New Information about Post Finasteride Syndrome (PFS)

At this year’s ISHRS meeting in Las Vegas, Dr. Alan Jacobs a neuroendocrinologist at Duke University School of Medicine spoke on the topic of Post Finasteride Syndrome (PFS). This condition has been described in the literature as a continuation of sexual side effects even after discontinuation of the drug. Men may also complain of other persistent side effects such as ‘brain fog’ or cognitive impairment. The condition remains poorly understood, mostly due to the fact that it has a very short half-life. Based on pharmacokinetic data, the drug is fully metabolized and out of the body in less than a week.

Dr. Jacobs has treated over 500 cases of PFS and believes that the condition may be related to a complex interplay of the pituitary and hypothalamus. He described a condition called hypogonadotropic hypogonadism which may closely resemble PFS. The good news is that this condition does appear to be treatable. But he discussed how some men may be predisposed to this condition, if they already suffer from depression or anxiety. Others have hypothesized that a pre-existing tendency for panic attacks, obsessive-compulsive disorder (OCD), or body dysmorphic disorder (BDD) may also portend the development of PFS.

You can read Dr. Jacobs’ blog here:
http://blog.alanjacobsmd.com

A recent meta-analysis was published on the prevalence of sexual side effects in men taking 5-alpha reductase inhibitors (finasteride and dutasteride).* The study found that there was a statistically significant correlation with sexual side effects for men taking this class of drugs for benign prostatic hypertrophy (BPH, which affects an older group). The study did NOT find a statistically significant correlation among men who were taking the drug for hair loss (younger age group). This supports existing data that suggests that other factors such as age, vascular disease, diabetes, or depression may be more likely to explain sexual side effects than simply taking finasteride (Propecia/Proscar) or dutasteride (Avodart).

• Citation: Liu L, Zhao S, Li F, et al. Meta-Analysis of Effect of 5-ARIs on Sexual Function. J Sex Med 2016.