Advances in Knowledge of Androgens: How Intentional and Accidental Neurosteroid Changes Inform Us of Their Action and Role

    December 2020 in “ Current Sexual Health Reports
    Cheryl A. Frye, Dan DaCosta, Vincenzo Lembo, Alicia A. Walf
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    TLDR Finasteride can have lasting negative effects on brain function and behavior by disrupting neurosteroid production.
    The document from December 1, 2020, reviews the impact of androgens and neurosteroids on behavior, cognition, and brain protection, emphasizing the significant effects of finasteride, a 5α-reductase inhibitor used to treat male pattern baldness and benign prostate hyperplasia. Finasteride disrupts the conversion of testosterone to dihydrotestosterone, leading to altered hormone levels and neurosteroid production, which can result in feminizing and demasculinizing effects, mood disorders, and persistent psychopathologies known as post-finasteride syndrome. The document cites studies indicating that finasteride users have lower levels of certain neurosteroids in cerebrospinal fluid and plasma, with lasting dysregulation even after drug cessation. Animal studies also show that finasteride affects reproductive, social, cognitive, and affective behavior, suggesting profound neurological and behavioral consequences. The document concludes that the effects of finasteride extend beyond its clinical applications, with potential adverse impacts on brain function due to its effect on neurosteroid production.
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