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

TLDR The document sets criteria for diagnosing long-term sexual dysfunctions caused by certain medications.

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 cited in this study

7 / 7 results

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

17 citations, September 2020 in “Journal of Endocrinological Investigation”

Post-finasteride patients show changes in gut bacteria, possibly causing various symptoms.

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”

Finasteride for hair loss may cause lasting sexual, genitourinary, mental, and anti-androgenic side effects in young men.

research Altered Methylation Pattern of the SRD5A2 Gene in the Cerebrospinal Fluid of Post-Finasteride Patients: A Pilot Study

8 citations, July 2019 in “Endocrine connections”

Finasteride affects SRD5A2 gene pattern, possibly causing lasting side effects.

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”

Antidepressants, 5α-reductase inhibitors, and isotretinoin can cause long-lasting sexual dysfunction.

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

40 citations, April 2018 in “Endocrine”

PFS and PSSD are similar conditions with persistent sexual dysfunction after stopping medication.

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”

Post-finasteride patients show changed neuroactive steroid levels, possibly causing erectile dysfunction and depression.

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

185 citations, March 2011 in “The Journal of Sexual Medicine”

Finasteride for hair loss can cause long-lasting sexual side effects like low libido and erectile dysfunction.

Similar Research

5 / 1000+ results

research Post-Finasteride Syndrome and Post-SSRI Sexual Dysfunction: Two Clinically Similar Conditions

November 2023 in “Frontiers in Neuroendocrinology”

Some people experience lasting sexual, psychological, and sleep problems after using finasteride or SSRI antidepressants, possibly due to similar underlying causes.

research PSSD, PFS, PRSD: A Perspective for Aetiology and Treatment

April 2023

The paper suggests that a decrease in estrogen receptor activity may cause sexual dysfunction syndromes and proposes hormonal treatments.

research Finasteride, Isotretinoin, and Serotonin Reuptake Inhibitors: A Study on Enduring Sexual Dysfunction

December 2018 in “Reactions Weekly”

Some medications may cause lasting sexual dysfunction.

Insights Into the Peripheral Nature of Persistent Sexual Dysfunction Associated With Post-Finasteride, Post-SSRI, and Post-Accutane Syndromes: Lessons Learned From a Case Study

research Insights Into the Peripheral Nature of Persistent Sexual Dysfunction Associated With Post-Finasteride, Post-SSRI, and Post-Accutane Syndromes: Lessons Learned From a Case Study

February 2025 in “International Urology and Nephrology”

Peripheral treatments showed some improvement in sexual dysfunction, but central symptoms remain challenging.

Post-Finasteride Syndrome: When Will We Get the Courage to Fight the Dictating Pharma Industry Despite Awareness of Sexual, Neurological, and Metabolic Side Effects in Young Men for Over a Decade

research Post-Finasteride Syndrome: When Will We Get the Courage to Fight the Dictating Pharma Industry Despite Awareness of Sexual, Neurological, and Metabolic Side Effects in Young Men for Over a Decade

January 2020 in “Archives of urology”

Finasteride, a drug used for certain conditions, can cause serious side effects like sexual dysfunction, suicidal thoughts, and increased diabetes risk, and there's a need for more awareness and research about these effects.

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

Research cited in this study

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

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

research Altered Methylation Pattern of the SRD5A2 Gene in the Cerebrospinal Fluid of Post-Finasteride Patients: A Pilot Study

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

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

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

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

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