Finasteride Side Effects After Stopping: PFS & What Are They?

guy suffering from Finasteride Side Effects After Stopping
Written by
Morgan German
Medically approved by
Ahmad Chaudhry M.D.

Certain health conditions affect men more than women. The two most common conditions that significantly affect men are androgenetic alopecia and benign prostatic hyperplasia (BPH). Both of these disorders are associated with hormonal imbalances in men. Finasteride are often taken to alleviate these problems. However, some reported finasteride side effects after stopping.

Finasteride is a widely known medication used to treat hair loss and prostate problems in men. Women also use finasteride as a hormone therapy to manage and treat endocrine disorders. Albeit its use in hair loss and prostate disorders, finasteride leads to sexual dysfunction and impaired libido in men.

Read more on Finasteride:

What is Finasteride?

Finasteride is an oral medication that is available in pharmacies by the names Proscar and Propecia. Finasteride, in their clinical trial, inhibits the activity of 5-alpha reductase, an important enzyme of androgen metabolism. It alleviates the symptoms of BPH in men.

Finasteride is also used to prevent and treat male androgenetic alopecia, or male pattern hair loss. Women who experience excessive hair growth including transgender women, also derive benefits from finasteride, however, studies do not support the use of finasteride for female pattern baldness.

How Finasteride Works?

Finasteride suppresses the activity of the enzyme, 5-alpha reductase. This enzyme testosterone into dihydrotestosterone (DHT), a biologically active and more potent form of male sex hormone. DHT attaches to its receptors on the prostate gland and follicles.

DHT promotes hyperplasia or increased growth in the prostate gland and may lead to BPH when larger quantities of this enzyme are present in the blood. The condition may also result from overexpression and increased activity of the same enzyme.

Concerning growth, DHT shrinks the follicles and shortens the anagen or growth phase of the growth cycle. This causes the hair to become thinner and weaker than normal as they fall out. This is termed male pattern baldness or male androgenetic alopecia.

Finasteride acts as a 5-alpha reductase inhibitor, prevents hypertrophy of the prostate gland, and neutralizes the effects of DHT on follicles and the growth cycle - thus promoting the treatment of hair loss

Benefits of Finasteride

Finasteride for Benign Prostatic Hyperplasia

Finasteride treats the symptoms associated with BPH. The initial part of the male urethra passes through the prostate gland. Enlarged prostate hinders the function of the urethra and bladder, leading to frequent but difficult urination.

People, who suffer from BPH, lose urinary continence and find it difficult to have control over micturition. With regular use of finasteride, urgent and frequent urination subside along with relief from pain while urinating as the prostate reduces in size. The drug also resolves nocturia, the urge to urinate at night, which also improves sleep in these patients.

Finasteride for Male Androgenetic Alopecia

Finasteride acts on the hair follicles of the scalp, and not elsewhere in the body. Finasteride increases the growth of hair and prevents hair loss in men suffering from male pattern baldness. It reduces the amount of DHT in blood by blocking 5-alpha reductase, which ultimately protects hair follicles from DHT-induced damage. Finasteride restores the growth cycle and improves the health of the hair and scalp.

Finasteride and Prostate Cancer

Studies show that finasteride decreases the risk for low-grade prostate tumors by stimulating apoptosis and reducing the growth of the prostate gland. However, finasteride increases the risk of high-grade prostate tumors by decreasing the amount of DHT in the cells due to the inhibition of 5-alpha reductase.

How to Use Finasteride?

Finasteride is an oral medication that is available in 1 milligram and 5 milligrams tablets. Adults should consume 1mg tablet each day for hair loss. Adults with BPH have prescribed 5 mg per day. However, the dosing varies from person to person depending on the type and condition they are suffering from. Doctors need to consider drug interactions, medical history, and medical conditions while prescribing finasteride to the patients.

How Long Does Finasteride Take to Work?

People who take finasteride for the growth of hair tend to observe visible growth after 3 months of regular use. However, people should be aware of the fact that finasteride is NOT a hair loss treatment or a treatment for the underlying condition, but only causes growth. Therefore, discontinuing the drug will result in hair loss.

For BPH, finasteride takes 6 months to yield visible results. Similar to male pattern hair loss, finasteride only relieves the symptoms and reduces the size of the prostate gland, and does not correct the underlying pathology. Therefore, stopping the intake of this drug will cause the prostate to grow in size followed by the onset of related symptoms.

Who Should Not Take Finasteride?

  1. People who develop allergic reactions upon consuming finasteride should refrain from using the medication.
  2. Finasteride is not prescribed to individuals younger than 18 years of age.
  3. People suffering from liver diseases should consume the medicine after consulting a physician.
  4. Pregnant and breastfeeding women should avoid using finasteride due to a lack of evidence regarding its safety.
  5. Those who consume alcohol and tobacco should discontinue these first before using finasteride.

What Are Finasteride Side Effects?

Following are the common side effects of finasteride:

  1. Finasteride use leads to skin rash in individuals allergic to the drug.
  2. Finasteride sexual side effect affects libido and decreases the sex drive of a person.
  3. Finasteride commonly leads to erectile dysfunction in males. This medication hinders the ability of a man to maintain an erection or achieve an orgasm.
  4. Finasteride causes tenderness and an increase in the size of breasts.
  5. Finasteride leads to ejaculation disorders in men.

