An official website of the United States government. The Food and Drug Administration Adverse Event Reporting System (FAERS) was queried to identify medications with the highest frequency of ED adverse event reports from 2010-2020 The top 20 medications with the highest frequency of ED were included in the disproportionality analysis Of these 20 medications, there were 6,142 reports of ED and 5-alpha reductase inhibitors (5-ARIs) accounted for 2,823 (46%) of these reports Seven medications showed significant levels of disproportionate reporting but finasteride and dutasteride had the highest PRRs: 110.03 (103.14-117.39) and 9.40 (7.83-11.05) respectively Physicians and patients should be familiar with medications that are associated with ED. Hi, no I dont have insomnia. Maksym et al., Post-finasteride . Pharmacological Management of Pattern Hair Loss. 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. 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? It is not known why some men are susceptible to the potential adverse effects of finasteride, while othersthe majorityare not affected.Further research is needed on who is susceptible to the persistent, adverse side-effects of finasteride and on the underlying mechanisms of the medication. I have a good friend who, with the best of intentions, told me about his positive hair plug experience and wanted to make [sure] I didnt miss my window of opportunity for treatment. Post-finasteride syndrome (PFS) is a constellation of serious adverse side effects manifested in clinical symptoms that develop and persist in patients during and/or after discontinuing finasteride treatment in men with pattern hair loss (androgenetic alopecia) or benign prostatic hyperplasia. Stopping finasteride treatment can cause post-finasteride syndrome. Donald Trumps hair loss drug tied to anger, depression, and self-harm in new medical study: The Daily Mail, March 21, 2017, Symptomatic finasteride users had significantly lower International Index of Erectile Function composite score and significantly lower scores for each of its domains of erectile function, sexual desire, orgasmic function, intercourse satisfaction, and overall satisfaction.There exists a significant positive correlation between a subset of Beck Depression Inventory scores related to negative attitude and blood oxygen level dependent activity., Characteristics of Men Who Report Persistent Sexual Symptoms After Finasteride Use for Hair Loss: The Journal of Clinical Endocrinology & Metabolism, July 2018. There are feared side effects [from finasteride] that include sexual dysfunction in men, some of which can be very serious. But Nobody Warned Me about Finasteride! As of 2018, 15,000 cases of adverse reactions to finasteride were reported to the WHOwhich is a huge number to begin with. If youve already done blood tests and want to learn how to interpret them, check out these articles: If DHT is high, then you dont have to focus on boosting DHT, but maybe rather allopregnanolone through increasing 5-AR type 1. Also I jumped the gun on TRT out of frustration and desperation. Propecia should have never been approved, and its authorization should be revoked as soon as possible. HCG will most likely increase progesterone, but hopefully, it can stimulate 5AR which will increase allopregnanolone. According to Bernard BegaudThis drug should never have been marketed for cosmetic purposes. But now that it is available, its up to those concerned to decide whether or not to take this medication, or to stop taking it. BioBalance Healthcast: The Ugly Truth About Finasteride, June 7, 2021. These observations encouraged the present systematic review of the research literature pertaining to changes in mood and possible increases in suicidal ideation and behavior in association with or following treatment with finasteride This systematic review of reports concerning adverse psychiatric effects of finasteride treatment supports the conclusion that such treatment is significantly associated with risk of clinical depression, as well as high rates of sexual dysfunction and evidence of increased risk of suicidal ideation and perhaps of suicidal behavior. They have low libido. By no means this would be considered a small number and should not be dismissed or ignored. Baldness Medication Can Cause Permanent Erection Problems (English translation): De Volkskrant, February 