Post-finasteride syndrome: a surmountable challenge for clinicians
Traish, Abdulmaged M.
Fertility and Sterility · 113(1):21-502020
Abstract (paraphrased)
Systematic evaluation of 250+ articles (1989–2019) on finasteride/dutasteride concludes PFS is a real constellation of persistent sexual, neurological, physical and mental effects in a susceptible subset, proposing endocrine disruption plus epigenetic susceptibility as the mechanism. Notes inadequate adverse-event reporting in most trials.
Plain-language summary (paraphrased)
After reviewing decades of clinical literature, Traish concludes that persistent sexual dysfunction, depression, anxiety and suicidal thoughts occur in a subset of men on 5-alpha-reductase inhibitors regardless of age, dose or study length. He proposes finasteride acts as an endocrine disruptor that triggers lasting epigenetic changes — DNA methylation, histone modification and androgen-receptor upregulation — which persist after the drug is gone.
Why it’s in the corpus
Foundational PFS review; the central pharmacology-plus-epigenetics hypothesis for the corpus. Directly frames genetic/epigenetic susceptibility.
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Related records
- Peer-reviewed paper
The post-finasteride syndrome: clinical manifestation of drug-induced epigenetics due to endocrine disruption
Traish, Abdulmaged M. · Current Sexual Health Reports · 10(3):88-103
Proposes that 5-alpha-reductase inhibitors act as endocrine disruptors, producing drug-induced epigenetic changes in gene expression that explain why symptoms persist after discontinuation.
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Post-Finasteride Syndrome And Post-SSRI Sexual Dysfunction: Two Clinical Conditions Apparently Distant, But Very Close
Giatti, Silvia; Diviccaro, Silvia; Cioffi, Lucia; Melcangi, Roberto Cosimo · Frontiers in Neuroendocrinology · 72
Argues PFS and PSSD share overlapping clinical features (sexual dysfunction, psychological complaints, sleep disorders) and likely common mechanisms involving neuroactive steroids, serotonin/dopamine/catecholamine signaling and gut microbiota, possibly…
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Post-finasteride syndrome and post-SSRI sexual dysfunction: two sides of the same coin?
Giatti, Silvia; Diviccaro, Silvia; Panzica, Giancarlo; Melcangi, Roberto Cosimo · Endocrine · 61(2):180-193
A review by the Milan group of post-SSRI sexual dysfunction and post-finasteride syndrome, which share symptoms that persist after the drug is stopped: a felt disconnection between brain and penis, loss of libido and sex drive, difficulty with erection and…
PFS-0062018PFSPSSDCore corpus