In some patients the treatment is associated with adverse side effects that could become persistent after therapy discontinuation, resulting in the so-called post-finasteride syndrome (PFS). This site needs JavaScript to work properly. So thankful to have found this article. An important pattern of symptoms was common among all cases who committed suicide in the setting of finasteride use: insomnia and persistent sexual dysfunction after medication discontinuation. MeSH Yes, in general its safer with less sides, but some people have reported similar side effects as fin. Find support. Immunohistochemical Evaluation of Androgen Receptor and Nerve Structure Density in Human Prepuce from Patients with Persistent Sexual Side Effects after Finasteride Use for Androgenetic Alopecia: PLOS ONE, June 24, 2014. Published by Elsevier Inc. All rights reserved. Keep me posted if you like. From 50UI per day. Unauthorized use of these marks is strictly prohibited. 2023 Feb 2;12(3):653. doi: 10.3390/plants12030653. Hi man, Id use pregnenolone and D-phenylalanine to counter the long term sides. Course. How Avodart and Proscar Affect Libido: Prostate Cancer Research Institute, May 3, 2021. [O]ur results showed that [finasteride] treatment affected the expression of a number of accumbal proteins involved in key functional processes, such as regulation of GABAergic neurotransmission, as well as steroid and pyrimidine metabolism. For the time being, as a general rule: Refrain from prescribing oral finasteride to a patient with a personal history of depression, sexual dysfunction, or fertility problems. And they all say, You may be able to reduce baldness, but it comes with a serious risk of impotence, ejaculation problems, testicular pain and, just as bad, a risk of breast cancer. Men reporting Post-Finasteride Syndrome experience side effects that persist after stopping finasteride or other 5-alpha reductase inhibitors. My sides are: Thats a very common thing. What do you think of TRT is PCT to recover from PFS? Response (via Twitter) to the top 20 adverse reactions to finasteride filed with the FDA: April 23, 2021. These serious adverse side effects include persistent or irreversible sexual, neurological, physical and mental side effects. @MariaUloko discusses #postfinasteridesyndrome and #pssd. The Medical Mystery Behind Americas Best-Selling Hair-loss Drug: Tonic magazine, Nov. 21, 2016. Adverse Sexual Effects of Treatment with Finasteride or Dutasteride for Male Androgenetic Alopecia: A Systematic Review and Meta-analysis. I got Post Accutane Syndrom, which is related to PFS, there is a down regulation of 5 alpha reductase 1. If estrogen is high, focus on lowering that, as estrogen is a potent inducer of serotonin and prolactin. The Drug that Banishes Baldness Can Ruin a Mans Love Life: Daily Mail, July 22, 2019. BioBalance Healthcast: The Ugly Truth About Finasteride, June 7, 2021. A few top supplements to lower estrogen include: For more a comprehensive guides on lowering estrogen, check out this article: Dopamine, testosterone and DHT go hand in hand with improving cognitive function, creativity, determination, positivity, problem-solving, euphoria, etc. Propecia was approved in 1997 as a solution to slow male pattern baldness. And its not worth it. Thats the responsibility of the doctor who prescribes the medication, or the pharmacist who supplies it. Thus, it is inappropriate to dismiss this condition. I think progesterone is high because its not converted further downstream possibly due to 5AR downregulation. But that does not mean you have to live with all the symptoms for that long. You can argue with the theoretician but you cant argue with the anecdotal stories of successful recovery. I am quite distressed atm and hope this is not permanent and everyone is telling me Im just hypochondriac but I know my sexual function is inhibited for the time being. Winston-Salem, NC, Ross J. Baldessarini, MD, Professor of Psychiatry, Quoc-Dien Trinh, MD, Associate Professor of Surgery, Wexner Medical Center, Ohio State University, Govinda Healthcare Medicentre, New