Post-Finasteride Syndrome

    August 2019 in “ BMJ ”
    Shelly L. Gray, Todd P. Semla
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    TLDR Post-finasteride syndrome causes sexual, physical, and psychological symptoms, but more research is needed to understand its causes and connection to finasteride.
    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.
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