15, 2019. wow very helpful articular and explains my symptoms exactly. I have hundreds of [PFS] patients. Have you tried getting loads of sunlight? I also had dysbiosis in my gut which is slowly being resolved with the help of probitics. MeSH Treatment of young subjects is of increasing concern due to accumulating evidence that daily use of oral finasteride has several severe adverse effects.Since finasteride inhibits T conversion into DHT, which is responsible for most androgen activity, it is plausible that prolonged finasteride use in predisposed individuals could simulate the effects of aging in young men. Keep me posted if you like. Physicians treating male pattern hair loss should discuss with patients the potential risk of adverse events with finasteride. Men reporting Post-Finasteride Syndrome experience side effects that persist after stopping finasteride or other 5-alpha reductase inhibitors. Prostatis Allopregnanolone, the Neuromodulator Turned Therapeutic Agent: Thank You, Next? You can send me an email at menelite101@gmail.com with your labs (and any addition info you might deem relevant) so I can take a look. Ive made a 80% recovery so far and I keep improving however your hypothesis is quite scary. I tried only. Its really not the serotonin thats so beneficial. Many have never recovered sexual functioning, not worth the risk. Topical progesterone the skin is rich in 5-AR, so applying progesterone to the skin should increase allopregnanolone. [E]very day I receive more and more emails from young men whose lives have been changed by finasteride. The authors declare no conflicts of interest. Some say it's all in the mind, a made-up mythbut those who suffer from it surely know they're not just a hypochondriac. Do not take finasteride for hair lossDo not take finasteride for any purposeFor many years, Public Citizens Health Research Group has classified both [Proscar and Propecia] as Do Not Use because their benefits do not outweigh their adverse effects. Discover, October 2020. THC has been shown to increase brain pregnenolone, but this study shows that cannabis users have higher pregnanolone (a 5-metabolite) and lower allopregnanolone (a 5-metabolite) (, Get lots of sunlight, especially in the morning. You might thus benefit from things that stimulate bile flow such as taurine and TUDCA. My biggest issue is low/no libido. There are currently only 134 reports of Post-5-alpha reductase inhibitor syndrome in FAERS. 5 Common Medications That Can Cause Erectile Dysfunction: MedShadow, June 9, 2019. Post-finasteride syndrome is a rare condition that some men may experience after taking finasteride (Proscar, Propecia). Huh? J Urol. Sex Med Rev. In addition, many doctors dont understand or even recognize PFS as a real disease and these patients will suffer alone. Persistent sexual side effects of finasteride: could they be permanent? Finasteride is a steroid 5-alpha-reductase inhibitor, approved for the treatment of androgenetic alopecia and benign prostate hyperplasia. We propose that the Dermatologist Society remove from their guidelines the utilization of finasteride for male pattern hair loss., Sexual and Nonsexual Problems after Finasteride Used for Hair Loss in Young Men: American Society for Mens Health, 2014. : June 21, 2022. For the time being, as a general rule: Refrain from prescribing oral finasteride to a patient with a personal history of depression, sexual dysfunction, or fertility problems. Access this article for 1 day for:38 / $45 / 42 (excludes VAT). Two papers in a short period of time showing higher rates of suicide with finasteride. 2019 Apr;7(2):277-282. doi: 10.1016/j.sxmr.2018.07.003. Sexual, physical, and overall adverse effects in patients treated with 5-reductase inhibitors: a systematic review and meta-analysis. If you stop with fin, then DHT should be back to normal in about 1-2 weeks (tissue binding lasts 4-5 days). Using finasteride for hair loss is like shooting at sparrows with cannons. You have to choose between hair and sex drive and your personality and your marriage or your partnership Ive tried giving testosterone to patients who are on finasteride at the same time. official website and that any information you provide is encrypted I remember being depressed, emasculated, and hopeless. A Pill the Doctor Gave Me Destroyed My Life. Are you sensitive to dietary fats and have greasy stool with fat floating on the surface of the water after pitching a loaf? Conducting RNA microarray analysis, 1,446 genes were . Please enable it to take advantage of the complete set of features! no libido [A]gree. Statement (via Twitter) in response to Jagan Kansal, MDs tweet, Thoughts on propecia in young guys causing decreased libido, possibly permanent? November 13, 2020. 