[T]here is no known treatment for lifelong PFS. Sexual Problems of Men With Androgenic Alopecia Treated With 5-Alpha Reductase Inhibitors. Im wondering if that Has to do with gut health. What is post-fin syndrome anyway? I have had PFS for 15 years, just came across your article, would you be interested in looking at my labs for comment? Re: Post-Finasteride Syndrome: A Surmountable Challenge for Clinicians. Episode 18. Definitely see this. What happens if you get side ef. Post-Finasteride Syndrome: how to resolve it by - MENELITE If estrogen is high, focus on lowering that, as estrogen is a potent inducer of serotonin and prolactin. I have personally seen in my practice otherwise completely healthy young men who come in for ED and the only medication they had taken was finasteride for hair loss. Post-finasteride syndrome is a rare condition that some men may experience after taking finasteride (Proscar, Propecia). By reducing DHT so drastically, effects can occur in the genital tissues and in the brain. Also its strange. What is Post-Finasteride Syndrome? If you have a subscription to The BMJ, log in: Subscribe and get access to all BMJ articles, and much more. Mechanisms of finasteride So let's discuss what the drug, finasteride, does in the first place. Post-finasteride syndrome is a legit thing. Emerging post-marketing reports of persistent depression and sexual side effects have led to growing concerns about the safety of 5-reductase inhibitors and prompted product labelling changes in many regulatory jurisdictions.1234 Since 2008, at least 17 countries including the United Kingdom and the United States have warned prescribers of the potential for depression, sexual side effects, or both with finasteride.5, Post-finasteride syndrome is an ill defined and controversial syndrome associated with a constellation of sexual, physical, and psychological symptoms that develop during or after finasteride exposure and persist after discontinuation (box 1).35 The incidence of post-finasteride syndrome is unknown, as are the biological mechanisms, but we know that 5-reductase inhibitors reduce synthesis of brain neurosteroids, which affect mood, cognition, and libido.36. Response (via Twitter) to query by Harrison Kalodimos, MD: What are some atypical medication side effects that you have seen in practice and look out for now on a regular basis? April 1, 2021. It shows a much higher signal in comparison with other drugs used for alopecia or suspected to affect mood Im surprised the FDA has not done these simple comparisons to explore safety signals for finasteride. 16 Insidious2k 1 yr. ago Pfs means that the side effects of fin are persistent even when you discontinue the med. Disclaimer. Post-Finasteride Syndrome: Current Views and Where do We Stand? Also, increased depression, anxiety and suicidal ideation in a subset of men treated with these drugs were commonly reported in a number of studies. Hi, being a young guy with PFS since 8 months this article has been very helpful to furthermore understand what is possibly going on, so thank you. Sure I can do that for you. It can be reversed yes. These steroids have been shown to influence brain function, and their presence may help explain the profound psychological changes such as depression and suicidality that have been associated with finasteride use. 2021 Nov;7(6):524-526. doi: 10.1159/000514365. Additional information on the Post-finasteride Syndrome as well as ongoing information about treatment options can be obtained at the PFS Foundation: https://www.pfsfoundation.org. In the last decade, concerns have emerged around finasteride, a drug used for treating male-pattern baldness and prostate gland enlargement. And it must be mentioned that there are cases in which these functions are irreversibly impaired, which means there is no recovery after discontinuation of use. In addition, it is imperative to study in detail the molecular mechanisms that cause this condition, trying to identify a possible genetic predisposition, in order to limit the burden of PFS. In December 2018, I treated scar (not his real name), a 28-year-old man who was distressed by a number of symptoms associated with finasteride, a drug he had been taking for 12 months for alopecia, as prescribed by his dermatologist. Health care professionals should keep themselves abreast of these potential signals and, accordingly, conduct a full evaluation and a detailed, personalized risk-benefit