Delhi, India, Associate Professor of Urology University of Arizona, University of Miami Miller School of Medicine, Omer Onur Cakir, MD, Department of Urology, Bagcilar Training and Research Hospital, Istanbul, Turkey, Pelita Harapan University Faculty of Medicine, Tangerang, Indonesia, Shelly Gray, PharmD, Shirley & Herb Bridge Endowed Professor, University of Washington School of Pharmacy, YOU & WEE Urologic Surgery & Wellness, Sarasota, FL, Faysal A. Yafi, MD, Associate Professor of Urology, University of California, Irvine Medical Center, Naeem Bhojani, MD, Associate Professor of Urology, Andrology Fellow, Northwestern University, Wedad Saeed Al-Qahtani, Assistant Professor, Naif Arab University for Security Sciences, Riyadh, Saudi Arabia, Abdulmaged M. Traish, PhD, Professor of Biochemistry and Urology, Mark A. Moyad, MD, Director of Preventive & Alternative Medicine, University of Michigan Department of Urology, Abdulilah Al Malik, Regulatory Affairs Director, Saudi Arabia, The Psychiatric Institute, University of Illinois at Chicago, Douglas G. Adler, MD, Professor of Medicine, Medical Director, Sperling Prostate Center, Serrate & Ribal Institute of Urology, Barcelona, Roberto Melcangi, PhD, Head of Neuroendocrinology, Department of Pharmacological and Biomolecular Sciences, Silvia Diviccaro, PhD, Post-Doctoral Fellow, Department of Pharmacological and Biomolecular Sciences, Irwin Goldstein, MD, Clinical Professor of Surgery, University of California at San Diego, Editor-in-Chief, The Journal of Sexual Medicine, Department of Urology, David Geffen School of Medicine, University of California, Los Angeles, Krohnstiegcenter Dermatology Center, Hamburg, Germany, Glickman Urological and Kidney Institute, Cleveland Clinic, Hospitalist, UAB Medicine, Birmingham, AL, Andrea Militello, MD, Urologist/Andrologist, Department of Urological, Biomedical and Translational Sciences, Federiciana University, Michael Zitzmann, MD, Andrology Professor, Michael Carmone, MD, Director, Health Research Group, Dietrich von Herrath, MD, Chief Physician, Steven M. Belknap, MD, Research Assistant Professor of Dermatology and Medicine, Northwestern University Feinberg School of Medicine, Marcel Waldinger (1955-2019), MD, PhD, Professor, Department of Pharmacology, Shalendar Bhasin, MD, Professor of Medicine, Alex Tatem, MD, Fellow in Andrology, Male Fertility and Microsurgery, Department of Urology, NYU Grossman School of Medicine, Franois Desgrandchamps, MD, PhD, Chief of Urology, Bernard Bgaud, MD, Professor of Pharmacology, Carla Di Loreto, PhD, Experimental and Clinical Medical Sciences, Nelson Novick, MD, Clinical Professor of Dermatology, Charles J. Ryan, MD, Distinguished Professor of Clinical Medicine and Urology, Jan Tytgat, PhD, Professor of Toxicology and Pharmacology, Erika Cecchin, PhD, Researcher in Clinical and Experimental Pharmacology, Donatella Caruso, PhD, Professor of Pharmacology and Biology, Ralph M Treb, MD, Proefssor of Dermatology, Center for Dermatology and Hair Diseases, Zrich, Sabina Cauci, PhD, Medical and Biological Sciences, Christine A Ganzer, PhD, Assistant Professor, Silvia Giatti, PhD, Pharmacological and Biomolecular Sciences, Bruhin & Associates Psychotherapists, San Diego, California, Professor of Urology, Feinberg School of Medicine, Carlo Trombetta, MD, Head of Department of Urology, Dirk Michielsen, MD, Professor of Urology. The https:// ensures that you are connecting to the Now two months after stopping Dudasteride, my twitches and brain zaps are now greatly diminshed, insomnia is still a problem though. Efforts to explain persistent symptoms are undermined by poor long term data on harms, Finasteride, a 5-reductase inhibitor, was approved in 1992 for the treatment of benign prostatic hyperplasia; a lower dose (1 mg) was approved in 1997 for male pattern baldness. Propecia (finasteride) for Androgenetic Alopecia "I have PFS (Post-Finasteride Syndrome). Although nobody knows how many men it impacts, its effects are devastating. It can prevent hair loss and decrease prostate enlargement, but not surprisingly, it can