As prescribers, our primary duty is to do no harm. Meanwhile, professional organizations may provide educational materials for physicians in order to increase their awareness regarding the scope of these persistent catastrophic adverse effects of finasteride and dutasteride. And they know the risks but prefer the hair. There is no cure or treatment . Accordingly, Health Canada and the UAE Ministry of Health recommend that companies that produce products containing [finasteride] add the above-mentioned warning to the internal leaflet of their products. technical support for your product directly (links go to external sites): Thank you for your interest in spreading the word about The BMJ. However, cognitive functions, depression, and quality of life were not improved. Bone pain Do Anti-Baldness Remedies Make You Impotent? In a cohort of men prescribed finasteride for routine treatment of AGA, most would have been excluded from the pivotal studies that supported US Food and Drug Administration approval for AGA. Hi Gary, But now I would not feel comfortable recommending Propecia to a young, sexually active man. 8600 Rockville Pike And its not worth it. Therefore, the effects of a subchronic treatment of finasteride.have been evaluated in male rats. One month after the last treatment.changes in neuroactive steroid levels, steroid receptorsand GABA-A receptor subunitswere detected. With that in mind, DHT can take anywhere from4 weeks to 2 years or more to recover(R). I think androsterone and allopregnanolone, or topical DHEA and progesterone would be good options. The concept of PFS has emerged from reports of non-dermatologists, neuroendocrinological research and reflections, and uncontrolled studies of low quality and with a strong bias selection, while a significant nocebo effect among patients informed about possible side effects of finasteride is recognized. We recommend patients who have already submitted a report submit a new one using this reaction type. I can definitely have a look for you and see if I find anything that needs optimization. Keeping it low, below 7ng/ml, is absolutely key to improving. prostatis In my own practice, I see probably a half-dozen patients a year who come in with the observationHey, I was feeling fine, I went on [Propecia], and after that, I noticed these changes in my sexual health. Havent used this drug in over 7 years of practice except in very rare cases. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). I remember being depressed, emasculated, and hopeless. 2022 Mar;8(2):169-170. doi: 10.1159/000518750. The Impact of 5-Reductase Inhibitor Use for Male Pattern Hair Loss on Men's Health. Chiriac G, Cauci S, Mazzon G, Trombetta C. Andrology. I think this is what we are seeing here. sharing sensitive information, make sure youre on a federal Like clomid, nolvadex, HCG? This can lead to numbness in the penis and erectile and libido disorders, which are related to what happens in the brain. Treatment of young subjects is of increasing concern due to accumulating evidence that daily use of oral finasteride has several severe adverse effects.Since finasteride inhibits T conversion into DHT, which is responsible for most androgen activity, it is plausible that prolonged finasteride use in predisposed individuals could simulate the effects of aging in young men. As the name suggests, PFS is most commonly associated with finasteride, which was licensed for the treatment of male pattern baldness in 1997. FOIA Ive made a 80% recovery so far and I keep improving however your hypothesis is quite scary. If prolactin is high, dopamine is most likely low and serotonin elevated, so then it would be good to focus on lowering prolactin. Agreed. I have patients who come in to see me for sexual problems. It can be reversed yes. Have you tried nearly everything, but nothing seems to move the needle? FDA is concerned that use of finasteride by pediatric patients may pose long-term safety risks regarding growth, development and sexual function. 2021 Nov;7(6):524-526. doi: 10.1159/000514365. Markthceck (SWR TV) Lifestyle Drug Finasteride: Dead pants instead of a bald head? Androstanediol glucoronide is a hormone derived from DHT (the hormone inhibited by finasteride). Stop finasteride: 45.6% Post-finasteride syndrome is characterized by persistent sexual, physical, and mental health side effects that continue even after stopping the medication. been putting it off, but this convinced me to see a doctor and gives me hope. I think progesterone is high because its not converted further downstream possibly due to 5AR downregulation. I will never prescribe finasteride. Yuck. Hi, being a young guy with PFS since 8 months this article has been very helpful to furthermore understand what is possibly going on, so thank you. Regulatory Effects of Thai Rice By-Product Extracts from. And the interesting thing is that the average age of this group was 32 to 34 years old This drug for young men must be taken off the market. Response (via Twitter) to medical student Rainy Horowitzs question: What sex-med topics do you think urology residents would most benefit learning about? Whats happening to the progesterone if I try HCG? Punk?. I think its important to be educated about the potential side effects. The treating