2022 Oct;10(5):100543. doi: 10.1016/j.esxm.2022.100543. Adding a warning to pharmaceutical preparations containing the medicinal substance finasteride: Administrative Circular No. DHEA potently increases androsterone levels, and that is how its thought to lower anxiety. and transmitted securely. Alteration of Gut Microbes in Benign Prostatic Hyperplasia Model and Finasteride Treatment Model. I suffered PFS till 4 years with many problems: Published by Elsevier Inc. All rights reserved. Yes After nearly 4 years of suffering, I have finally & fully recovered from Post Finasteride Syndrome All my symptoms have subsided and improved with this method which takes a while but I am fully functional It's H.C.G (HCG) dosed at 250IU Monday, Wednesday and Friday only. Response (via Twitter) to the top 20 adverse reactions to finasteride filed with the FDA: April 23, 2021. If a patient treated with 1 mg finasteride develops psychiatric symptoms, treatment should be stopped. 2019 Jan 1;99(1):12-17. doi: 10.2340/00015555-3035. 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. 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. According to the Post-Finasteride Syndrome Foundation, the symptoms can be physical, mental, neurological, or sexual, and can persist even after you stop taking the medication. My goal is to get off Trazodone as quickly as possible, any recomendationsto further aid with insomnia ? Updated Review of the Hair Loss and Prostate Drug Finasteride: Worst Pills, Best Pills, January 2020. While you still dont hear much about it PFS as we call it is something we should at least call attention to [I]ts really important that men are informed about PFS so that they can decide whether or not they actually take finasteride. Bethesda, MD 20894, Web Policies Direct Healthcare Professional Communication letter, October 4, 2018. How much Glycin and Niacinamid do you recommend? Responding, via Twitter, to the study Association of 5-Reductase Inhibitors With Dementia, Depression, and Suicide: December 25, 2022. 8600 Rockville Pike Utah Mens Health YouTube channel: July 11, 2019. 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.) Post finasteride syndrome and adrenal fatigue can be interrelated. Hi David, Based on currently available data, the use of 5-reductase inhibitors in patients with a history of depression, sexual dysfunction or infertility must be carefully and individually evaluated. One key indisputable clinical evidence noted in all reported studies with finasteride and dutasteride was that use of these drugs is associated with development of sexual dysfunction, which may persist in a subset of men, irrespective of age, drug dose or duration of study. Post-finasteride syndrome: An emerging clinical problem: Neurobiology of Stress, May 2020. 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. What few people know is that there are 5-R and 3 types of 5-R enzymes and that theyre not only involved in the conversion of testosterone to DHT, but also in the: Many of the benefits of testosterone, such as enhanced insulin sensitivity, reduced catabolism, higher dopamine, increased thyroid hormone production, are mediated by DHT, and blocking DHT production prevents those effects/benefits. What do you think about proviron and other DHT derived steroids? Allopregnanolone, the Neuromodulator Turned Therapeutic Agent: Thank You, Next? Careers. (2009) of 2017. Frontiers in Endocrinology, May 2020. We stopped prescribing finasteride because the risk is just too high. Often have low t. Make sure to check dht also! Maybe not atypical, but anxiety/panic due to finasteride. Bookshelf But now I would not feel comfortable recommending Propecia to a young, sexually active man. Responding, via Twitter, to the study Association of 5-Reductase Inhibitors With Dementia, Depression, and Suicide: December 24, 2022. CreGAAtine vs creatine monohydrate: Its not better! Unauthorized use of these marks is strictly prohibited. (PFS) Post finasteride syndrome is real and affects millions of people