How to Deal with the Issues of Fertility, Malignancies, and Postfinasteride Syndrome While Prescribing Finasteride for Male Pattern Hair Loss

The document discusses the use of oral finasteride for the treatment of male pattern hair loss (MPHL), acknowledging its high efficacy and favorable safety profile. However, concerns about fertility issues, malignancy, and postfinasteride syndrome have been raised by users and prescribers. The authors suggest a system for patient selection and risk assessment, which includes considerations for fertility, regular Prostate-Specific Antigen (PSA) determinations, and specific mental health assessments. The document also notes that finasteride significantly reduces the risk of prostate cancer for those who opt for regular screening. While gynecomastia is a known, rare side effect of finasteride, current studies indicate that exposure to finasteride is not associated with an increased risk of male breast cancer. The authors emphasize the importance of patient understanding and involvement in treatment selection and active patient role in treatment.