What is Post-Finasteride Syndrome?

Post-Finasteride Syndrome is a condition that is characterised by a range of persistent symptoms that occur after a course of Finasteride has stopped. Not all Finasteride users will be affected by the syndrome because it is a very rare condition. One study estimates over 1,000 men experience PFS worldwide. [1] This is a relatively low number of cases, considering there are millions of Finasteride users worldwide.

While there are ongoing debates about the existence of the medical condition, only a few studies have shown evidence of the condition. More research is needed to understand it in further detail.

You can tell if you have PFS if you experience any of the following common symptoms after discontinuing the use of Finasteride [2]:

Physical

• Muscle wastage and twitching
• Gynecomastia (breast tissue swelling)
• Fatigue
• Dry eyes and skin
• Metabolic changes
• Digestion problems
• Tooth and gum problems
• Bone problems

Sexual

• Erectile dysfunction
• Loss of libido and sexual desire
• Penile and testicular changes
• Ejaculatory disorders
• Pleasureless orgasm

Neurological

• Depression
• Brain fog
• Anxiety
• Dizziness
• Insomnia (difficulty falling/staying asleep)
• Memory impairment
• Tinnitus (ringing in the ear)
• Blurred vision
• Suicidal thoughts
• Anhedonia (inability to experience pleasure)

Some of the symptoms are similar to the side effects of Finasteride such as loss of libido and erectile dysfunction. However, on-drug side effects are not classified as PFS symptoms.

In a survey completed by the PFS network, 427 submissions were received. Results showed over 50% of the respondents used Finasteride for 200 days or less and reported a variety of symptoms including muscle cramps, twitching, thin skin, fatigue and muscle weakness. [3]

The exact cause of PFS is not fully clear. However, it is believed to be related to the way Finasteride impacts the body’s production of a hormone called dihydrotestosterone (DHT). Finasteride is an active ingredient used to treat male pattern baldness and it works by reducing an enzyme that is responsible for converting testosterone into dihydrotestosterone (DHT). Finasteride 1mg is the recommended daily dosage for treating male pattern baldness. While it provides clinically proven hair growth results, it may impact the body’s hormonal levels, causing symptoms of PFS.

Other research suggests that genes may play a role. In a study of the clinical characteristics and genetic variants in PFS patients, 3 males aged between 20 and 30 years with a PFS duration of 1 to 3 years were enrolled. The male patients were reported to suffer from erectile dysfunction, anxiety, feelings of isolation, and insomnia. After analysing their clinical and genetic information, variants in genes were detected and these genes showed potential risk genes. [4]

There is no research yet that indicates exactly how long PFS can last. Individuals can experience persistent symptoms for weeks, months, or even years after stopping a course of Finasteride.

As of yet, there is no approved or evidence-based treatment for PFS. [5]

In the meantime, symptoms of PFS can be relieved by maintaining a healthy lifestyle, getting regular exercise, as well as limiting alcohol and caffeinated drinks. For depression and anxiety-related symptoms, speaking with a therapist can help improve mental health and well-being.

If you have recently discontinued the use of topical or oral Finasteride, it’s important to keep track of any unusual symptoms and consult with your healthcare provider if you feel worried or concerned. As mentioned before, PFS is a very rare condition so it wouldn’t affect the majority of Finasteride users, even long-term users.

If you want to avoid the risk of developing it, there are Finasteride alternatives available for male pattern baldness such as Minoxidil. However, Finasteride is an FDA-approved and UK-licensed medication and results from alternatives may not be as effective.

In general, it is safe for men to take Finasteride to treat hair loss or male pattern baldness. Despite this, all 5-alpha reductase inhibitors come with potential side effects. Finasteride side effects include decreased sex drive or erectile dysfunction (affecting 1 in 100 people). [6]

Luckily, common side effects of Finasteride typically decrease after a while. If you are considering Finasteride for hair loss or worried about developing Post-Finasteride Syndrome, always talk to your healthcare provider.