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

androgens neurosteroids finasteride 5α-reductase inhibitor testosterone dihydrotestosterone male pattern baldness benign prostate hyperplasia post-finasteride syndrome neurosteroid production cerebrospinal fluid plasma reproductive behavior social behavior cognitive behavior affective behavior Propecia DHT BPH

Studysummary This review discusses the role of neurosteroids and androgens throughout different life stages, noting the potential disruptions caused by 5α-reductase inhibitors like finasteride, but no new clinical results are reported. Our plain-language summary of this paper — not a Tressless recommendation.

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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