An observational retrospective evaluation of 79 young men with long‐term adverse effects after use of finasteride against androgenetic alopecia

• Published in: Andrology (Oxford) Vol. 4; no. 2; pp. 245 - 250
• Main Authors: Chiriacò, G., Cauci, S., Mazzon, G., Trombetta, C.
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.03.2016
• Subjects: 5-alpha Reductase Inhibitors - adverse effects; 5‐alpha‐reductase inhibitor; Adult; AGA; Alopecia - drug therapy; benign prostatic hyperplasia; erectile dysfunction; Finasteride - adverse effects; finasteride safety; finasteride side effects; follicle stimulating hormone; free testosterone; Humans; loss of libido; luteinizing hormone; Male; male pattern hair loss; PFS; Post‐finasteride syndrome; Reproduction - drug effects; Retrospective Studies; sexual dysfunction; testosterone; sexual dysfunction; finasteride safety; testosterone; Post-finasteride syndrome; 5-alpha-reductase inhibitor; luteinizing hormone; erectile dysfunction; male pattern hair loss; free testosterone; AGA; finasteride side effects; PFS; benign prostatic hyperplasia; follicle stimulating hormone; loss of libido
• ISSN: 2047-2919; 2047-2927; 2047-2927
• DOI: 10.1111/andr.12147

Summary Concern regarding adverse effects of finasteride is increasing. We aimed to determine the type and frequency of symptoms in men having long‐term sexual and non‐sexual side effects after finasteride treatment (a condition recently called post‐finasteride syndrome, PFS) against androgenetic alopecia (AGA). Subjects were recruited at the Urology Unit of the Trieste University‐Hospital, and from a dedicated website. Out of 79 participants, 34% were white Italians, mean age was 33.4 ± 7.60 years, mean duration of finasteride use was 27.3 ± 33.21 months; mean time from finasteride discontinuation was 44.1 ± 34.20 months. Symptoms were investigated by an ad hoc 100 questions' questionnaire, and by validated Arizona Sexual Experience Scale (ASEX) and Aging Male Symptom Scale (AMS) questionnaires. By ASEX questionnaire, 40.5% of participants declared getting and keeping erection very difficult, and 3.8% never achieved; reaching orgasm was declared very difficult by 16.5%, and never achieved by 2.5%. By the ad hoc questionnaire, the most frequent sexual symptoms referred were loss of penis sensitivity (87.3%), decreased ejaculatory force (82.3%), and low penile temperature (78.5%). The most frequent non‐sexual symptoms were reduced feeling of life pleasure or emotions (anhedonia) (75.9%); lack of mental concentration (72.2%), and loss of muscle tone/mass (51.9%). We contributed to inform about symptoms of PFS patients; unexpectedly loss of penis sensitivity was more frequent than severe erectile dysfunction and loss of muscle tone/mass was affecting half of the subjects. Further studies are necessary to investigate the pathophysiological and biochemical pathways leading to the post‐finasteride syndrome.