having a pre-existing mental health condition like depression may also be a risk factor for developing PFS .
How common is post-Finasteride syndrome?
The number of men affected by post-Finasteride syndrome isn’t yet known, but it seems to be very rare. One study estimates approximately 1,000 men worldwide experience PFS . This makes the incidence rate extremely low, given that there are more than two million Finasteride users in the US alone .
How long does post-Finasteride syndrome last?
No studies have yet confirmed how long PFS symptoms can last. One research study found that side effects could persist for 40 months or more after stopping Finasteride use, though this was just until the time of interview . Symptoms may have persisted for longer. In these cases, the men surveyed had taken Finasteride for an average of 28 months.
However, it’s important to note that while these patients reported adverse side effects, they weren’t scientifically assessed. So the nocebo effect may have been in play here.
PFS: treatment and recovery
As yet, there are no confirmed treatments for post-Finasteride syndrome treatment. Hormonal treatments are unlikely to be successful . Much more research is needed to find and test treatments for PFS.
In the meantime, the best way to tackle PFS is to treat your symptoms. See your GP for advice, and use tried and tested methods to relieve symptoms. For example, getting regular exercise, eating a healthy diet, and using coping techniques may help improve feelings of anxiety.
Should you take Finasteride?
While post-Finasteride syndrome is an understandable concern for many Finasteride users, remember that it’s a very uncommon condition. Most evidence suggests Finasteride is safe and effective for treating hair loss . These Finasteride results show just how effective it can be as a hair loss treatment:
Finasteride results in a 25-year-old male patient.
Finasteride effectiveness at baseline, 12 months, and 24 months.
But as with any pharmaceutical treatment, there’s a risk of lingering side effects. These usually clear up soon after you stop taking the medication. So you must use your own judgement to decide if the potential benefits outweigh the potential risks. If you’re worried about the repercussions of using Finasteride, consider trying one of these Finasteride alternatives.
To learn more about whether Finasteride is the right treatment for you, read more in our Finasteride series:
- A Comment on the Post-Finasteride Syndrome
- Post-finasteride syndrome: An emerging clinical problem
- Use of Finasteride in the Treatment of Men With Androgenetic Alopecia (Male Pattern Hair Loss)
- Finasteride and sexual side effects
- Persistent sexual side effects of finasteride for male pattern hair loss
- Post-finasteride syndrome: a surmountable challenge for clinicians
- Global online interest in finasteride sexual side effects
- Neuroactive steroid levels and psychiatric and andrological features in post-finasteride patients
- Post-Finasteride Syndrome: An Induced Delusional Disorder with the Potential of a Mass Psychogenic Illness?
- Finasteride | Drug Usage Statistics 2020
- Relative Efficacy of Minoxidil and the 5-α Reductase Inhibitors in Androgenetic Alopecia Treatment of Male Patients
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