also suppress sexual function. Treatment options for androgenetic alopecia: Efficacy, side effects, compliance, financial considerations, and ethics: November 2021. Bethesda, MD 20894, Web Policies Dr Amy Killen, anti-aging and regenerative physician specializing in sexual opt. Based on currently available data, the use of 5-reductase inhibitors in patients with a history of depression, sexual dysfunction or infertility must be carefully and individually evaluated. Thanks for the positive feedback and Im glad its helpful. You dont have to be a genius to realize that, when youre taking away the most potent form of testosterone, and youre affecting, for example, ejaculate volume, clearly something is changing around the prostate area. Here is how you focus specifically on increasing allopregnanolone: The optimal range for estrogen is around 20pg/ml and if yours is much higher, it would be best to make it a priority to lower it. Dont risk your future children for a little hair. Many clinicians are unaware of the scope of the persistent physical and psychological adverse effects of finasteride while it is in usage and despite its discontinuation. While you still dont hear much about it PFS as we call it is something we should at least call attention to [I]ts really important that men are informed about PFS so that they can decide whether or not they actually take finasteride. They see a woman, they say intellectually, I know I am supposed to be interested in you. 2021 Nov;7(6):524-526. doi: 10.1159/000514365. This is how the National Institutes of Health refers to Post-Finasteride Syndrome, and there is a specific reaction type in FAERS which can be selected. In a cohort of men prescribed finasteride for routine treatment of AGA, most would have been excluded from the pivotal studies that supported US Food and Drug Administration approval for AGA. Bethesda, MD 20894, Web Policies Acta Derm Venereol. You have to choose between hair and sex drive and your personality and your marriage or your partnership Ive tried giving testosterone to patients who are on finasteride at the same time. People kill themselves after taking [finasteride]I had a colleague who took his own life 15 years ago, so I know it happensand so many people with the same symptoms cant be wrong. In men affected by the PFS, the level of Androstanediol Glucuronide is not restored to previous finasteride levels. A Clinical Overview of Finasteride and Its Potential Causative Links to Long-term Side-effects: The Medical Independent, Jan. 22, 2015. Balding? I remember being depressed, emasculated, and hopeless. Is This Hair-loss Drug Dangerous? Disclaimer. There are numerous hormonal and nonhormonal treatment options for men with PFS. I found some recovery stories with these compounds. Up to 20 percent of subjects reporting persistent sexual dysfunction for six or more years after stopping the drug, suggesting the possibility that it may never go away. Pharmacological treatments, including finasteride and oral contraceptives, that inhibit 5-RI, which results in a blood and brain allopregnanolone decrease also affect subunit expression of GABAA receptor and are associated with mood symptoms and suicide and are part of post-finasteride syndrome. Importantly, adverse effects associated with finasteride can persist even after discontinuing its use, leading to what has been termed post-finasteride syndrome, including sexual, physical, and psychiatric symptoms, including depression, anxiety, cognitive impairment, and suicidal ideation. But I am actually not interested in you. A Comment on the Post-Finasteride Syndrome. An official website of the United States government. Our analysis indicates that, nonetheless, [PFS] is clearly a problem that is important to the general public that warrants intervention. Patients considering using these medications should be very careful and speak to a Urologist in person about risks, benefits, and indications of treatment. Can take a year to improve. Sexual Problems of Men With Androgenic Alopecia Treated With 5-Alpha Reductase Inhibitors. Finasteride is