clinician should have knowledge and awareness about the higher prevalence of depression and sexual dysfunction in the subset of men seeking treatment for AGA in comparison to the general population. Androsterone worked wonders for me. I added finasteride to my 2021 list of Drugs to Avoid. Taking Propecia or Proscar to Prevent Hair Loss is Associated with Depression, Anxiety, and Sexual Problems: National Center for Health Research website, 2021. Epub 2021 Oct 21. Some say its all in the mind, a made-up mythbut those who suffer from it surely know theyre not just a hypochondriac. Over time, it has been considered a safe and well-tolerated drug with rare and reversible side effects. New Information about Post Finasteride Syndrome (PFS) October 2, 2016 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 study reinforces the importance of considering the long-term effects of finasteride use on DED as part of the systemic sequelae of androgen depletion and provides anticipatory guidance for patients and ophthalmologists. If youve already done blood tests and want to learn how to interpret them, check out these articles: If DHT is high, then you dont have to focus on boosting DHT, but maybe rather allopregnanolone through increasing 5-AR type 1. Should We Fear Hair-loss Medications? We propose that the Dermatologist Society remove from their guidelines the utilization of finasteride for male pattern hair loss., Sexual and Nonsexual Problems after Finasteride Used for Hair Loss in Young Men: American Society for Mens Health, 2014. Bethesda, MD 20894, Web Policies A growing number of doctors, researchers and therapists have in recent years been voicing their concerns about finasterides potential to cause persistent physical and mental side effects, known as post-finasteride syndrome (PFS), in a subset of patients. Epub 2016 Jan 13. [Propecia] is a scary drug and we have no idea who might be affected worse by it. sharing sensitive information, make sure youre on a federal Post-finasteride syndrome is a serious state of permanent sexual, mental and physical side effects which do not resolve after quitting the drug It is also surmised by the few specialists in the medical field that a type of receptor or brain damage has occurred.Men suffering from PFS are plagued with many physical, mental, and emotional symptoms that have led to long-term depression, marital problems and divorce, and now several reported cases of suicide. Post finasteride syndrome is real. There are feared side effects [from finasteride] that include sexual dysfunction in men, some of which can be very serious. My blood level are ok only progesterone and colesterolo are higher than the max range. Well, SSRI drugs almost never only inhibit the reuptake of serotonin, but they often also increase allopregnanolone, decrease serotonin receptor sensitivity, block certain serotonin receptors, release dopamine and histamine, etc. [A]pproximately 30 million young men, worldwide, would be prescribed finasteride or dutasteride to treat male pattern hair loss. Post-finasteride syndrome: a surmountable challenge for clinicians: Fertility and Sterility, January 2020. The most frequent non-sexual symptoms were reduced feeling of life pleasure or emotions (75.9%), lack of mental concentration (72.2%) and loss of muscle tone/mass (51.9%)Further studies are necessary to investigate the pathophysiological and biochemical pathways leading to the post-finasteride syndrome. HCG increased my anxiety. From frail and hypogonadal, to gaining 60lbs of muscle, boosting testosterone over 1,000ng/dl and becoming a successful entrepreneur. The effects in the brain of finasteridehave been poorly explored. 2023 Feb 2;12(3):653. doi: 10.3390/plants12030653. Drugs to shrink the prostate (dutasteride, finasteride) shouldnt be used for years on end because it can negatively impact the heart. Seen this far too often to doubt that its real. Here are a few good ways to increase dopamine: For more a comprehensive guide on boosting dopamine, check out this article: If dopamine is low, then prolactin will most likely be high. Many clinicians are unaware of the scope of the persistent physical and psychological adverse effects of finasteride while it is in usage and despite its discontinuation. 16 Insidious2k 1 yr. ago Pfs means that the side effects of fin are persistent even when you discontinue the med. Its always been a question in my mind: Was this a lingering drug effect, or are there other factors coming into play? Use of 5ARIs for treatment of AGA may lead to persistent sexual, genitourinary, physical, psycho-cognitive, and anti-androgenic sequelae even after cessation of 5ARI therapy Two subjects (8%) committed suicide during or after the study. Very high levels of finasteride might then also be able to block 5R, which will reduce bile flow. A Pill the Doctor Gave Me Destroyed My Life. So I suggest you continue with Minoxidil and multivitamins. A Pill the Doctor Gave Me Destroyed My Life (English translation): Die Zeit, Feb. 22, 2018. 2022 Oct 27;10(11):2725. doi: 10.3390/biomedicines10112725. In association with adverse sexual effects and depression, suicidal ideation and behavior have sometimes been associated with finasteride treatment. 