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

Studysummary This study evaluated potential penile vascular changes and persistent adverse effects in men discontinuing 5α-reductase inhibitors for androgenic alopecia, but no new clinical results were reported.

Our plain-language summary. Not medical advice or a treatment recommendation. Consult a qualified healthcare professional before changing treatment. Full disclaimer

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

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

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

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This study found that 5α-reductase inhibitors significantly increase the risk of erectile dysfunction and hypoactive sexual desire in men with benign prostatic hyperplasia, compared to placebo.

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

50 citations , March 2017 in “PeerJ”

This study found that longer exposure to 5α-reductase inhibitors significantly increased the risk of persistent erectile dysfunction, especially in younger men exposed to finasteride.

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”

This study found no evidence of androgen deficiency or decreased peripheral androgen action in men with persistent sexual symptoms after finasteride use, but identified links to depressed mood and abnormal brain function.

research Emotional Consequences of Finasteride: Fool’s Gold

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

This study found that nearly half of men using finasteride reported clinically significant depression, highlighting the need for psychiatric screening and careful risk assessment by prescribing clinicians.

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”

This study found that men experiencing long-term symptoms after finasteride use for androgenetic alopecia frequently reported loss of penis sensitivity and anhedonia, among other effects, indicating potential post-finasteride syndrome.

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

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

This study highlights that adverse effects from finasteride may persist in men after discontinuation, indicating a potential "post-finasteride syndrome.

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

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

In this study, 96% of men with persistent sexual side effects from finasteride reported continued dysfunction after discontinuation, suggesting these effects may endure long-term.

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

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This review discusses persistent adverse effects of 5α‐reductase inhibitors, like diminished libido and erectile dysfunction, in some patients and highlights the need for patient discussions before therapy, especially for androgenetic alopecia.