Has anyone here taken finasteride or dutasteride and gotten post finasteride syndrome (PFS) from them? I have a theory as to why this seems to happen in transgender women more than cis men
u/drwillpowers
r/asktransgendercirca 2020–2021 (exact date not verified)
Dr Will Powers’ own statements and theorizing
Summary (paraphrased)
Powers proposed that PFS stems from deficient allopregnanolone, a neurosteroid produced downstream of 5-alpha-reductase via the AKR1C enzyme family. He hypothesized that only people carrying decreased-function variants in AKR1C genes develop the syndrome when 5AR is blocked, which would explain why it is rare. He noted PFS symptoms closely resemble severe postpartum depression (which responds to brexanolone, a synthetic allopregnanolone), suggested AKR1C variants may be statistically enriched in transgender people (unconfirmed, based on 23andMe data he had collected), and reported two PFS-like patients improved on rectal progesterone — while stressing N=2 was weak evidence.
Why it’s in the corpus
Foundational statement of Powers' early PFS model: a gene–drug interaction theory linking 5AR inhibition, neurosteroid synthesis genes, and persistent symptoms. Directly relevant to pharmacological and genetic relationships in PFS; introduces the AKR1C hypothesis the corpus should track against later literature.
Some fields on this page come from the release’s Markdown edition, which carries text the JSON edition omits.
Related records
- Powers gene claim
AKR1C (family) — decreased-function variants
Confidence: secondary
PFS stems from deficient allopregnanolone, a neurosteroid made downstream of 5-alpha-reductase via AKR1C enzymes. Only people carrying decreased-function AKR1C variants develop the syndrome when 5AR is blocked, explaining its rarity. He noted symptom overlap…
PGL-AKR1C-familycirca 2020-2021PFSCore corpus - Video
Healthcare of the Transgender Patient (Powers Method)
William J. Powers, D.O. · Chen Merami · 2:03:27 (7407s)
background pharmacology: 5ARI neurosteroid depletion, rectal progesterone protocol, androgen blockade
YT-3g52vlv5YWo2024PFSCore corpus - Video
Rethinking Reductase: The Case for Progesterone and DHT Balance in Men
unidentified presenter (Wellness By Design Project; not confirmed as Powers) · The Wellness By Design Project · 11:32 (692s)
5α/5β reductase biochemistry; allopregnanolone depletion in PFS; progesterone modulation
YT-17MNS2Z6kV02026-02-16PFSCore corpus