2016 Mar;4(2):245-50. doi: 10.1111/andr.12147. In addition, many doctors dont understand or even recognize PFS as a real disease and these patients will suffer alone. Federal government websites often end in .gov or .mil. Finasteride blocks the glutathione production leading to mycotoxin build up if you were living or working near mould and not knowing it. My private email list for written articles, exclusive offers, sales & more: http://bit.ly/2mtASGW https://gorillamind.com . (A call with me is usually $200, but since this is your first call, I've got you covered.). Altered methylation pattern of the SRD5A2 gene in cerebrospinal fluid of post-finasteride patients: a pilot study, The Drug that Banishes Baldness Can Ruin a Mans Love Life, Post-finasteride syndrome: An emerging clinical problem, Hair Loss Drug Propecia Carries Risk of Losing Something Else, Response (via Twitter) to query by Harrison Kalodimos, MD: What are some atypical medication side effects that you have seen in practice and look out for now on a regular basis?. You have to choose between hair and sex drive and your personality and your marriage or your partnership Ive tried giving testosterone to patients who are on finasteride at the same time. But Nobody Warned Me about Finasteride! Adverse Sexual Effects of Treatment with Finasteride or Dutasteride for Male Androgenetic Alopecia: A Systematic Review and Meta-analysis. What is post-fin syndrome anyway? The Difficult Hair Loss Patient: Guide to Successful Management of Alopecia and Related Conditions: August 2015. I wanted to take a minute to talk to you about post-finasteride syndrome since more and more men are coming in with complaints after taking finasteride. I think [Propecia] is a potentially dangerous drug. Propecia should have never been approved, and its authorization should be revoked as soon as possible. 100% agree. Maksym et al., Post-finasteride . Successful Finasteride Treatment Can Lead to Permanent Problems: Deutsche Apotheker Zeitung, April 2018. PMC Conclusion: This study showed that short and/or long (CAG)n and (GGN)n repeats had different frequencies according to symptoms reported by patients with PFS, likely reflecting the vast array of genes modulated by the AR [and] a U-curvilinear profile of (CAG)n repeats for skin dryness symptoms, where the two extremes exhibited a worse condition than medium repeats. Also do you recommend an androsterone supplement, I havent heard of that option so far. Since 2008, at least 17 countries including the United Kingdom and the United States have warned prescribers of the potential for depression, sexual side effects, or both with finasteride. Course. This warning is now mentioned in finasterides package insert. Its awful when a patient doesnt know whats happening, and takes a medication for a specific purpose, but then develops side effects that may be more damaging than its positive effects. A low estimated prevalence of PFS cannot be an excuse for nonvigilance since the drug is used by millions of relatively young and healthy individuals.". Side effects thought to be caused by post-finasteride syndrome can be mild or serious. While the sexual side effects of 5ARIs are well known, there may be persistent genitourinary, physical, psycho-cognitive, anti-androgenic and penile vascular changes after 5ARI discontinuation. An observational retrospective evaluation of 79 young men with long-term adverse effects after use of finasteride against androgenetic alopecia. What happens if you get side ef. Available toxicity information from clinical trials of finasteride in men with [androgenic alopecia] is very limited, is of poor quality, and seems to be systematically biased. 2021 Dec 13;54(4):422-434. doi: 10.1055/s-0041-1739254. Thanks in advance. Every dermatologist has their own way of treating the condition. From 50UI per day. An official website of the United States government. However, PFS is now so prevalent that it has its own foundation, the Post-Finasteride Syndrome Foundation, where you can acquire a great deal of sobering information, enough to make you wonder why anyone would take the drug to begin with. Case report: a study of the clinical characteristics and genetic variants of post-finasteride syndrome patients. cold penis [Y]ou need to understand that hair[-loss] is not a life-threatening condition. Men who take finasteride for baldness or receding hairlines can develop sexual dysfunction. If estrogen is high, focus on lowering that, as estrogen is a potent inducer of serotonin and prolactin. (I got my hair transplant at 36). Federal government websites often end in .gov or .mil. Researchers have found low levels of neurosteroids, including allopregnanolone, in the cerebrospinal fluid of post-finasteride syndrome patients. Dont risk your future children for a little hair. Kratom vs kava: the best one for feeling amazing! Glycine about 5g daily and niacinamide about 500mg-1g daily. Although nobody knows how many men it impacts, its effects are devastating. One key indisputable clinical evidence noted in all reported studies with finasteride and dutasteride was that use of these drugs is associated with development of sexual dysfunction, which may persist in a subset of men, irrespective of age, drug dose or duration of study.
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