Powers gene claimCore corpus

AKR1C (family) — decreased-function variants

Confidence: secondarycirca 2020-2021

Dr Will Powers’ own statements and theorizing

Paraphrased from his public posts and talks. His mechanistic and genetic claims are unpublished hypotheses — read them as “Powers theorizes…”, not as established fact.

Powers’ claim (paraphrased)

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 with postpartum depression and reported two PFS-like patients improving on rectal progesterone (N=2, self-flagged as weak evidence).

Some fields on this page come from the release’s Markdown edition, which carries text the JSON edition omits.

Powers · Reddit post
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/asktransgender
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…
DWP-0012020PFSCore 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
Peer-reviewed paperPSSD Discord pick
Post-SSRI Sexual Dysfunction (PSSD): A comprehensive review of epidemiology, pathophysiology, and clinical management
Xie, M.; Huang, P.; Wang, S.; Ma, J.; Zeng, Y.; Sun, J. · Journal (SAGE; 2026)
Systematic review (PubMed/Web of Science/Scopus to April 2024) finding persistent symptoms in up to 74% of affected cohorts beyond 6 months; pathophysiology multifactorial — 5-HT1A desensitization, neurosteroid (allopregnanolone) depletion via 5α-reductase…
HTR1A
PSSD-0032026PFS PSSDCore corpus

Powers’ claim (paraphrased)

Related records

Powers · Reddit post

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/asktransgender

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…

DWP-0012020PFSCore 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

Peer-reviewed paperPSSD Discord pick

Post-SSRI Sexual Dysfunction (PSSD): A comprehensive review of epidemiology, pathophysiology, and clinical management

Xie, M.; Huang, P.; Wang, S.; Ma, J.; Zeng, Y.; Sun, J. · Journal (SAGE; 2026)

Systematic review (PubMed/Web of Science/Scopus to April 2024) finding persistent symptoms in up to 74% of affected cohorts beyond 6 months; pathophysiology multifactorial — 5-HT1A desensitization, neurosteroid (allopregnanolone) depletion via 5α-reductase…

HTR1A

PSSD-0032026PFS PSSDCore corpus