Neuroactive Steroid Levels and Psychiatric and Andrological Features in Post-Finasteride Syndrome Patients

Recent studies have revealed persistent side effects in patients treated with finasteride for male pattern hair loss, raising significant concerns. This study explored the psychiatric and andrological features of men suffering from post-finasteride syndrome (PFS) and investigated whether neuroactive steroid levels in cerebrospinal fluid (CSF) and plasma were altered.

The study included 16 male patients who experienced persistent sexual dysfunction and mental health issues after discontinuing finasteride. The findings were alarming: eight of these patients were diagnosed with major depressive disorder (MDD), and all showed signs of erectile dysfunction (ED), with some even displaying severe ED. Notably, abnormal somatosensory evoked potentials of the pudendal nerve were observed in patients with severe ED, indicating a potential neuropathy affecting erection control.

Further analysis revealed significant alterations in neuroactive steroid levels in both CSF and plasma. Specifically, decreased levels of pregnenolone, progesterone, and dihydrotestosterone, along with increased levels of testosterone and dehydroepiandrosterone, were noted. These changes suggest that finasteride has a broad impact on neuroactive steroid levels, potentially contributing to the persistent symptoms observed in PFS patients.

This study underscores the profound and lasting effects of finasteride on both physical and mental health, emphasizing the need for greater awareness and caution in its use for treating hair loss.

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