Side Effects of finasteride: A Synthesis of Findings from 24 Studies

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Original Abstract of the Article

Major Research Findings

Finasteride is a drug used to treat male pattern baldness and benign prostatic hyperplasia. It is generally considered safe and well-tolerated, but there have been reports of side effects. 21 . Finasteride works by inhibiting the enzyme 5α-reductase, which converts testosterone to dihydrotestosterone (DHT). 15 DHT is a hormone that contributes to hair loss and prostate enlargement. By blocking this conversion, finasteride helps to reduce DHT levels, leading to potential improvement in hair growth and reduction in prostate size. 15 However, the long-term safety of finasteride and the effects of discontinuing the drug are still being investigated. 24 .

Reasons for Side Effects

The mechanism of finasteride's side effects is not fully understood, but it is believed to be related to disruptions in hormone balance due to the inhibition of 5α-reductase. 24 Finasteride inhibits 5α-reductase, decreasing the levels of DHT in the body. 24 DHT plays a role in various bodily functions, including sexual development and function, and its reduced levels can lead to hormonal imbalances. This disruption in hormonal balance is thought to contribute to side effects such as sexual dysfunction and mood disorders. 24 . Finasteride can also affect the brain by influencing neurotransmitter balance, potentially contributing to mental health side effects. 5 .

Common Side Effects

Sexual Dysfunction

One of the most common side effects of finasteride is sexual dysfunction. 22 、 24 This is thought to occur because finasteride disrupts the balance of sex hormones by inhibiting DHT conversion from testosterone. 24 Sexual dysfunction can include decreased libido, erectile dysfunction, and ejaculatory problems. 24 There is also evidence that finasteride may reduce sperm count and sperm motility. 23 While these side effects may improve after stopping finasteride, some individuals experience persistent side effects. 24 If you are considering taking finasteride, it is important to talk to your doctor to understand the risks and benefits.

Mood Disorders

Mood disorders such as depression and anxiety have been reported as potential side effects of finasteride. 24 Finasteride can affect the brain by altering neurotransmitter balance, possibly contributing to these mental health conditions. 5 Some research suggests that finasteride may increase the risk of suicidal thoughts. 24

Other Side Effects

Finasteride can also cause a variety of other side effects besides sexual dysfunction and mood disorders. 22 These may include breast enlargement, headaches, digestive problems, fatigue, dizziness, hair loss, and skin rashes. 22 Some studies have suggested a potential link between finasteride use and an increased risk of prostate cancer. 22 However, the exact relationship between finasteride and prostate cancer risk is complex and requires further investigation. The risk may vary depending on factors such as dosage and duration of finasteride use. 22

Side Effects Management

Sexual Dysfunction

In many cases, sexual dysfunction associated with finasteride improves after discontinuing the drug. 24 However, some individuals may experience persistent side effects. 24 If persistent side effects occur, it is important to consult with a doctor to find appropriate treatment options. 24 Lifestyle modifications, such as quitting smoking, engaging in regular exercise, and maintaining a balanced diet, can also be helpful in managing sexual dysfunction and promoting overall health. 24

Mood Disorders

Mood disorders related to finasteride may improve with drug discontinuation in some cases. 24 However, persistent side effects can occur. 24 If these persist, it is important to seek medical advice for appropriate management strategies. 24 Stress management techniques, such as yoga, meditation, or music therapy, can help to prevent mood disorders. 24

Comparison of Studies

Research Similarities

Several studies have consistently shown that finasteride is effective for treating male pattern baldness and benign prostatic hyperplasia. 15 These studies also agree that finasteride can lead to side effects such as sexual dysfunction and mood disorders. 22 、 24

Research Differences

The occurrence rate and severity of finasteride side effects can vary greatly among individuals. 22 There is also limited research available on the long-term consequences of finasteride use. 24

Considerations for Everyday Life

Finasteride can be a valuable treatment for male pattern baldness and benign prostatic hyperplasia, but it is important to be aware of the potential side effects. 22 Before starting finasteride, discuss the risks and benefits with your doctor. 22 Individuals with a history of sexual dysfunction or mood disorders should be particularly cautious when considering finasteride use. 22 If you experience any side effects while taking finasteride, consult your doctor immediately. 22

Current Research Limitations

There is still a need for more research to fully understand the side effects of finasteride. 24 In particular, long-term effects and the mechanisms behind side effect development require further investigation. 24

Future Research Directions

Research is needed to investigate the long-term safety of finasteride and the effects of discontinuing the drug. 24 By understanding the mechanisms behind finasteride side effects, it may be possible to develop new treatments to mitigate these effects. 24

Conclusion

Finasteride can be an effective treatment for male pattern baldness and benign prostatic hyperplasia, but it is associated with the risk of side effects, including sexual dysfunction and mood disorders. 22 Always discuss the risks and benefits with your doctor before starting finasteride. 22 If you experience any side effects, consult your doctor immediately. 22

Literature analysis of 24 papers
Positive Content
9
Neutral Content
3
Negative Content
12
Article Type
2
0
0
7
23
1.