worldwide. You dont have to be a genius to realize that, when youre taking away the most potent form of testosterone, and youre affecting, for example, ejaculate volume, clearly something is changing around the prostate area. In my opinion, I do not recommend using finasteride for the treatment of hair loss as its side effects are more dangerous. Dont let any man you know take that poison! There are numerous hormonal and nonhormonal treatment options for men with PFS. It's real alright. Researchers have found low levels of neurosteroids, including allopregnanolone, in the cerebrospinal fluid of post-finasteride syndrome patients. An official website of the United States government. Annals of Medical and Health Sciences Research, January 2022. This Hair-Loss Drug Has Powerful Effects: Mens Health Germany, June 2021. The concept of PFS has emerged from reports of non-dermatologists, neuroendocrinological research and reflections, and uncontrolled studies of low quality and with a strong bias selection, while a significant nocebo effect among patients informed about possible side effects of finasteride is recognized. Limited research exists exploring the psychological corollaries of post-finasteride syndrome and preexisting Axis I and Axis II mental health conditions. Chiriac G, Cauci S, Mazzon G, Trombetta C. Andrology. Finasteride is a 5-alpha reductase inhibitor that's used to treat androgenetic alopecia (a clinical term for male pattern baldness) and benign prostatic hyperplasia (non-cancerous growth of the prostate gland). Case report: a study of the clinical characteristics and genetic variants of post-finasteride syndrome patients. You do think that these hypothetical damages can be reversed ? Some people do have success with HCG, but less so with clomid. Please enable it to take advantage of the complete set of features! Post-finasteride syndrome is characterized by persistent sexual, physical, and mental health side effects that continue even after stopping the medication. Although, they would like you to believe testosterone replacement is the only solution to make a full recovery. Since some of the effects of androgen inhibition cannot be reversed once local androgen levels are re-established, it is temping to speculate that patients could still suffer from adverse sexual effects several months or even permanently after finasteride discontinuation. 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. As I read websites like yours and CDsNuts. My hypothesis is that finasteride can cause brain damage which needs to be reversed. VRT-TV, Belgium. I will not prescribe finasteride to young men with MPB because of the potential side effects. Don't listen to bad doctors who tell you its all in your head. Cannibus is my only vice, so any suggestions would be greatly appreciated. 2022 Oct 26;12(11):1567. doi: 10.3390/biom12111567. No libido A low estimated prevalence of PFS cannot be an excuse for nonvigilance since the drug is used by millions of relatively young and healthy individuals.". Potential side effects of the drug Trump reportedly takes for hair loss: The Washington Post, Feb. 3, 2017. There is not a lot of (if any) scientific evidence to backup this up yet, but that doesn't mean that it's non-existent. 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. Who would have thought trying to enhance the hairline would cause bigger problems! Although some of these side effects may go away with time, others may be permanent. How to Deal with the Issues of Fertility, Malignancies, and the Postfinasteride Syndrome while Prescribing Finasteride for Male Pattern Hair Loss. The brain fog has never gone away. I have seen some cases of post-finasteride-syndrome that do not revert to anything. HTX Urology website, December 2019. Bookshelf Bone pain 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 . 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. What happens if you get side ef. Response (via Twitter) to Rachel S. Rubin, MD, vis-a-vis the clinical study titled Post-finasteride syndrome: An emerging clinical problem, January 2, 2020. 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. But unfortunately, in some men, the damage is hardwired. Its unnatural for adult men to have low levels of this molecule. 