assessment for patients before each prescription of finasteride. This may result in side effects such as memory problems or sexual dysfunction (problems that affect the desire for or ability to have sex). Post-Finasteride Syndrome (PFS) describes serious neurological, physical and sexual side effects that persist - and commonly develop - after discontinuation of the 5alpha reductase inhibitor finasteride (Propecia, Proscar, generics). Unable to load your collection due to an error, Unable to load your delegates due to an error. Unfortunately, some of the side effects of finasteride are more serious and persistent than the original condition it is intended to treat [W]e encountered a surprising association between finasteride use and presence of optic neuropathy or retinopathy To worsen the situation, the neuropsychiatric impact of finasteridechanges in mood and behaviorcan alter practitioner perceptions about affected patients, resulting in a psychosomatic diagnosis. Androsterone both allopregnanolone and androsterone are potent GABA agonists, so might substitute to a degree for each other. While finasteride may reduce incidence of BPH and/or change the incidence or type of prostate cancer one gets, it also seems to increase the risk of self harm and/or suicide in both younger and older men. Often have low t. Make sure to check dht also! In my opinion, these medications are contraindicated in this population. This study reinforces the importance of considering the long-term effects of finasteride use on DED as part of the systemic sequelae of androgen depletion and provides anticipatory guidance for patients and ophthalmologists. Post-finasteride syndrome: a surmountable challenge for clinicians: Fertility and Sterility, January 2020. Side effects thought to be caused by post-finasteride syndrome can be mild or serious. The use of Finasteride (Proscar) for the prevention of cancer is limited since it only prevents the harmless type of prostate cancer (the SKY Stage.) By definition, the condition is characterized by sexual dysfunction, somatic symptoms, and psychological disorders that persist after cessation of finasteride treatment. However, PFS is now so prevalent that it has its own foundation, the Post-Finasteride Syndrome Foundation, where you can acquire a great deal of sobering information, enough to make you wonder why anyone would take the drug to begin with. It is a terrible syndrome that can take you from being a perfectly healthy individual to a shadow of your own self living 24/7 in a torture chamber physically and mentally. Patients who are having emotional issues on finasteride, at the one-milligram dose, young men, need to be removed from finasteride. progesterone -dihydroprogesterone (a very important neuroactive steroid and precursor to allopregnanolone), deoxycorticosterone dihydrodeoxycorticosterone (DHDOC), cortisol 5-dihydrocortisol (for the deactivation of cortisol), aldosterone 5-dihydroaldosterone, which increases the excretion of salt, the opposite of aldosterone, dry skin or thinning of the skin, weight gain, elevated glucose and lipids and worsening of insulin sensitivity(, diminished libido, erectile dysfunction, ejaculatory complaints, penile discomfort, loss of scrotal sensitivity, scrotal discomfort, loss of pubic hair, increased sperm density and, Alcohol (not a long term or good strategy really). I think its a combination of low energy production due to cellular damage and excess ROS production. They have muted orgasms, reduced volume of ejaculate, reduced penile sensation If it is 1.4 percent [of finasteride patients who experience persistent sexual dysfunction] and there are several million people on this product, youre looking at 300,000 men rendered impotent by a hair-loss drug. The brain fog has never gone away. DHEA potently increases androsterone levels, and that is how its thought to lower anxiety. Do Anti-Baldness Remedies Make You Impotent? Emotional Consequences of Finasteride: Fool's Gold - PubMed We probably dont have the precise data wed need to answer that. You can download a PDF version for your personal record. I train a lot, heavy resistance, HIIT, play sport, drink very little. sharing sensitive information, make sure youre on a federal Concern regarding adverse effects of finasteride is increasing. Although some of these side effects may go away with time, others may be permanent. My physical and psychological strength is coming back. However, it can