Post-Finasteride Syndrome

Post-finasteride syndrome is a controversial syndrome associated with a range of sexual, physical, and psychological symptoms that develop during or after finasteride exposure and persist after discontinuation. The incidence of post-finasteride syndrome is unknown, as are the biological mechanisms, but it is known that 5a-reductase inhibitors reduce synthesis of brain neurosteroids, which affect mood, cognition, and libido. The evidence for a causal link between finasteride and persistent symptoms is low quality, and safety reporting has been inadequate in clinical trials of 5a-reductase inhibitors. More research is needed to understand the biological underpinnings of post-finasteride syndrome and to determine whether patient reports of persistent symptoms are caused by finasteride.