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: Journal of Sexual Medicine, November 2016. In my opinion, these medications are contraindicated in this population. If estrogen is high, focus on lowering that, as estrogen is a potent inducer of serotonin and prolactin. How do you explain that? I wanted to take a minute to talk to you about post-finasteride syndrome since more and more men are coming in with complaints after taking finasteride. Ongoing Concerns Regarding Finasteride for the Treatment of Male-Pattern Androgenetic Alopecia: JAMA Dermatology, November 2020. Markthceck (SWR TV) Lifestyle Drug Finasteride: Dead pants instead of a bald head? Epub 2016 Jan 13. You must know that this molecule, finasteride, has been the subject of more than 2,600 scientific articles found in trustworthy databases. Reggie told me that sometimes he got confused for no reason and he felt tired all the time. National Library of Medicine Androstanediol glucoronide is a hormone derived from DHT (the hormone inhibited by finasteride). 2012 Nov;9(11):2927-32. doi: 10.1111/j.1743-6109.2012.02846.x. 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. Reaction (via Twitter) to publication of the study Investigation of Suicidality and Psychological Adverse Events in Patients Treated With Finasteride, in JAMA Dermatology, January 19, 2021. 2022 Jul-Aug;24(4):390-397. doi: 10.4103/aja202171. Based on data of this study, I will strong[ly] recommend to my patients [that] using finasteride has the probability of suicidehigher than 22% than no use. But be careful, friends. Proscar can hardly be categorized as safe because it can cause breast augmentation, reduced libido andimpotence. Thanks for reaching out. 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. [T]here is no known treatment for lifelong PFS. In my clinical experience, the length of time on the medication does not correlate with the severity or duration of the side effects. A Letter Regarding Finasteride: SouthBayRetina.com, May 2021. Moreover, the effects persisted long after the drug had been discontinued.[T]hey then called in men with PFS, took skin from the penis and found that the density of androgen receptors in men with PFS was about twice that of those without. Statement via Twitter, February 10, 2022. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). FOIA Its Monday, which means its time for a poll! I am 29 now and started at 22. An observational retrospective evaluation of 79 young men with longterm adverse effects after use of finasteride against androgenetic alopecia: Androlog, Jan. 13, 2016. I am quite distressed atm and hope this is not permanent and everyone is telling me Im just hypochondriac but I know my sexual function is inhibited for the time being. 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. Only individuals who are born with intersex characteristics (hermaphrodites) have low levels of this hormone. Epub 2019 Jan 16. Increasing carbon dioxide production. While the sexual side effects of 5ARIs are well known, there may be persistent genitourinary, physical, psycho-cognitive, anti-androgenic and penile vascular changes after 5ARI discontinuation. The Impact of 5-Reductase Inhibitor Use for Male Pattern Hair Loss on Men's Health. In 2017, the European Medical Agency recommended adding warnings of potential risk of suicidal ideation to product information for finasteride. Sexual functioning is returning to some extent. And this sequence for me is very clinically significan[t]. I think this is what we are seeing here. [O]ur results showed that [finasteride] treatment affected the expression of a number of accumbal proteins involved in key functional processes, such as regulation of GABAergic neurotransmission, as well as steroid and pyrimidine metabolism. Mens Health and Fertility Lifestyle Information: Weill Cornell Medicine Center. There is accumulating evidence that it negatively impacts male fertility. So thats all gone in many men, just because of finasteride. So lets discuss what the drug, finasteride, does in the first place. They need to be better informed. Every patient must be thoroughly informed about its side effects. Patients considering using these medications should be very careful and speak to a Urologist in person about risks, benefits, and indications of treatment. My total t is 650 ng/dl. Disclaimer. I feel deeply for all my balding brothers out there who are suffering from this poison. Thats the responsibility of the doctor who prescribes the medication, or the