Finasteride 5 mg and sexual side effects: how many of these are related to a nocebo phenomenon?

Author: MondainiNicola, GonteroPaolo, GiubileiGianluca, LombardiGiuseppe, CaiTommaso, GavazziAndrea, BartolettiRiccardo

Ejaculation disorders
Erectile dysfunction
Libido loss

Erectile dysfunction, loss of libido, and ejaculation disorders are consistent side effects of finasteride in up to 15% of patients after 1 year of therapy.

Controlled Clinical TrialA clinical trial that evaluates the effectiveness of a treatment by comparing a group that receives the intervention with a group that receives a placebo or standard treatment.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

2.

Efficacy and safety of 3% minoxidil versus combined 3% minoxidil / 0.1% finasteride in male pattern hair loss: a randomized, double-blind, comparative study.

Author: TanglertsampanChuchai

AGA treatment
Minoxidil/finasteride efficacy

Combined 3% minoxidil and 0.1% finasteride lotion was more effective than 3% minoxidil lotion in treating androgenetic alopecia without causing significant side effects.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

4.

The post-finasteride syndrome: possible etiological mechanisms and symptoms.

Author: LeliefeldHerman H J, DebruyneFrans M J, ReismanYakov

Alopecia treatment
BPH treatment
Post-finasteride syndrome
Sexual side effects

This review discusses the side effects of finasteride and dutasteride, synthetic 5α-reductase inhibitors (5ARIs), including sexual, neurological, and other dysfunctions, as well as the increased incidence of high-grade prostate cancer. It highlights the importance of weighing the risks and benefits of 5ARIs and the need for further research to address the long-term consequences of 5ARI use.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

7.

Gut Inflammation Induced by Finasteride Withdrawal: Therapeutic Effect of Allopregnanolone in Adult Male Rats.

Author: DiviccaroSilvia, GiattiSilvia, CioffiLucia, FalvoEva, HerianMonika, CarusoDonatella, MelcangiRoberto Cosimo

ALLO protective effect
Finasteride side effects
PFS

Chronic treatment with finasteride followed by withdrawal significantly decreased allopregnanolone (ALLO) levels in the colon of adult male rats, correlating with increased IL-1β, TNF-α, serotonin, and decreased dopamine. ALLO treatment counteracted some of these alterations.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

8.

Case report: a study of the clinical characteristics and genetic variants of post-finasteride syndrome patients.

Author: LiXiaogang, GuoYe, LuYi, LiHaolong, YanSongxin, LiHongjun, LiYongzhe

PFS
Psychological disorders
Sexual dysfunction

This study investigates post-finasteride syndrome (PFS), a spectrum of persistent symptoms reported by some patients after finasteride treatment, using next-generation sequencing (NGS) to explore genetic variants and their potential role in the development of PFS.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.

Language : English

11.

Weekly treatment with SAMiRNA targeting the androgen receptor ameliorates androgenetic alopecia.

Author: YunSung-Il, LeeSang-Kyu, GohEun-Ah, KwonOh Seung, ChoiWoorim, KimJangseon, LeeMi Sun, ChoiSoon Ja, LimSeung Sik, MoonTae Kee, KimSin Hae, KyongKeeyeol, NamGaewon, ParkHan-Oh

Treat AGA

This study demonstrated that self-assembled micelle inhibitory RNA (SAMiRNA) nanoparticles selectively suppressed androgen receptor (AR) expression in vitro, with clinical studies confirming its efficacy in androgenetic alopecia (AGA). SAMiRNA-AR68 was found to be a potent AR silencer that could be efficiently delivered to hair follicles, leading to decreased AR mRNA and protein levels. Clinical studies showed that SAMiRNA targeting AR mRNA could be a potential novel topical treatment for AGA.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

13.

The connection of 5-alpha reductase inhibitors to the development of depression.

Author: SaengmearnuparpThiraphat, LojanapiwatBannakij, ChattipakornNipon, ChattipakornSiriporn

Depression
Neuropsychiatric adverse effects

This review summarizes the association between 5-alpha reductase inhibitors (5-ARIs) and depression, including the condition known as 'post finasteride syndrome (PFS)'. Several clinical studies have linked 5-ARIs to a higher incidence of depressive symptoms and neuropsychiatric side effects. Potential mechanisms, such as alteration in neuroactive steroids, dopaminergic dysfunction, and neuroinflammation, are discussed.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

14.

Phytochemicals With Anti 5-alpha-reductase Activity: A Prospective For Prostate Cancer Treatment.

