Emotional impact of PFS: what helps

Post-finasteride syndrome (PFS) can bring low mood, anxiety, emotional numbness and a deep sense of isolation, and these can last after the last tablet. Support from people who understand, a GP who listens and talking therapy can all help.

If you’re having thoughts of not wanting to be here, call Samaritans free on 116 123 (UK and Ireland), day or night. Our page on suicidal thoughts with PFS has more help.

Sam was 25 when he took finasteride for about a week. Ten weeks after his symptoms began, his mum hugged him and told him he’d be all right. “I just couldn’t feel that,” he says. He describes life as “like being on mute all the time”.

Watch this extract to hear him describe it in his own words. He was filmed early, before the three months that the proposed 2022 criteria for PFS ask for.

Play video: Sam on feeling disconnected after finasteride

So why does this happen, why can it feel so lonely, and what helps?

What does PFS feel like emotionally?

For many people it feels flat, as if someone turned the volume down on life. Others describe constant worry, low mood or a short temper they don’t recognise.

PFS isn’t only about sex. The 2022 criteria for PFS say depression, suicidal thoughts and cognitive problems can come with the sexual changes, or without them. So the emotional side is part of the condition, and often the hardest part.

Is the low mood caused by finasteride itself?

It may be, at least in part. The UK leaflet says depressed mood, depression and, less often, suicidal thoughts “have been reported” in men taking it. It lists anxiety too.

The leaflet also says sexual problems “may contribute to mood alterations”. So two things can happen at once: the medicine, and what it does to a life.

Depression seems common with PFS. One small study of men with lasting problems after finasteride found signs of depression in about 3 in 4, against 1 in 10 men with hair loss who’d never taken it. The men weren’t picked at random, so it can’t tell you your own odds. Our page on PFS anxiety and depression goes further.

Why do people with PFS feel so alone?

Partly because it’s hard to explain, and partly because many aren’t believed. Friends may not have heard of PFS, and some doctors haven’t either.

The isolation reaches partners too. Thammika was married for five years to a man with lasting problems after finasteride. “This is definitely not this man’s fault,” she says. She describes a deep loneliness. The marriage ended, but she says they stayed close as co-parents.

Her interview is worth watching if you’re trying to see PFS from the other side of a relationship.

Play video: Thammika on her marriage after finasteride

Frustration and anger are common reactions to all this.

What helps with the emotional side of PFS?

Start with people who get it. Talking to someone who has lived with PFS can make the first months feel less lonely. Our WhatsApp peer support groups are run by people affected, and you can read without posting. Our guide to peer support for PFS lists other places.

Tell one person close to you. Our page on talking to family and friends about PFS has words you can borrow.

Talking therapy can help with anxiety and low mood, even though it doesn’t treat PFS. In England you can refer yourself to NHS Talking Therapies without seeing a GP.

Small daily things can steady you. Keep a regular bedtime, get outside and move a little if your body allows. Breathing exercises can take the edge off panic. Writing, music or painting gives feelings somewhere to go. None of this cures PFS, but it can make a bad day easier.

Your GP is part of this too. Tell them when your mood changed, and what else changed with it. A clear timeline helps.

1. Your medicine: “Finasteride 1 mg from March 2024, last tablet June 2025.”
2. What changed: “Felt flat and anxious from August 2025. Less feeling in my penis from May.”
3. How it was before: “No anxiety or depression before 2024.”

Finasteride helps many men keep their hair. Whether it’s right for you is a decision for you and your prescriber. If you’re still taking it, the UK leaflet says to stop and contact your doctor if your mood changes. Many people say it took time to be taken seriously. You can report it without a doctor agreeing.

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. Low mood and emotional numbness count too.
• 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?

Does the emotional impact of PFS go away? For some people it has lasted years after stopping. Nobody knows yet who will be affected, or whether it will ease. Getting help for your mood now is worthwhile either way, whatever happens with the other symptoms.

Is it normal to feel angry about PFS? Yes. Many people feel angry about what happened, or about not being believed. Anger is easier to carry when you can say it out loud to someone who understands, such as a peer group or a therapist.

Can PFS affect mood without sexual symptoms? Yes. The PFS criteria say depression and cognitive problems can occur on their own. Having no sexual symptoms doesn’t rule out PFS.

Sam couldn’t feel his mum’s hug. If something like that has happened to you, tell one person this week, and report it.

Sources

1. Organon. Propecia 1 mg film-coated tablets: patient information leaflet, electronic Medicines Compendium, last revised May 2026. Section 2: “Mood alterations such as depressed mood, depression and, less frequently, suicidal thoughts have been reported”; “If you experience any of these symptoms stop taking Propecia and contact your doctor for further medical advice”; impaired sexual function “may contribute to mood alterations”. Section 4, frequency unknown: anxiety; “persistent difficulty having an erection after discontinuation of treatment”, persistent decrease in sex drive and persistent problems with ejaculation after discontinuation.
2. MHRA. Finasteride and dutasteride: updated safety warnings for psychiatric side effects and sexual dysfunction, Drug Safety Update, 11 May 2026: finasteride “is associated with depression, suicidal ideation and sexual dysfunction which may persist after treatment is stopped”.
3. 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 developed through expert agreement. Section 5 (PFS): cognitive impairment, depression and suicidality can accompany or occur independently of sexual difficulties.
4. Irwig MS. Depressive symptoms and suicidal thoughts among former users of finasteride with persistent sexual side effects. J Clin Psychiatry 2012;73(9):1220-3. 61 former users against 29 controls with hair loss; depressive symptoms (BDI-II 14 or more) in 46 of 61 (75%) against 3 of 29 (10%). Small and self-selected.
5. NHS. NHS Talking Therapies: self-referral without a GP, for adults registered with a GP in England.
6. Moral Medicine. “I would give everything I have to get my life back.” Sam’s life with Post Finasteride Syndrome, 12 June 2024. Embedded from 7:10 to 9:45. 25 years old at 1:14; the hug from his mum at 7:47; “like being on mute all the time” at 13:55.
7. Moral Medicine. Post-Finasteride Syndrome Ended My Marriage, Thammika’s interview, 30 April 2025. “This is definitely not this man’s fault” at 3:30; married five years at 4:00; co-parents at 9:15; loneliness at 14:00.
8. Samaritans. Contact a Samaritan: 116 123, free, day or night, UK and Ireland.

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