affect general appearance. Some recommend andractim, available in Europe (and online). We aimed to determine the type and frequency of symptoms in men having long-term sexual and non-sexual side effects after finasteride treatment (a condition recently called post-finasteride syndrome, PFS) against androgenetic alopecia (AGA). Reacting To Joe Rogan Talk About Finasteride, DHT And Post - YouTube Post-Finasteride Syndrome: Legit or Mythic? - YouTube What is the post-finasteride syndrome? - YouTube Regulatory Effects of Thai Rice By-Product Extracts from. Statement (via Twitter) in response to a study titled Sexual Dysfunction in Men Taking Systemic Dermatologic Medication: A systematic review, June 6, 2019. I tried an illegal drug that increases dopamine and all of my issues went away briefly, so i think dopamine is a big piece of the puzzle here, especially with penis sensitivity. Keep me posted if you like. Unauthorized use of these marks is strictly prohibited. Pills for Hair Growth: YouTube, June 2022. This site needs JavaScript to work properly. Health Canada recently recommended adding a warning to products containing [finasteride] While being administered the above-mentioned drug, patients may develop muscle weakness and stiffness, which in turn may cause pain to the patient, damage to muscle tissue and an increase in kinase enzymes. Pharmacological Management of Pattern Hair Loss. Also I jumped the gun on TRT out of frustration and desperation. A review of 17 randomized controlled trials (including more than 17,000 patients) demonstrated a nearly twofold increase in sexual, ejaculatory and orgasmic dysfunction in young men using Propecia for male pattern hair loss. The aim of this study was to explore how having a preexisting personal and/or familial history of a psychiatric diagnosis and certain personality traits may influence anxiety and depression . No libido Taking Propecia or Proscar to Prevent Hair Loss is Associated with Depression, Anxiety, and Sexual Problems: National Center for Health Research website, 2021. Nevertheless, it has been suggested that a patient history of preexisting mental health disorder, particularly depression, may put patients at an increased risk. Hair Loss Drug Propecia Carries Risk of Losing Something Else: NBC News, March 10, 2017. Epub 2016 Jan 13. If I can increase my DHT levels again by upping my TRT and take an estrogen blocker (blood levels were elevated) with regular workouts how long do you think it would take to return to normal? Im not beholden to trT. is a recovery really possible? Unauthorized use of these marks is strictly prohibited. It is frequently marketed as androgen deprivation therapy for treatment for male pattern baldness. BPH? wow very helpful articular and explains my symptoms exactly. Can take a year to improve. Doctors & Researchers Speaking Out - The Post-Finasteride Syndrome Yuck. Punk?. Patients and doctors remain largely unaware of the long-term consequences of this drug on the nervous system and mental health. 2016 Mar;4(2):245-50. doi: 10.1111/andr.12147. Do you generally feel overstimulated and suffer from insomnia? I started losing hair about 18 yrs old if that helps, Hi I got post finasteride syndrome like side effects from saw palmettherbal blend of dht natural inhibitors from amazon https://www.amazon.com/product-reviews/B004PVLWW0/ref=acr_dp_hist_2?ie=UTF8&filterByStar=two_star&reviewerType=all_reviews#reviews-filter-bar and i did blood work (rosch eclia methodology) but endos cant find anything that could cause all the side effects im dealing with. Finasteride: NOT a benign drug. Federal government websites often end in .gov or .mil. The https:// ensures that you are connecting to the 5-R type 1, which creates the neurosteroids 5-DHP and allopregnanolone downregulate the glutamatergic system. And thats huge. All healthcare providers should learn about these conditions as finasteride/SSRIs are commonly prescribed. [T]hese data indicate the urgent need for high-quality clinical trials, with long-term follow up, specifically addressing sexual function and mood disorders. Id love to help you out. Keywords: The Virility Paradox: The Vast Influence of Testosterone on Our Bodies, Minds, and the World We Live In: February 2018. It's sold under the brand names Propecia and Proscar. I think androsterone and allopregnanolone, or topical DHEA and progesterone would be good options. The authors declare no conflicts of interest. This Hair-Loss