pharmacist who supplies it. As yet, the condition is not recognized by the medical community, although individuals who suffer from PFS present with relatively homogenous symptoms. CO2 keeps serotonin in check. No one informed me this could be a risk! HHS Vulnerability Disclosure, Help So optimizing cellular function with CoQ10, necessary vits and minerals, thyroid hormones, neurosteroids, etc., should all be helpful at restoring the problem. I think its important to be educated about the potential side effects. Have you tried nearly everything, but nothing seems to move the needle? Even if you take just a little finasteride, it can actually drop your DHT so low that men become impotent. These symptoms are very rare, but once you have them, its forever. Winston-Salem, NC, Ross J. Baldessarini, MD, Professor of Psychiatry, Quoc-Dien Trinh, MD, Associate Professor of Surgery, Wexner Medical Center, Ohio State University, Govinda Healthcare Medicentre, New Delhi, India, Associate Professor of Urology University of Arizona, University of Miami Miller School of Medicine, Omer Onur Cakir, MD, Department of Urology, Bagcilar Training and Research Hospital, Istanbul, Turkey, Pelita Harapan University Faculty of Medicine, Tangerang, Indonesia, Shelly Gray, PharmD, Shirley & Herb Bridge Endowed Professor, University of Washington School of Pharmacy, YOU & WEE Urologic Surgery & Wellness, Sarasota, FL, Faysal A. Yafi, MD, Associate Professor of Urology, University of California, Irvine Medical Center, Naeem Bhojani, MD, Associate Professor of Urology, Andrology Fellow, Northwestern University, Wedad Saeed Al-Qahtani, Assistant Professor, Naif Arab University for Security Sciences, Riyadh, Saudi Arabia, Abdulmaged M. Traish, PhD, Professor of Biochemistry and Urology, Mark A. Moyad, MD, Director of Preventive & Alternative Medicine, University of Michigan Department of Urology, Abdulilah Al Malik, Regulatory Affairs Director, Saudi Arabia, The Psychiatric Institute, University of Illinois at Chicago, Douglas G. Adler, MD, Professor of Medicine, Medical Director, Sperling Prostate Center, Serrate & Ribal Institute of Urology, Barcelona, Roberto Melcangi, PhD, Head of Neuroendocrinology, Department of Pharmacological and Biomolecular Sciences, Silvia Diviccaro, PhD, Post-Doctoral Fellow, Department of Pharmacological and Biomolecular Sciences, Irwin Goldstein, MD, Clinical Professor of Surgery, University of California at San Diego, Editor-in-Chief, The Journal of Sexual Medicine, Department of Urology, David Geffen School of Medicine, University of California, Los Angeles, Krohnstiegcenter Dermatology Center, Hamburg, Germany, Glickman Urological and Kidney Institute, Cleveland Clinic, Hospitalist, UAB Medicine, Birmingham, AL, Andrea Militello, MD, Urologist/Andrologist, Department of Urological, Biomedical and Translational Sciences, Federiciana University, Michael Zitzmann, MD, Andrology Professor, Michael Carmone, MD, Director, Health Research Group, Dietrich von Herrath, MD, Chief Physician, Steven M. Belknap, MD, Research Assistant Professor of Dermatology and Medicine, Northwestern University Feinberg School of Medicine, Marcel Waldinger (1955-2019), MD, PhD, Professor, Department of Pharmacology, Shalendar Bhasin, MD, Professor of Medicine, Alex Tatem, MD, Fellow in Andrology, Male Fertility and Microsurgery, Department of Urology, NYU Grossman School of Medicine, Franois Desgrandchamps, MD, PhD, Chief of Urology, Bernard Bgaud, MD, Professor of Pharmacology, Carla Di Loreto, PhD, Experimental and Clinical Medical Sciences, Nelson Novick, MD, Clinical Professor of Dermatology, Charles J. Ryan, MD, Distinguished Professor of Clinical Medicine and Urology, Jan Tytgat, PhD, Professor of Toxicology and Pharmacology, Erika Cecchin, PhD, Researcher in Clinical and Experimental Pharmacology, Donatella Caruso, PhD, Professor of Pharmacology and Biology, Ralph M Treb, MD, Proefssor of Dermatology, Center for Dermatology and Hair Diseases, Zrich, Sabina Cauci, PhD, Medical and Biological Sciences, Christine A Ganzer, PhD, Assistant Professor, Silvia Giatti, PhD, Pharmacological and Biomolecular Sciences, Bruhin & Associates Psychotherapists, San Diego, California, Professor of Urology, Feinberg School of Medicine, Carlo Trombetta, MD, Head of Department of Urology, Dirk Michielsen, MD, Professor of Urology.
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