Post-Finasteride Syndrome Update: Point/Counterpoint

In 2015, Dr. Mohit Khera presented an update on Post-Finasteride Syndrome (PFS) at the ISHRS Annual Scientific Meeting, which influenced the audience's opinion towards finasteride. However, the speaker raised concerns about the lack of clarification of some unsubstantiated conclusions and potential conflicts of interest. Dr. Khera's study was funded by the Post-Finasteride Syndrome Foundation, and while many believe PFS is a real entity, no studies have definitively established this. Dr. Khera also raised concerns about male breast cancer, infertility, and prostate cancer related to finasteride use. However, large cohort studies found no statistical evidence of increased breast cancer incidence in men using 5-alpha reductase inhibitors (ARIs). There is also data suggesting that finasteride does not adversely affect fertility in healthy men. The initial study suggesting 5 ARIs cause high-grade prostate cancer was later countered by subsequent analysis. The speaker concluded that placebo-controlled clinical trials are needed to assess a causal link to finasteride and determine at-risk patient populations.