Characteristics of Men Who Report Persistent Sexual Symptoms After Finasteride Use for Hair Loss

Source: This article is based on the study “Characteristics of Men Who Report Persistent Sexual Symptoms After Finasteride Use for Hair Loss” by Shehzad Basaria et al., published in The Journal of Clinical Endocrinology & Metabolism. You can access the full study here.

Finasteride, a medication commonly used to treat benign prostatic hyperplasia (BPH) and androgenetic alopecia (AGA), has been associated with a range of persistent sexual side effects in some men, even after discontinuation of the drug. These symptoms have led to significant distress among affected individuals and have prompted extensive research into the potential underlying mechanisms.

Understanding the Study

The study by Basaria et al. aimed to explore whether the persistent sexual symptoms reported by some finasteride users were due to androgen deficiency, decreased peripheral androgen action, or ongoing inhibition of steroid 5α-reductase (SRD5A) enzymes. The study included three groups of men:

• Group 1: Finasteride users who reported persistent sexual symptoms after discontinuing the drug.
• Group 2: Age-matched finasteride users who did not report any sexual symptoms.
• Group 3: Healthy men who had never used finasteride.

Participants underwent a series of assessments, including evaluations of sexual function, mood, cognition, hormone levels, body composition, and brain activity through functional magnetic resonance imaging (fMRI).

Key Findings

1. No Evidence of Androgen Deficiency

The study found that men who reported persistent sexual symptoms after finasteride use had hormone levels, including testosterone and dihydrotestosterone (DHT), that were within normal ranges. There were no significant differences in androgen receptor (AR) gene sequences, SRD5A1, or SRD5A2 gene expression among the groups, suggesting that these symptoms were not linked to androgen deficiency or genetic variations.

2. Sexual Dysfunction and Mood Disturbances

Men in Group 1 exhibited significantly lower scores in sexual function and higher depression scores compared to the other groups. The fMRI results showed abnormal brain activity in regions associated with sexual arousal and depression, indicating potential neurobiological changes in these individuals. This suggests that the persistent symptoms may be related to changes in brain function rather than hormonal imbalances.

3. No Significant Differences in Physical or Cognitive Function

Interestingly, the study found no significant differences in body composition, muscle strength, or objective cognitive function among the groups. However, men in Group 1 reported higher subjective memory complaints, which may be linked to their mood disturbances rather than actual cognitive deficits.

Implications for Treatment

The findings of this study suggest that the persistent sexual symptoms experienced by some finasteride users are unlikely to be alleviated by treatments aimed at correcting androgen deficiency, such as testosterone replacement therapy. Instead, these symptoms may require a different approach, focusing on the treatment of depression and sexual dysfunction through psychological or neurological interventions.

Conclusion

This study provides important insights into the characteristics of men who report persistent sexual symptoms after finasteride use. It highlights the need for healthcare providers to be aware of these potential side effects and to approach treatment with a focus on addressing mood and sexual function rather than solely targeting hormone levels. Further research is necessary to fully understand the underlying mechanisms and to develop effective treatments for those affected.

Resources for Affected Individuals

• What is Post-Finasteride Syndrome (PFS)?
• Report Your Side Effects
• PSSD/PFS Registry

If you are suffering from finasteride/Propecia side effects, you can find help on our WhatsApp community by joining here.