PFS and relationships: coping after a crash

Finding it harder to be with friends or a partner since a crash? Post-finasteride syndrome (PFS) can last after stopping finasteride, and it often changes your social life and your relationship. Smaller plans, honest talk and people who understand make it easier to stay connected.

The UK Propecia leaflet lists problems with erections, sex drive and ejaculation that persisted “after discontinuation of treatment”. Many partners and friends won’t have seen that line.

So why does PFS reach into friendships, and how can you and the people close to you adjust?

Why does PFS affect friendships and social life?

It affects them because the symptoms people describe make ordinary plans harder. Tiredness, low mood, anxiety and problems with concentration and memory can turn a night out into something you dread.

PFS is more than a sexual problem. Proposed diagnostic criteria from 2022 say cognitive problems, depression and suicidal thoughts can occur even without sexual difficulties. So a crash can touch your energy, your mood and your patience, as well as intimacy.

Matt took finasteride for three years without problems. A few weeks after he stopped, he says, “I began to feel very emotionally numb.” That kind of change is hard to explain over a drink.

Play video: Matt on feeling emotionally numb after finasteride (extract)

How can I keep a social life with PFS?

Shrink the plans rather than cancelling everything. People in our community describe a few changes that help:

• Fewer, smaller meetings. One or two close friends somewhere quiet, instead of a big party.
• Daytime plans. A coffee or a walk in place of late nights and drinking.
• Rest built in. A free day after a busy one, so tiredness doesn’t pile up.
• Online when you can’t go out. A regular video call keeps a friendship going from home.

You don’t owe anyone the full story. “I’ve got a long-term health problem and I’m pacing myself” is enough for most people.

How do I talk to my partner about PFS?

Start with what changed and when, then what you need. A partner can’t support a problem they can only guess at.

Some couples set a regular time to talk about how things are going, so it doesn’t only come up in a bad moment. Others find a couples therapist gives both people a safe space to say what’s hard. A therapist who knows chronic illness can help even if they’ve never heard of PFS.

Share something they can read in their own time. Our PFS page and the leaflet line above are a calm place to start.

It can be lonely for a partner too. Thammika was married for five years to a man with lasting sexual problems after finasteride. In her interview with Moral Medicine she says, “This is definitely not this man’s fault.” She describes a deep loneliness, and the marriage ended, though she says they stayed close as co-parents.

Her story is one person’s, and many couples stay together. It’s worth watching with a partner, because it says out loud what both sides often keep quiet.

Play video: Thammika on her marriage after finasteride

How can couples stay close when sex is difficult?

Many couples widen what closeness means. Touch without pressure, like holding hands or a massage, can matter more when sex is hard or impossible for a while.

Shared things help too: a hobby, a walk, a series you watch together. They give you time as a couple that isn’t measured by sex. If sexual problems are one of your symptoms, a GP can check for other causes, and you can ask what support is available locally.

What you can do

These medicines help many people. If you have side effects, that’s a decision for you and your prescriber. The Propecia leaflet says to stop and contact your doctor if you have mood changes such as depression.

If you have thoughts of suicide, call the Samaritans on 116 123 in the UK, any time.

Other patients are often the first people who don’t need it explained. You can join the SIDEfxHUB forum, the Post-Finasteride Syndrome Facebook group or our WhatsApp peer support groups for your region.

Pointing a friend or partner to these resources can help them understand, too.

Report it: it helps everyone

A doctor’s note helps you. A report to the medicines regulator helps everyone else: it is how patterns get noticed.

• No proof needed. A suspicion is enough, even years after stopping.
• Where: the Yellow Card scheme in the UK, MedWatch in the US.
• Use the right words. If symptoms continued after stopping, write Post 5-alpha-reductase inhibitor syndrome (MedDRA 10082430).

Our reporting guide walks you through it

What else do people ask?

Should I tell friends about PFS? Only as much as you want. Close friends often cope better with a short, honest explanation than with repeated cancellations. You can say it’s a health problem after a medicine and leave the details for later, or never.

Can a relationship survive PFS? Many do, though it can take work from both people. Talking early, getting outside help and keeping closeness beyond sex all help. Nobody has measured how relationships fare with PFS, so stories like Thammika’s are what we have.

Is it normal to feel isolated? Yes, many people with PFS describe it. Low mood and tiredness make it easy to withdraw. Small, regular contact, even a message or a short call, keeps the door open. If low mood takes over, talk to your GP.

Thammika’s words are a good place to begin a hard conversation: it isn’t anyone’s fault. Then report what happened to you, so it gets counted.

Sources

1. Healy D, Bahrick A, Bak M and colleagues. Diagnostic criteria for enduring sexual dysfunction after treatment with antidepressants, finasteride and isotretinoin. Int J Risk Saf Med 2022;33(1):65-76. Proposed criteria from expert agreement. Section 5 (finasteride): cognitive impairment, depression and suicidality “can occur independently of any sexual difficulties”. “The incidence of these conditions is unknown.”
2. Organon. Propecia 1 mg film-coated tablets, patient leaflet, electronic Medicines Compendium, last revised May 2026. Section 2: mood alterations such as depressed mood, depression and, less frequently, suicidal thoughts; “stop taking Propecia and contact your doctor for further medical advice as soon as possible”. Section 4, frequency unknown: “persistent difficulty having an erection after discontinuation of treatment”, persistent decrease in sex drive and persistent problems with ejaculation after discontinuation.
3. Moral Medicine, This Year I’m turning 30 years old, and I haven’t felt an orgasm since I was 24, Matt’s film, 6 April 2026, embedded as an extract from 5:26 to 6:45. From the auto-captions: three years on finasteride “without any issues” (4:24); “I began to feel very emotionally numb” (5:32 to 5:37). His story: Matt’s story.
4. Moral Medicine, Post-Finasteride Syndrome Ended My Marriage, Thammika’s interview, 30 April 2025. From the auto-captions: “This is definitely not this man’s fault” (3:30); married five years (4:00); no cognitive or emotional symptoms (4:15); best friends and co-parents (9:15); loneliness (14:00).
5. GOV.UK. Report a problem with a medicine or medical device.

Sources checked on 22 October 2026. AI-assisted writing and review, not clinical review.