Abstract

The constellation of persistent sexual, neurological, and physical adverse effects in patients who discontinue 5α-reductase inhibitors (5ARIs) – collectively termed Post-Finasteride Syndrome (PFS) – has garnered recent attention with the Food and Drug Administration (FDA) and French National Agency for Drug Safety (ANSM), resulting in amendment of finasteride’s label to include a warning of the risk of persistent side effects. The purpose of this study is to further elucidate the persistent sexual, genitourinary, physical, psychiatric, cognitive, and androgenic effects of 5ARIs in men treated for androgenic alopecia (AGA). This was a retrospective case-control study that evaluated the sexual, genitourinary, physical, psychiatric, cognitive, and androgenic effects of 5ARIs in 25 subjects with a history of 5ARI use for AGA and 25 controls. Patient self-reported symptoms and validated questionnaires including the International Index of Erectile Function (IIEF), International Prostate Symptom Score (IPSS), Patient Health Questionnaire-9 (PHQ-9), the Epworth Sleepiness Scale (ESS) and the Androgen Deficiency in the Aging Male (ADAM) were used to evaluate outcomes in a standardized manner. Penile Duplex Doppler Ultrasound (PDDU) results were used to evaluate penile vascular parameters.

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