phasing out of my practice. really have been feeling like an empty husk like described lately, almost like a part of me was ripped out, but maybe one day i can find it again. The patient needs to know that, and to be able to say, Im stopping now. Finasteride blocks the glutathione production leading to mycotoxin build up if you were living or working near mould and not knowing it. An observational retrospective evaluation of 79 young men with long-term adverse effects after use of finasteride against androgenetic alopecia. PFS is real. Rzeszotek S, Kolasa A, Pilutin A, Misiakiewicz-Has K, Sielatycka K, Wiszniewska B. Biomedicines. Well, SSRI drugs almost never only inhibit the reuptake of serotonin, but they often also increase allopregnanolone, decrease serotonin receptor sensitivity, block certain serotonin receptors, release dopamine and histamine, etc. I think androsterone and allopregnanolone, or topical DHEA and progesterone would be good options. Yes After nearly 4 years of suffering, I have finally & fully recovered from Post Finasteride Syndrome All my symptoms have subsided and improved with this method which takes a while but I am fully functional It's H.C.G (HCG) dosed at 250IU Monday, Wednesday and Friday only. The androgen sensitive meibomian glands may be altered in those taking anti-androgen medications, and especially finasteride given its unique potency and targeted effects compared to other anti-androgenics. Thanks for reaching out. There is no cure or treatment . Response via Twitter to the Karolinska Institutet study Association of 5-Reductase Inhibitors With Prostate Cancer Mortality: May 31, 2022. An observational retrospective evaluation of 79 young men with long-term adverse effects after use of finasteride against androgenetic alopecia. Two papers in a short period of time showing higher rates of suicide with finasteride. Have you tried NGF boosting supplements such as lions mane or even Cerebrolysin? BPH? Epub 2018 Oct 6. Determining if You Suffer from PFS Finasteride, dutasteride and saw palmetto are 5-alpha reductase inhibitors that can trigger an enduring sexual dysfunction with a very similar profile to post-SSRI sexual dysfunction. Usually its ED. SperlingProstateCenter.com, Aug. 30, 2018. How do you explain that? If you are unable to import citations, please contact Statement via Twitter to fellow clinicians: June 5, 2022. Concern regarding adverse effects of finasteride is increasing. 2022 Jul-Aug;24(4):390-397. doi: 10.4103/aja202171. Have you tried nearly everything, but nothing seems to move the needle? And I have to use huge amounts of testosterone to overcome this drug. 2016 Mar;4(2):245-50. doi: 10.1111/andr.12147. In 8600 Rockville Pike Copyright 2023 BMJ Publishing Group Ltd, Brent Area Medical Centre: Salaried GP - Brent Area Medical Centre, Minehead Medical Centre: GP Consultant - Minehead Medical Centre, Meadows Surgery: GP Opportunity (up to 8 sessions) - The Meadows Surgery, Ilminster, Beckington Family Practice: Salaried GP - Beckington Family Practice, Millbrook Surgery: Salaried GP - Millbrook Surgery, Womens, childrens & adolescents health. I stop just about every patient that comes to me on this medication. I dont think its very responsible for dermatologists to use [finasteride] to combat hair loss. 2019 Jan 1;99(1):12-17. doi: 10.2340/00015555-3035. A second 5-reductase inhibitor, dutasteride, was approved in 2001 for benign prostatic hyperplasia. (English version): 66 Minutes, Feb. 3, 2019, Persistent adverse effects development from finasteride in young men include erectile dysfunction, low libido, lack of orgasm and depression. (A call with me is usually $200, but since this is your first call, I've got you covered.). HCG increased my anxiety. They barely help LUTS, cause bad sexual side effects, cause false reassurance in those with an elevated/rising PSA, and now this. Bone pain Epub 2022 Jul 14. Reaction (via Twitter) to publication of the study Investigation of Suicidality and Psychological Adverse Events in Patients Treated With Finasteride, in JAMA Dermatology, January 19, 2021.