Drug Has Powerful Effects: Mens Health Germany, June 2021. Some say its all in the mind, a made-up mythbut those who suffer from it surely know theyre not just a hypochondriac. The treating clinician should have knowledge and awareness about the higher prevalence of depression and sexual dysfunction in the subset of men seeking treatment for AGA in comparison to the general population. So lets discuss what the drug, finasteride, does in the first place. Published by Elsevier Inc. All rights reserved. Epub 2022 Jan 10. Although, they would like you to believe testosterone replacement is the only solution to make a full recovery. Sant report on the suicide of PFS patient Romain Mathieu: France 5 News, Nov. 24, 2016. Cannibus is my only vice, so any suggestions would be greatly appreciated. technical support for your product directly (links go to external sites): Thank you for your interest in spreading the word about The BMJ. CreGAAtine vs creatine monohydrate: Its not better! I have patients ask about [finasteride] all the time and I always discuss the risks of sexual dysfunction at length but its amazing how many guys seem not to care. I have tried a few of the a above already alone with no improvement however I think a holistic combination may be the answer. So far I tread Clomid and nolvadex cycles but I only had one day where libido returned, rest of time didnt feel anything good or bad when on it. An observational retrospective evaluation of 79 young men with longterm adverse effects after use of finasteride against androgenetic alopecia: Androlog, Jan. 13, 2016. 100% agree. But Nobody Warned Me about Finasteride! Have you tried nearly everything, but nothing seems to move the needle? PMC And can we talk about the real risks of cognitive decline with them??? I tried only. Post-Finasteride Syndrome Exists!! I have patients who come in to see me for sexual problems. Do tests to see pregnenolone, progesterone, testosterone, DHT, thyroid (TSH, total and free T4 and T3, rT3), estradiol, estrone-sulfate and cortisol (both blood and 24h saliva). If you know of additional doctors, researchers and/or therapists who have published warnings of persistent side effects stemming from finasteride use, and/or if you would like to suggest adding a medical professional to our Medical Professionals list, please email pertinent links/names to proberts@pfsfoundation.org. Expanding (via Twitter) on a study published in JAMA Dermatology he co-authored, titled Investigation of Suicidality and Psychological Adverse Events in Patients Treated With Finasteride, December 7, 2020. What Was the Cause? 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. Organizations such as the Post-Finasteride Syndrome . Propeciadiminishes dihydrotestosterone levels and suppresses libido in about 10 percent of men but is much more profound in younger guys Try stopping and using minoxidil instead for hair preservation. Careers. (my prostate is checked and fine), Statement (via Twitter) to medical colleague: January 19, 2022. I cannot sustain an erection during sex, suffer from genital anesthesia and/or numbness, have muted/blocked/pleasureless orgasms when I masturbate, and suffer from brain fog, memory loss, and thinking at times. 2019 Dec;22(4):250-259. doi: 10.1080/13685538.2018.1548589. Responding, via Twitter, to the study Association of 5-Reductase Inhibitors With Dementia, Depression, and Suicide: December 25, 2022. I will never prescribe finasteride. Check 3adiolG for increases and 3adiol for decreases. [T]here has been a Red Hand Letter for this drug since 2018. That little pill messed me up pretty good Very few [primary care physicians] are starting proscar or avodart. Sexual dysfunction; depression; erectile dysfunction; loss of libido; suicidal ideation. Thanks for citing our work [Dr. Faysal]. What do you think about a PCT strategy to see if that helps? Gut Inflammation Induced by Finasteride Withdrawal: Therapeutic Effect of Allopregnanolone in Adult Male Rats. 2022 Oct 27;10(11):2725. doi: 10.3390/biomedicines10112725. 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. He Became Depressed and His Sex Drive Disappeared. 