Diagnostic Criteria for Enduring Sexual Dysfunction After Treatment With Antidepressants, Finasteride, and Isotretinoin

October 2021 in “ The international journal of risk and safety in medicine ”

David Healy, Audrey S. Bahrick, Maarten Bak, Angelo Barbato, Rocco Salvatore Calabrò, Barbara Chubak, Fiammetta Cosci, Antonei B. Csoka, Barbara D'Avanzo, Silvia Diviccaro, Silvia Giatti, Irwin Goldstein, Heiko Graf, Wayne J.G. Hellstrom, Michael S. Irwig, Emmanuele A. Jannini, Paddy K.C. Janssen, Mohit Khera, Manoj Therayil Kumar, Joanna Le Noury, Michał Lew-Starowicz, David Edmund Johannes Linden, C. Lüning, Dee Mangin, Roberto Cosimo Melcangi, Omar Walid Muquebil Ali Al Shaban Rodríguez, Jalesh N. Panicker, Arianna Patacchini, Amy M. Pearlman, Caroline F. Pukall, Sanjana Raj, Yacov Reisman, Rachel Rubin, Rudy Schreiber, Stuart Shipko, Barbora Vašečková, Ahad Waraich

finasteride isotretinoin antidepressants post-SSRI sexual dysfunction PSSD post-finasteride syndrome PFS post-retinoid sexual dysfunction PRSD erectile dysfunction antipsychotics NOACs Propecia Accutane SSRIs

Studysummary This paper describes the development of diagnostic criteria for several enduring sexual dysfunction conditions following the use of certain medications, highlighting common sexual and non-sexual symptoms. Our plain-language summary of this paper — not a Tressless recommendation.

The document establishes diagnostic criteria for enduring sexual dysfunctions following the use of antidepressants, finasteride, and isotretinoin, including conditions like post-SSRI sexual dysfunction (PSSD), post-finasteride syndrome (PFS), and post-retinoid sexual dysfunction (PRSD). Common symptoms are decreased genital sensation, reduced sexual desire, and erectile dysfunction. The criteria were developed from two large case series and refined by a multidisciplinary panel to improve diagnosis and research, acknowledging potential future adjustments. The document also introduces Post-SSRI asexuality, linked to early SSRI exposure, and notes that similar dysfunctions may arise from other drugs like antipsychotics and NOACs.

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research Alterations of Gut Microbiota Composition in Post-Finasteride Patients: A Pilot Study

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This study found that the gut microbiota composition in patients with post-finasteride syndrome differs significantly from healthy controls, with reduced diversity and specific microbial changes, suggesting a potential diagnostic marker and therapeutic target.

Penile Vascular Abnormalities in Young Men with Persistent Side Effects After Finasteride Use for the Treatment of Androgenic Alopecia

research Penile Vascular Abnormalities in Young Men with Persistent Side Effects After Finasteride Use for the Treatment of Androgenic Alopecia

7 citations , June 2020 in “Translational Andrology and Urology”

This study evaluated potential penile vascular changes and persistent adverse effects in men discontinuing 5α-reductase inhibitors for androgenic alopecia, but no new clinical results were reported.

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This study found that post-finasteride syndrome patients showed a tissue-specific methylation pattern of the SRD5A2 promoter in cerebrospinal fluid, potentially affecting neuroactive steroid levels and related behavioral symptoms.

research Enduring Sexual Dysfunction After Treatment With Antidepressants, 5α-Reductase Inhibitors, and Isotretinoin: 300 Cases

54 citations , May 2018 in “International journal of risk & safety in medicine”

This study observed enduring sexual dysfunction reported in 300 cases globally following the use of SSRIs, finasteride, and isotretinoin, with common symptoms like genital anaesthesia and loss of libido.

research Post-Finasteride Syndrome and Post-SSRI Sexual Dysfunction: Two Sides of the Same Coin?

40 citations , April 2018 in “Endocrine”

This review discusses post-SSRI sexual dysfunction and post-finasteride syndrome, highlighting unknowns about their true incidence and underlying causes, and reports no new clinical results.

research Neuroactive Steroid Levels and Psychiatric and Andrological Features in Post-Finasteride Patients

58 citations , April 2017 in “The Journal of Steroid Biochemistry and Molecular Biology”

This study found that patients with post-finasteride syndrome exhibited major depressive disorder, severe erectile dysfunction, and neuropathy, alongside altered neuroactive steroid levels in cerebrospinal fluid.

research Organic Causes of Erectile Dysfunction in Men Under 40

2152 citations , November 2013 in “Urologia Internationalis”

This study reviews the significant prevalence of organic etiologies, especially vascular causes, in erectile dysfunction among men under 40 and emphasizes thorough evaluation and consideration of treatment options like exercise and PDE-5 inhibitors.

research Persistent Sexual Side Effects of Finasteride for Male Pattern Hair Loss

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This study found that 94% of healthy men reported low libido and 92% reported erectile dysfunction as persistent sexual side effects after using finasteride for male pattern hair loss, with these effects lasting on average 40 months post-discontinuation.