Library

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…

2025 follow-up preclinical study in rats treated with finasteride for 20 days then withdrawn for a month, with allopregnanolone given to a subgroup during withdrawal. Withdrawal produced colonic inflammation (elevated M1 macrophages, reduced butyrate)…

Review summarizing four decades of research locating where neurosteroids act on GABA-A receptors. It walks through mutagenesis, chimeric receptors, and electrophysiology work that mapped potentiation and direct-activation pockets within the receptor's…

Whole-transcriptome (RNA-seq) analysis of hypothalamus and hippocampus in adult male rats treated with finasteride for 20 days and examined 24 h after last dose and 1 month after withdrawal. Treatment altered 186 genes in hypothalamus and 19 in hippocampus…

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…

RNA-seq of hypothalamus and nucleus accumbens in male rats treated with paroxetine for 2 weeks and re-examined after 1 month of withdrawal. The nucleus accumbens showed 245 differentially expressed genes at end of treatment and 6 persisting at withdrawal…

Review arguing that gut transit time is a top covariate driving interindividual variation in gut microbiota composition and activity, yet is rarely accounted for in microbiome research. Faster transit favors carbohydrate fermentation and beneficial…

Using Israeli health-maintenance-organization (Clalit Health Services) records over a 19-year period, the authors compared 866 healthy, non-smoking men aged 21-49 who had used serotonergic antidepressants with 11,436 eligible men who had not (unmatched…

Rat study of 20-day finasteride treatment followed by one-month withdrawal, measuring steroids, neurotransmitters, cytokines, and gut-permeability markers in the colon. Both treatment and withdrawal lowered allopregnanolone, and post-withdrawal this coincided…

Using in silico screening plus in vitro/in vivo assays, identified a novel protein off-target of paroxetine that may contribute to SSRI-induced sexual dysfunction, expanding the pharmacology beyond serotonin reuptake inhibition.

Pilot study comparing fecal microbiota of 21 PFS patients (23 recruited, 2 excluded for low sequencing depth) with 10 healthy men whose sequences came from an earlier study, using 16S rRNA sequencing. Two richness measures (Chao1 and Faith's phylogenetic…

This Baylor-affiliated team compared gene expression in penile skin cells from 26 men with post-finasteride syndrome against 26 healthy controls. They found 1,446 genes over-expressed and 2,318 under-expressed in the PFS group, with the androgen receptor gene…

Adult male Wistar rats trained on a partially baited radial-arm maze then received finasteride (30 or 100 mg/kg) or vehicle for seven days. The high dose produced clear spatial-memory deficits on retention testing and reduced sociability with loss of…

Traish argues that dihydrotestosterone (DHT) is far more than a prostate-and-hair hormone, documenting its physiological roles in liver, pancreatic beta-cell function and survival, ocular and lacrimal function, and kidney physiology. Blocking DHT synthesis…

Short research letter from Samsung Medical Center (Sungkyunkwan University) reporting macular abnormalities associated with 5α-reductase inhibitor use. The SideFXHub article that surfaced it additionally leans on an unpublished South Bay Retina clinic…

In what the authors described as a prospective case-control study, 25 young men with persistent adverse effects after finasteride for hair loss were compared with 28 controls using validated questionnaires (IIEF, IPSS, PHQ-9, sleepiness scales…

In this pilot case-control study, 16 PFS patients were compared with 36 controls who had never used finasteride: 18 surgical patients giving cerebrospinal fluid (2 of whom also gave blood) and 18 blood-only donors; controls' mean age was 40.8 years vs 34.5 in…

Human embryonic kidney (HEK-293) cells were cultured in 50 micromolar citalopram for 30 days and then profiled genome-wide for DNA methylation changes. Of roughly 25,000 gene promoters assayed, 626 showed significant differential methylation versus controls…

In 66 PFS patients, short/long (CAG)n and (GGN)n repeat lengths in the androgen receptor gene were associated with different symptom frequencies (libido loss, genital sensitivity changes, muscle tone, skin dryness, etc.), with a U-shaped pattern for some…

Multicenter case-control study of 16 men with post-finasteride syndrome, combining psychiatric/andrological phenotyping with cerebrospinal fluid and plasma neuroactive-steroid measurements in 14 of them (2 declined CSF sampling), compared against 25 surgical…

Basaria's group compared three groups of men: 25 finasteride users with persistent sexual symptoms, 13 asymptomatic finasteride users, and 18 men who never used the drug. Assessments covered hormones, body composition, cognition, and brain activity via fMRI…

Review of two glucuronidation enzymes, UGT2B15 and UGT2B17, that convert DHT metabolites (3α-diol and androsterone) into inactive, easily excreted glucuronide conjugates. It describes how these enzymes control local androgen availability and androgen-receptor…

Survey of 532 respondents identified 183 possible PSSD cases (23 high-probability); female sex, genital anesthesia and depression predicted current severity, but dose did not; genital anesthesia was independent of depression/anxiety.

The team compared the prevalence of two androgen receptor polymorphisms, CAG-rs4045402 and GGN-rs3138869, across 69 men with androgenetic alopecia who developed persistent side effects after finasteride, 91 untreated men with alopecia, and 76 untreated men…

Irwig studied 24 otherwise healthy young men who had taken low-dose finasteride for hair loss and developed persistent sexual side effects, measuring their hormone levels and semen quality against reference populations. Although average testosterone and DHT…

In a retrospective case-control design, foreskin tissue from 8 men with persistent sexual side effects (including genital sensitivity loss) more than 6 months after stopping finasteride was compared with tissue from 11 healthy circumcision controls never…

Mouse study using a transgenic human-CYP2D6 model, finding that human CYP2D6 is expressed not only in liver but also in brain, where it altered serotonin and metabolite levels plus broader brain metabolomic profiles, and shifted anxiety-related behavior. The…

Preclinical prostate-cancer study in which prolonged bicalutamide exposure produced a resistant cell subline that overexpressed androgen receptor protein and phosphorylated AR, proliferating at tenfold lower androgen concentrations than parent cells — without…

Proposes that common pharmaceuticals can cause lasting epigenetic modifications (DNA methylation, chromatin changes) as side effects — a new field of "pharmacoepigenetics" — potentially explaining persistent post-treatment syndromes.