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. Sex Med Rev. Propecia (finasteride) for Androgenetic Alopecia "I have PFS (Post-Finasteride Syndrome). Natural solution without any success. At the same time, a recent study demonstrated changes in the levels of certain steroids in cerebrospinal fluid of men taking finasteride for hair loss. Hence, it is mandatory to ask about patients histories of preexisting depression or sexual dysfunction before starting finasteride treatment. These serious adverse side effects include persistent or irreversible sexual, neurological, physical and mental side effects. Men who take finasteride for baldness or receding hairlines can develop sexual dysfunction. The Top 20 Hair Loss Studies of 2020: Donovan Medical (YouTube), December 11, 2020. 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. My blood level are ok only progesterone and colesterolo are higher than the max range. Epub 2021 Oct 21. The Drug that Banishes Baldness Can Ruin a Mans Love Life: Daily Mail, July 22, 2019. Thank you so much for your time. So thats all gone in many men, just because of finasteride. People take their own lives because of the effects of the drug, but also because they cant get through to anyone and they are not believed. Bookshelf Statement (via Twitter) in response to study titled Long-Term Effects of Finasteride on Prostate Cancer Mortality, January 29, 2019. Updated Review of the Hair Loss and Prostate Drug Finasteride, Statement (via Twitter) in response to study titled Long-Term Effects of Finasteride on Prostate Cancer Mortality, Persistent erectile dysfunction in men exposed to the 5-reductase inhibitors, finasteride, or dutasteride, Response (via Twitter) to Rachel S. Rubin, MD, vis-a-vis the clinical study titled Post-finasteride syndrome: An emerging clinical problem, 5 Common Medications That Can Cause Erectile Dysfunction, Baldness Medication Can Cause Permanent Erection Problems, Donald Trumps hair loss drug tied to anger, depression, and self-harm in new medical study, Characteristics of Men Who Report Persistent Sexual Symptoms After Finasteride Use for Hair Loss, The Medical Mystery Behind Americas Best-Selling Hair-loss Drug, Statement (via Twitter) in response to SWOG Cancer Research Network article titled Finasteride Safe, Long-Term Results Show, Supposed Miracle Baldness Cure Creates Serious Health Concerns Among Hair Restoration Professionals, Sexual and Nonsexual Problems after Finasteride Used for Hair Loss in Young Men, 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, The Virility Paradox: The Vast Influence of Testosterone on Our Bodies, Minds, and the World We Live In, A pharmacogenetic survey of androgen receptor (CAG)n and (GGN)n polymorphisms in patients experiencing long term side effects after finasteride discontinuation, Patients treated for male pattern hair with finasteride show, after discontinuation of the drug, altered levels of neuroactive steroids in cerebrospinal fluid and plasma, The Difficult Hair Loss Patient: Guide to Successful Management of Alopecia and Related Conditions, Potential side effects of the drug Trump reportedly takes for hair loss, Androgen Receptor (AR) Gene (CAG)n and (GGN)n Length Polymorphisms and Symptoms in Young Males With Long-Lasting Adverse Effects After Finasteride Use Against Androgenic Alopecia, Finasteride 1 mg in Alopecia: Sexual Dysfunction, Suicidal Ideation, Persistent Sexual, Emotional, and Cognitive Impairment Post-Finasteride, A Clinical Overview of Finasteride and Its Potential Causative Links to Long-term Side-effects, Effects of Subchronic Finasteride Treatment and Withdrawal on Neuroactive Steroid Levels and Their Receptors in the Male Rat Brain, Hair Loss Drug Under Fire For Sexual Side-Effects, Sant report on the suicide of PFS patient Romain Mathieu, An observational retrospective evaluation of 79 young men with longterm adverse effects after use of finasteride against androgenetic alopecia, Exploring the neural mechanisms of finasteride: a proteomic analysis in the nucleus accumbens. The most notable finding was that adverse effects persisted in each of the domains, indicating the possible presence of a post-finasteride syndrome., Persistent Sexual, Emotional, and Cognitive Impairment Post-Finasteride: American Journal of Mens Health, June 13, 2014. The FDA asked them to include a warning about side effects that can continue after stopping treatment. Finally, therapeutic strategies, [such as] neuroactive steroid treatment, able to relieve or to cure this condition are also urgently needed. Sexual dysfunction and suicidal ideation that appears to result from [finasteride] are important adverse effects. You might thus benefit from things that stimulate bile flow such as taurine and TUDCA.