Author: AziziAziemah, MuminNuramalina H, ShafqatNaeem

CaP prevention
Ejaculatory dysfunction
Erectile dysfunction
Loss of libido

This review discusses the use of phytochemicals, including phytosterols, polyphenols, and fatty acids, as potential alternatives to synthetic 5α-reductase inhibitors (5αRis) for prostate cancer (CaP) treatment. These phytochemicals exhibit anti-CaP properties and have shown inhibitory activity against 5αRs.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

15.

Finasteride for hair loss: a review.

Author: GuptaA K, VenkataramanM, TalukderM, BamimoreM A

Hair growth

Finasteride 1 mg/day is effective in increasing total hair count compared to placebo in patients with male androgenetic alopecia (AGA). It is generally well tolerated, but some side effects are possible.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

16.

Three-Dimensional Proteome-Wide Scale Screening for the 5-Alpha Reductase Inhibitor Finasteride: Identification of a Novel Off-Target.

Author: GiattiSilvia, Di DomizioAlessandro, DiviccaroSilvia, FalvoEva, CarusoDonatella, ContiniAlessandro, MelcangiRoberto Cosimo

Androgen-dependent condition treatment
Physical side effects
Psychological side effects
Sexual side effects

Finasteride, a widely used drug for androgen-dependent conditions, may cause sexual, psychological, and physical side effects. This study suggests that finasteride may inhibit phenylethanolamine N-methyltransferase (PNMT), the enzyme responsible for epinephrine synthesis, which may contribute to the side effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

17.

Finasteride interferes with prostaglandin-induced CatSper signalling in human sperm.

Author: BirchMichala Rosa, DissingSteen, SkakkebækNiels E, RehfeldAnders

Finasteride, a drug used to treat hair loss, may affect calcium signaling in human sperm through an interaction with the PGE1-binding site. This could potentially impact fertilization, but further investigation is needed.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

18.

Efficacy of Intralesional and Oral Dutasteride in the Treatment of Androgenetic Alopecia: A Systematic Review.

Author: Herz-RuelasMaira Elizabeth, Álvarez-VillalobosNeri Alejandro, Millán-AlanísJuan Manuel, de León-GutiérrezHumberto, Ocampo-GarzaSonia Sofía, Gómez-FloresMinerva, GrimaltRamón

Hair loss treatment

This systematic review compared the efficacy and adverse effects of oral versus intralesional dutasteride for the treatment of androgenetic alopecia. While both interventions showed a positive effect over placebo, limited data restricts definitive conclusions about the superior route. Further research is needed to clarify the optimal administration method for dutasteride in treating hair loss.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

19.

A Systemic Review on Topical Marketed Formulations, Natural Products, and Oral Supplements to Prevent Androgenic Alopecia: A Review.

Author: AshiqueSumel, SandhuNavjot Kaur, HaqueSk Niyamul, KoleyKartick

AGA treatment

This study reviewed topical marketed formulations, natural products, and CAM treatment options for androgenetic alopecia (AGA), a condition characterized by hair loss due to androgen hormones.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

21.

Post-finasteride syndrome: An emerging clinical problem.

Author: DiviccaroSilvia, MelcangiRoberto Cosimo, GiattiSilvia

Mood alteration
Post-finasteride syndrome
Sexual dysfunction

This review discusses adverse events related to 5 alpha-reductase (5α-R) inhibitors, including sexual dysfunction, mood alteration, and post-finasteride syndrome (PFS).

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

22.

Post-finasteride syndrome.

Author: PereiraAna Francisca Junqueira Ribeiro, CoelhoThaissa Oliveira de Almeida

Male androgenic alopecia treatment
Post-finasteride syndrome

Finasteride, a 5α-reductase inhibitor, has been associated with persistent side effects after discontinuation. Further research is needed to confirm the existence of post-finasteride syndrome.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

23.

Androgenetic alopecia: effects of oral finasteride on hormone profile, reproduction and sexual function.

Author: PallottiFrancesco, SenofonteGiulia, PelloniMarianna, CargneluttiFrancesco, CarliniTania, RadicioniAntonio F, RossiAlfredo, LenziAndrea, PaoliDonatella, LombardoFrancesco

Hormonal alterations
Sperm damage

This study aimed to evaluate the potential effects of finasteride treatment on sperm parameters, hormone profile, and sexual function in patients with androgenetic alopecia (AGA).

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

24.

Post-finasteride syndrome: a surmountable challenge for clinicians.

Author: TraishAbdulmaged M

PFS
Sexual dysfunction

This study reviews the scientific and clinical evidence for post-finasteride syndrome (PFS), a constellation of persistent adverse effects reported by some men after discontinuing finasteride treatment. The author argues that finasteride and dutasteride can induce persistent sexual, neurological, and physical side effects in predisposed individuals.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

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