postfinasteride

Postfinasteride refers to persistent symptoms that some individuals report after stopping finasteride, a 5-alpha-reductase inhibitor used to treat male pattern baldness and benign prostatic hyperplasia. The term postfinasteride syndrome (PFS) is used in patient communities and some medical discussions, though its existence and prevalence remain debated in the scientific literature.

Typical symptoms include sexual dysfunction such as reduced libido, erectile dysfunction, and ejaculation disorders; cognitive complaints such as memory problems or brain fog; mood disturbances including anxiety or depression; and physical changes such as fatigue, gynecomastia, or weight changes. Some patients also report sleep disturbances and sensory changes. The persistence of symptoms after discontinuation is the distinguishing feature.

Evidence is limited and controversial. Some case reports and surveys describe persistent symptoms, but controlled studies have not established a clear causal relationship, and many researchers emphasize methodological limitations and potential bias. The mechanism is unknown; proposed ideas include enduring alterations in neurosteroid levels, hormonal balance, or neurobiological pathways, but no consensus exists.

Diagnosis is clinical and based on history; there is no objective biomarker. Management focuses on reassurance, withdrawal of finasteride, evaluation for other causes, and symptom-targeted therapies (e.g., psychotherapy for mood symptoms, PDE5 inhibitors for erectile dysfunction, hormonal therapies where appropriate). Some individuals report gradual improvement over months to years, but data on prognosis are inconclusive.

Regulatory labels for finasteride acknowledge potential persistent sexual adverse effects, and clinicians generally weigh the risk against therapeutic benefits when considering treatment. See also: Finasteride, Androgenetic alopecia, Benign prostatic hyperplasia.