title: An observational retrospective evaluation of 79 young men with long-term adverse effects after use of finasteride against androgenetic alopecia.
abstract: Concern regarding adverse effects of finasteride is increasing. We aimed to determine the type and frequency of symptoms in men having long-term sexual and non-sexual side effects after finasteride treatment (a condition recently called post-finasteride syndrome, PFS) against androgenetic alopecia (AGA). Subjects were recruited at the Urology Unit of the Trieste University-Hospital, and from a dedicated website. Out of 79 participants, 34% were white Italians, mean age was 33.4 ± 7.60 years, mean duration of finasteride use was 27.3 ± 33.21 months; mean time from finasteride discontinuation was 44.1 ± 34.20 months. Symptoms were investigated by an ad hoc 100 questions' questionnaire, and by validated Arizona Sexual Experience Scale (ASEX) and Aging Male Symptom Scale (AMS) questionnaires. By ASEX questionnaire, 40.5% of participants declared getting and keeping erection very difficult, and 3.8% never achieved; reaching orgasm was declared very difficult by 16.5%, and never achieved by 2.5%. By the ad hoc questionnaire, the most frequent sexual symptoms referred were loss of penis sensitivity (87.3%), decreased ejaculatory force (82.3%), and low penile temperature (78.5%). The most frequent non-sexual symptoms were reduced feeling of life pleasure or emotions (anhedonia) (75.9%); lack of mental concentration (72.2%), and loss of muscle tone/mass (51.9%). We contributed to inform about symptoms of PFS patients; unexpectedly loss of penis sensitivity was more frequent than severe erectile dysfunction and loss of muscle tone/mass was affecting half of the subjects. Further studies are necessary to investigate the pathophysiological and biochemical pathways leading to the post-finasteride syndrome.
authors.affiliation: Urological Hospital Department, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Chiriacò
authors.affiliation: Department of Medical and Biological Sciences, School of Medicine, University of Udine, Udine, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Cauci
authors.affiliation: Urological Hospital Department, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Mazzon
authors.affiliation: Urological Hospital Department, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Trombetta
mesh_terms: D058891:5-alpha Reductase Inhibitors / Q000009:adverse effects*; D000328:Adult; D000505:Alopecia / Q000188:drug therapy*; D018120:Finasteride / Q000009:adverse effects*; D006801:Humans; D008297:Male; D012098:Reproduction / Q000187:drug effects*; D012189:Retrospective Studies
chemical_list: D058891:5-alpha Reductase Inhibitors; D018120:Finasteride
keywords: 5-alpha-reductase inhibitor; AGA; PFS; Post-finasteride syndrome; benign prostatic hyperplasia; erectile dysfunction; finasteride safety; finasteride side effects; follicle stimulating hormone; free testosterone; loss of libido; luteinizing hormone; male pattern hair loss; sexual dysfunction; testosterone