Impact of Finasteride on Serum PSA Levels in Men With Benign Prostatic Hyperplasia: A Systematic Review

    October 2025 in “ International Journal of Social health ”
    Johan Rirpad Muis Tampubolon, Christiany Permata Sari Lumban Toruan
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    TLDR Finasteride lowers PSA levels and prostate size, requiring adjusted PSA interpretation for accurate cancer screening.
    This systematic review analyzed the effects of finasteride on serum PSA levels in men with benign prostatic hyperplasia (BPH), finding that finasteride significantly reduces total PSA levels by 30% to over 50% and free PSA levels by up to 45%. Additionally, prostate volume and PSA density decreased by approximately 5% to 20%. The review, which included 9 studies from an initial 2,473, emphasizes the need for adjustment factors when interpreting PSA levels in men on finasteride therapy, as these changes are crucial for accurate prostate cancer screening. The findings suggest that finasteride not only aids in managing BPH by reducing prostate size but also necessitates refined PSA interpretation to avoid masking high-risk prostate cancer cases. Future research should focus on the long-term effects on free PSA and optimal PSA interpretation models during finasteride therapy.
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