Post-Finasteride Syndrome (Solved)

Post-Finasteride Syndrome (Solved)

Today we will gonna explain post-finasteride syndrome.

• What happens if you get side effects from finasteride?
• Are there long-lasting side effects?

In this post, we unpack what has come to be quite a controversial topic.

This was only described in 2011 which kind of amuses me because the drugs have been around since 1992 with men who are older than the typical men for both taking for baldness. Taking 5 times as much as the recommended dose for hair which was 5 milligrams a day for the prostate.

Nobody ever complained about finasteride syndrome when we were doing it in 50-year-old men at 5 milligrams a day.

But we have now this sudden emergence of a group of patients who are saying that they have had prolonged side effects after cessation of one milligram per day.

It got into the medical literature in a kind of a strange roundabout way where the researcher did a telephone survey of people on the internet who were complaining about this. It goes against all the normal rules of research projects for random selection.

So it was kind of hard to give a lot of scientific credibility to the initial report but once it was in the literature it took off.

We’re going to try and detect it just briefly for you today because it is a controversial subject. People like myself who’ve been in the field a long time and they treated a lot of patients don’t see it. But there are a group of people on the internet who have made these complaints so we have to take them seriously.

Finasteride side effects

We’re not saying that it’s a thing there or everyone is lying. There are side effects with Finasteride and having issues with low libido or erectile dysfunction is one of the world's documented side effects of taking finasteride.

Side effects divided into two groups of people

We can divide it into 2 groups of individuals.

Group 1. If we start the tablet there’s a group that initially acts within weeks, we’ll get side effects. There are people that don’t get side effects from a carry-on. But there are also individuals that have no side effects and then maybe months or years sometimes down the track. So it could be years or it could be months.

When will the side effects of Finasteride appear?

The longest when I’ve had documented victims was 18 months from there before the symptoms appeared. By my definition, the second group is the group that happens at least 4, 5, and 6 months after starting the Finasteride. Remember these are in our patients only taking 1 milligram 3 times a week.

This is not a post-Finasteride syndrome that we’re not talking about that, what we’re talking about is the incidence of side effects of taking the medication.

Group 2. If it happens within the first few weeks then we know that that individual has a degree of sensitivity to the medication and we’ll look at reducing or stopping it.

That’s the bigger group. The bigger group is if you’re going to react in the first month that’s the majority of people to react to Finasteride.

Why there are two groups of people that have side effects?

The answer to the question is that in the second group they’re really not as sensitive to it as the first group but because of the long time that finasteride lasts in the body.

Over many months it builds up and builds up and builds up in the system and this explains why they react differently when you stop finasteride.

What we do in that case is we either stop the medication or reduce the dose of the medication and the side effects go away. If it comes on quickly it goes away quickly that’s our experience.

How long does it take to clear Finasteride from the system?

However for the patients to get it later on in their treatment exposure it takes 3 months to clear from your system. So if you’ve got it after 9 months it might take 3 months before it cleared from your system and you started to feel an improvement in the symptoms.

What does that lead us to?

I think we should define the post-Finasteride syndrome. Is not people who have side effects after they stop, because if you’ve got side effects and you stop everybody could be in that category.

It’s going to be at least 3 months if not 6 months after you stop the tablet before we want to put them into this category of potentially having post-Finasteride side effects.

We sometimes see people in this group of people with post side effects, come back and see us and after a few months and have got issues.

In this scenario we get them to stop the medication for a few months and just reassure them they’re not going to lose a massive head hair if they’re off the medication for a few months.

What happens is the levels washout and then come back to baseline and then they can restart and then hopefully it’s the build-up is again slow going forward.

2 ways to resolve the post Finasteride side effects

You can come back in at a lower dose. I’ll often say to people in the scenario take one a week for a month see how that works if there’s no reaction take two a week for the next month if that’s no reaction then we’ll maybe take it back to three weeks or leave it at two weeks.

The other way to do it and what I say to patients is if you’re the person who takes it to 6, 7, 8, or 9 months and then starts to get symptoms whether it takes that long for you to get the symptoms. Then take it for 5 months take a month off then take it again for 5 months take a month off, in other words, give yourself a chance to clear it out of your system.

As you go along I found both those strategies have been quite effective in patients who have got the longer-term version of the side effects.

I think if you are one of the people in this sort of group this hopefully is some advice and some information so you understand what’s going on. I think the key is they’ve got a good chat with the prescribing physicians who prescribed it and get some good advice from there. Hopefully that this will help help you understand why this is happening in the first place.

Even on the most generous interpretation, one scientist I heard talking about it, though it was 1% of users might get that sort of reaction. That doesn’t really accord with what we’re seeing in real life.

By the way, the people who have post-Finasteride syndrome by that definition of long-standing symptoms afterward is less than the people who are not taking Finasteride who are complaining of the same symptoms.

Recap

Just to repackage. There are groups of people out there who have been on Finasteride who have had side effects with Finasteride who have come off the finasteride and let it wash out of the system but still have some residual effect of either loss of libido or issues with erectile dysfunction.

Why is that happening and how many of those people are out there?

The statistics show from the data is that the incidence of that happening is actually less than the normal occurrence of erectile dysfunction in the normal population.

Even if we’re not talking about the post-Finasteride syndrome, if we’re just talking about the side effects of Finasteride the number of people getting side effects of Finasteride is less than the same age group who are not taking it.

The reality is we’re just trying to reassure everyone yes and that this is not a big fear that people should have. This is a very low incidence and a very specific group of people have this problem.

I hope that addresses the issue with the post-Finasteride syndrome. There’s a lot on the internet out there and a lot of people that complain and say things, we were acknowledging that there is a group of people that have post side effects.

It’s not as clear-cut there but it’s easily manageable. Let’s also remember that the millions of men taking it are not on the internet telling what a great experience they’ve got.