Purpose of Review
A constellation of persistent adverse effects—collectively termed post-finasteride syndrome (PFS)—after 5α-reductase inhibitor treatment for benign prostatic hyperplasia (BPH) and androgenic alopecia (AGA) has recently been described. The severity of these sexual, physical, neurological, and psychiatric side effects raises important concerns regarding the treatment of these conditions, especially given the prevalence of indications for these medications. Here we review the literature exploring the symptoms, proposed mechanisms, and potential disease modulating factors for PFS.
While the persistent sexual side effects associated with PFS are well documented, research on the physical, neurological, and psychiatric adverse effects is much less ubiquitous. Though the mechanisms leading to PFS have been proposed, a clear treatment plan for these patients has not been established. In the treatment of BPH and AGA with 5α-reductase inhibitors, the risks of PFS should be considered.
The occurrence of persistent adverse sexual, physical, neurological, and psychiatric side effects after 5α-reductase inhibitor is well supported by the existing data. While additional studies are needed to better evaluate the role of 5α-reductase inhibitors in the manifestation of the symptoms of PFS, the risks of PFS should be critically evaluated when treating patients with BPH or AGA.
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Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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Conflict of Interest
Jeffrey K Than and Katherine Rodriguez declare no conflicts of interest; Mohit Khera reports research support from the Post-Finasteride Foundation and Boston Scientific, and consulting fees from Boston Scientific, Abbvie, Endo, and Coloplast, outside the submitted work.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
This article is part of the Topical Collection on Male Sexual Dysfunction and Disorders
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Than, J.K., Rodriguez, K. & Khera, M. Post-finasteride Syndrome: A Review of Current Literature. Curr Sex Health Rep 10, 152–157 (2018). https://doi.org/10.1007/s11930-018-0163-4
- Post-finasteride syndrome
- Benign prostatic hyperplasia
- Androgenic alopecia