Finasteride (Propecia) is the first-line treatment for enlarged prostate or benign prostatic hyperplasia (BPH).
Regretfully, very few pharmacological drugs can help with the condition.
Thus, finasteride remains a widely used drug, despite its known health risks.
Keep reading to learn about post-finasteride syndrome, its effects on the body, and how to treat it.
What is post-finasteride syndrome?
Post-finasteride syndrome (PFS) is a term that doctors use to describe specific long-term side effects of finasteride treatment.
Though these side effects may not be life-threatening, they cause much distress. These side effects continue to cause trouble for months and even years after discontinuing the drug therapy.
However, it is vital to know more about this syndrome. Early identification of the issue may help prevent or manage side effects.
Many of the side effects caused by prolonged finasteride use can be managed through lifestyle interventions, nutrition therapy, and supplements.
Post-finasteride syndrome is an umbrella term to describe the long-term side effects of finasteride therapy. PFS may include:
- Sexual dysfunction: This is the most common problem with prolonged finasteride use. Many men may experience reduced libido. Some may even experience erectile dysfunction. Additionally, many men may stop enjoying sex earlier due to reduced sperm production and changes in ejaculation.
- Neurological issues: Sex hormones are known to influence mood and brain health. Therefore, any drug blocking testosterone conversion to one of its active forms may also cause memory problems, cognitive decline, and other issues.
- Psychological effects: Some people who use finasteride for a long also report mood issues. It appears that finasteride can influence emotional well-being in some instances. Those who use the drug for a long become prone to depression and anxiety.
Here it is vital to understand that all people are different. It means that PFS may have different sets of signs and symptoms in various individuals.
In some, signs of sexual dysfunction may predominate, while psychological issues may predominate in others. Hence, identifying the problem is not that easy.
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How rare is post-finasteride syndrome?
Post-finasteride syndrome is an uncommon issue. It is so uncommon or rare that experts find it difficult to say what the chances are of anyone developing this syndrome.
Though PFS is rare, side effects of finasteride are not. It means that those who use this drug may develop one or another side effect. There is still a high chance that finasteride may lower libido and fertility.
Finasteride is considered a very safe drug. It causes health issues or side effects only in a small number of patients. If it caused these side effects commonly, authorities would not have approved the drug.
The reason for discussing PFS in detail is that one should understand that such a problem can occur on prolonged finasteride therapy.
Symptoms of PFS
Using finasteride for long may cause multiple symptoms characteristic of post-finasteride syndrome (PFS).
Many patients may continue to experience these symptoms long after discontinuing the drug therapy.
Some common symptoms of post-finasteride syndrome are:
- Sexual dysfunction: This mainly means reduced libido or sexual desire. However, some may also experience erectile dysfunction. Additionally, some may experience reduced ejaculation volume and lower sexual pleasure.
- Reduced fertility: Any drug that influences testosterone metabolism is quite likely to affect fertility. Though it may not cause complete infertility, it may lower male fertility.
- Physical signs: Many men may experience issues like low energy levels, fatigue, muscle and joint pains, dry skin, and low exercise tolerance.
- Mood disorders: Prolonged finasteride use may cause mood issues like anxiety, depression, mood swings, and other mental health issues. Some may start feeling readily irritated. Some also experience so-called emotional blunting or personality changes.
- Neurological issues: This may include memory decline and lack of mental clarity.
As already mentioned, one of the issues is that different people develop different sets of problems. Hence, the challenge in diagnosing the condition.
Can finasteride cause permanent damage?
Although finasteride is not likely to cause permanent or irreversible changes, it cannot be excluded. It must be remembered that issues like BPH occur in men older than 50 years of age.
Hence, reviving testosterone production or reversing specific changes is challenging in this age group.
Nevertheless, most issues caused by finasteride are reversible. Many of these issues will disappear on therapy discontinuation with the drug. Additionally, many men many benefits from some treatment and lifestyle interventions.
What causes post-finasteride syndrome?
Most signs and symptoms of finasteride occur due to blockage of the conversion of testosterone to dihydrotestosterone (DHT), one of the highly active forms of testosterone.
This conversion from testosterone to DHT occurs due to an enzyme produced by various body tissues called 5-alpha reductase. Finasteride inhibits the activity of this particular enzyme.
Does post-finasteride syndrome go away?
It is vital to understand that firstly finasteride causes reversible 5-alpha reductase inhibition. However, more importantly, this enzyme is continually produced by the body.
This means that as soon as one stops taking finasteride, tissue levels of 5-alpha reductase gradually return to normal levels.
However, prolonged use of finasteride and the absence of DHT in the body for long might cause certain degenerative changes.
Specific body tissues depend on DHT for their growth. Hence, its prolonged inhibition may cause irreversible destruction of those tissues.
Of course, even lost tissues may regenerate over time once finasteride has been discontinued. However, the journey to complete recovery may be long for some people. Since many finasteride users are primarily older adults, in some complete recovery might not occur.
Treatments
The first approach to the treatment is discontinuation of finasteride. This will give the body a chance to recover and restart producing DHT. This may slowly help the body recover from its impact.
However, many people would need treatment for their signs and symptoms. For example, some may need treatment for their reduced libido, like hormone replacement therapy. Others may benefit from medications like sildenafil to overcome erectile dysfunction.
Similarly, some individuals may need treatment for their mood disorders.
Finally, it is worth understanding that lifestyle interventions like exercise, nutrition therapy, and supplements might significantly accelerate recovery processes.
Home remedies
Since there is no specific treatment for post-finasteride syndrome (PFS), it is best treated through non-pharmacological means:
- Start exercising: This will boost testosterone levels, enhance growth hormone production, and many other health benefits.
- Engage in activities that promote sexual health: This may include taking vitamins and herbals, exercising, finding ways to maintain intimacy, and more.
- Get mentally active: One way to overcome brain fog is to start learning something new. You may start practicing hobbies, reading, learning new skills, engage in memory games.
- Consider dietary supplements: Here, there are a few things to remember. Firstly, you would need something for prostate support, especially if you discontinue finasteride. Secondly, consider supplements good for sexual health and mental well-being, like those rich in adaptogens. Additionally, consider taking vitamins.
Conclusion
In conclusion, post-finasteride syndrome (PFS) refers to the long-term side effects experienced by some individuals after discontinuing finasteride treatment.
While PFS is rare, it can cause distressing symptoms such as sexual dysfunction, mood disorders, neurological issues, and physical symptoms.
It is important to note that finasteride itself is generally well-tolerated, and most individuals do not experience these long-term effects.
However, if one experiences PFS, discontinuing the medication is the first step in managing it, thus allowing the body to recover.
Treatment options for PFS include addressing specific symptoms such as sexual dysfunction, mood disorders, and cognitive issues. Though one can manage PFS with medications,
it is better managed by non-pharmacological means, lifestyle interventions, nutrition therapy, and health supplements.
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