These side effects subside after discontinuing the use of finasteride.

In some cases, excessive use of finasteride leads to many severe side effects, which are as follows:

  1. Finasteride can cause edema, particularly affecting the throat, face, tongue, and lips.
  2. Finasteride also manifests as lumps and pain in breasts as well as nipple discharge.
  3. Finasteride offsets the balance between estrogen and androgens that increases the risk of gynecomastia or male breast cancer. It also can cause prostate cancer.
  4. Individuals taking finasteride may also suffer from mental health deterioration.

An individual should immediately approach a doctor if he or she observes any of these symptoms.

Post Finasteride Syndrome - Side Effects after Discontinuing Finasteride

The side effects associated with finasteride use, subside after reducing or stopping the drug intake. These potential side effect symptoms include rashes, breast tenderness, persistent erectile dysfunction, and swelling. However, this may also give rise to severe consequences.

PFS is characterized by a set of side effects observed after discontinuing finasteride in men suffering from male pattern hair loss and BPH. The symptoms of PFS can be classified as sexual, physical, and mental side effects.

Sexual, erectile, and ejaculatory disorders subside after stopping finasteride intake. However, some individuals report persistent symptoms even after discontinuing the medication. Following are the persistent sexual side effects of PFS:

  1. Decreased libido or sex drive is a common finding in PFS.
  2. Impotency can be seen in men suffering from PFS. Such individuals face difficulty in achieving and maintaining an erection.
  3. Men affected by PFS fail to achieve an orgasm. Some individuals also complain of the absence of satisfaction and pleasure despite achieving an orgasm. This condition is called sexual anhedonia.
  4. PFS may also manifest as oligospermia or low sperm count in the ejaculate. Oligospermia causes difficulty in fertilizing an egg. In some cases, the volume of ejaculate is also less than normal. Such men face difficulties when planning a family.
  5. Inhibiting finasteride intake leads to numbness, pain, and shrinkage of the penis and testes.
  6. Peyronie's disease is characterized by abnormal curvature of the penis.
  7. People affected by PFS also fail to achieve morning and spontaneous erection.
  8. Individuals who suffer from PFS tend to be infertile and face difficulties while performing coitus.

Following physical side effects can be observed after quitting finasteride treatment:

  1. Gynecomastia is the undesirable growth of breasts in men. This affects the self-image and overall physique of a man affected by PFS.
  2. PFS also causes muscle atrophy. This results in muscle pain and weakness while performing routine tasks.
  3. Discontinuing finasteride also results in joint pain. This affects the overall wellbeing and quality of life of an individual.
  4. Extremely dry skin can be observed during finasteride treatment. Like other symptoms, this also persists even after stopping finasteride intake. This is caused by reduced sebum and oil production by the sebaceous glands in the skin.
  5. Chronic fatigue is a state of tiredness that lasts for more than 6 months. Chronic fatigue, listlessness, and lethargy are common among patients.
  6. The blood levels of PFS patients indicate high fasting glucose, low HDL or good cholesterol, and increased triglycerides which ultimately lead to obesity, and high body mass index. This increases the risk of systemic disorders in the future.
  7. Depression and adverse sexual effects of PFS increase the risk of attempted and completed suicide in men.

The neurological effects of PFS are:

  1. Patients find it difficult to remember and recall information.
  2. Such individuals also have a slower thought process, which has adverse effects on their performance at work or while studying.
  3. Cognitive skills such as analysis, comprehension, and problem-solving skills are also impaired because of terminating finasteride treatment.
  4. Depression, anxiety, loss of emotional changes, insomnia, and anhedonia also affect PFS patients. This tends to induce suicidal thoughts among these individuals.

Treatment for Post Finasteride Syndrome

There is no known treatment of PFS. However, careful selection of patients and monitoring the finasteride treatment may prevent the PFS to some extent. The symptoms of PFS start to subside within four to eight months after discontinuing the medicine.

Maximum results are observed five years after the onset of symptoms. For more information, we recommend visiting your local medical practitioner the Post Finasteride Syndrome Foundation, this article is not medical advice.

References

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  5. Traish AM. Post-finasteride syndrome: a surmountable challenge for clinicians. Fertil Steril. 2020 Jan;113(1):21-50. doi: 10.1016/j.fertnstert.2019.11.030. PMID: 32033719.
  6. Diviccaro S, Melcangi RC, Giatti S. Post-finasteride syndrome: An emerging clinical problem. Neurobiol Stress. 2019 Dec 26;12:100209. doi: 10.1016/j.ynstr.2019.100209. PMID: 32435662; PMCID: PMC7231981.
  7. Rezende HD, Dias MFRG, Trüeb RM. A Comment on the Post-Finasteride Syndrome. Int J Trichology. 2018 Nov-Dec;10(6):255-261. doi: 10.4103/ijt.ijt_61_18. PMID: 30783332; PMCID: PMC6369643.
  8. Post-Finasteride Syndrome Foundation. 2015. Global Public Health Advisory - US National Institutes of Health Recognises Post-Finasteride Syndrome. URL: campaign-archive2.com/?u=644fb8b633594fee188a85091&id=9cea0753a4&e=5459eb9419