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

June 2020 in “ Translational Andrology and Urology ”

Mohit Khera, Jeffrey K. Than, James Anaissie, Ali Antar, Weitao Song, Boriss Losso, Alexander W. Pastuszak, Taylor P. Kohn, Jorge Rivera Mirabal

finasteride androgenic alopecia 5-alpha reductase inhibitors penile vascular abnormalities sexual side effects genitourinary side effects psycho-cognitive side effects anti-androgenic changes Propecia AGA 5ARI

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

The study investigated the persistent side effects of finasteride use for androgenic alopecia in young men. The study found that the use of 5-alpha reductase inhibitors (5ARI) for AGA may lead to persistent sexual, genitourinary, psycho-cognitive, and anti-androgenic changes even after discontinuation of the therapy. The study also presented data on penile vascular abnormalities in young men with persistent side effects after finasteride use for the treatment of AGA. The study recommends additional clinical studies to assess non-sexual side effects that may persist after discontinuation of the drug and suggests that patients should be extensively counseled and monitored for possible side effects after initiation and discontinuation of this medication class.

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Research cited in this study

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research A Review of the FAERS Data on 5-Alpha Reductase Inhibitors: Implications for Postfinasteride Syndrome

35 citations , June 2018 in “Urology”

The review suggests younger men taking 1 mg finasteride report more side effects, including sexual, skin, metabolic, and psychological issues.

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 Brief: Self-Reports of Persistent Antiandrogenic, Estrogenic, Physical, and Psychological Effects of Finasteride Usage Among Men

research Research Brief: Self-Reports of Persistent Antiandrogenic, Estrogenic, Physical, and Psychological Effects of Finasteride Usage Among Men

9 citations , January 2018 in “American Journal of Men's Health”

Finasteride use can cause lasting negative effects like sexual dysfunction, depression, anxiety, and cognitive issues.

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research Sexual Dysfunction in Subjects Treated with Inhibitors of 5α-Reductase for Benign Prostatic Hyperplasia: A Comprehensive Review and Meta-Analysis

66 citations , April 2017 in “International Journal of Andrology”

Men taking 5α-reductase inhibitors for enlarged prostate have a higher chance of experiencing reduced sexual desire and erectile dysfunction.

research Persistent Erectile Dysfunction in Men Exposed to 5α-Reductase Inhibitors, Finasteride, or Dutasteride

50 citations , March 2017 in “PeerJ”

Using finasteride or dutasteride may cause long-lasting erectile dysfunction.

research Characteristics of Men Who Report Persistent Sexual Symptoms After Finasteride Use for Hair Loss

50 citations , September 2016 in “The Journal of Clinical Endocrinology and Metabolism”

Finasteride for hair loss may cause persistent sexual symptoms, depression, anxiety, and lower quality of life.

research Emotional Consequences of Finasteride: Fool’s Gold

31 citations , February 2016 in “American Journal of Men's Health”

Finasteride can cause serious emotional side effects; doctors should check patients' mental health history before prescribing.

An Observational Retrospective Evaluation of 79 Young Men with Long-Term Adverse Effects After Use of Finasteride Against Androgenetic Alopecia

research An Observational Retrospective Evaluation of 79 Young Men with Long-Term Adverse Effects After Use of Finasteride Against Androgenetic Alopecia

43 citations , January 2016 in “International Journal of Andrology”

Finasteride caused long-term sexual and non-sexual side effects in young men with hair loss.

research Persistent Sexual, Emotional, and Cognitive Impairment Post-Finasteride

81 citations , June 2014 in “American Journal of Men's Health”

Finasteride can cause lasting sexual, emotional, and cognitive issues, with varying severity.

research Persistent Sexual Side Effects of Finasteride: Could They Be Permanent?

112 citations , July 2012 in “The Journal of Sexual Medicine”

Finasteride may cause long-lasting sexual side effects.

Adverse Side Effects of 5α-Reductase Inhibitors Therapy: Persistent Diminished Libido, Erectile Dysfunction, and Depression in a Subset of Patients

research Adverse Side Effects of 5α-Reductase Inhibitors Therapy: Persistent Diminished Libido, Erectile Dysfunction, and Depression in a Subset of Patients

223 citations , December 2010 in “The Journal of Sexual Medicine”

Some patients taking finasteride or dutasteride may have ongoing sexual problems and depression even after stopping the medication.

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community Why some people experience problems on Finasteride/Dutasteride (my theory)

in Research/Science 18 upvotes 3 months ago

Some people have side effects from finasteride and dutasteride due to hormonal predisposition, especially if DHT dominant. Alternatives like RU58841, Pyrilutamide, and Breezula are suggested to target scalp androgen receptors without altering overall hormones.

community Why do most of you choose finasteride instead of dutasteride?

in Finasteride/Dutasteride 115 upvotes 9 months ago

Finasteride is preferred over dutasteride due to its longer history, more research, and FDA approval, despite dutasteride being more potent. Users report varied side effects, influencing personal treatment choices.

community How is dht not beneficial to you?

in Finasteride/Dutasteride 111 upvotes 1 month ago

DHT is important for sexual function and mood, but finasteride and dutasteride can reduce DHT, causing side effects like reduced libido and erectile dysfunction. These treatments are effective for hair loss, but their impact on DHT leads to debate.

community Dutasteride Infertility Debunked: Low T causes true infertility.

in Finasteride/Dutasteride 165 upvotes 11 months ago

Dutasteride and finasteride may temporarily affect semen quality but are unlikely to cause permanent infertility. The Kim et al. study is criticized for poor methodology, and many prefer hair retention over potential fertility concerns, using treatments like dutasteride, finasteride, and minoxidil.

community FCE 28260: A Forgotten 5α-Reductase Inhibitor

in Research 330 upvotes 1 year ago

FCE 28260 (PNU 156765), an under-explored 5α-reductase inhibitor, showcases promising results in research by Giudici et al., outperforming well-known treatments like Finasteride in reducing the conversion of testosterone to DHT. Its superior efficacy, demonstrated through lower IC50 values in both natural and human recombinant enzyme studies, suggests it could offer more effective management of DHT-related conditions. Additionally, its lower molecular weight hints at better potential for topical application, potentially offering advantages in treating conditions such as androgenic alopecia. Despite its potential, it has not advanced in development, possibly due to financial limitations, leaving its therapeutic prospects and side effect profile largely unexplored.

community 5 alpha reductase type 1 is in brain tissue producing the main endogenous gabaergic allopregnanolone, not 2. How can finasteride as a 5ar2 lower that?

in Finasteride/Dutasteride 25 upvotes 1 year ago

Finasteride and dutasteride are discussed for hair loss, with concerns about their effects on neurosteroids and potential side effects like depression. Alternatives like topical estrogen and lifestyle changes are considered, with varying opinions on mental health and hair regrowth.

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