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BPH? No Fun. Balding? Yuck. But Nobody Warned Me about Finasteride!

Finasteride is a class of drug called a 5-alpha reductase type II enzyme inhibitor. This basically means that without diminishing testosterone (male hormone) production, it blocks testosterone from interacting biochemically with cells. When it’s used to treat BPH, the trade name is Proscar. For balding, it’s called Propecia.

However, in 2012 the FDA introduced warning labels for both preparations... that was just the tip of the iceberg... the list of possible side effects has been expanded to include not just sexual problems, but also physical and psychological issues: breast development, fatigue, increased body fat, ringing in the ears, impaired memory and cognitive function, depression...

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Articles of Interest

Benign Prostatic Hyperplasia: Proscar Vs Flomax (Vs Propecia)

It doesn't have to be finasteride vs Flomax. Combination therapy is commonly employed to better treat patients with BPH. The use of both the alpha-blocker Flomax and the 5-alpha reductase inhibitor Proscar to simultaneously treat BPH has been shown to offer better results for those suffering from symptoms due to a diagnosis of BPH, if appropriate.

Effectiveness of Proscar in Treating Enlarged Prostates

Results of a four-year study involving 3,040 men have shown that those taking the drug finasteride (Proscar) for enlarged prostate glands reduced their risk of needing surgery or experiencing acute urinary retention by more than half.

Finasteride and Prostate Cancer: A Commentary

There was great hope that they would be safe, easy, and effective chemoprevention agents against prostate cancer, but studies show otherwise.

Finasteride and sexual side effects

This article critically examines the evidence available and makes recommendations as to how a physician should counsel a patient while prescribing the drug.

Finasteride can reduce prostate cancer risk long term

Fred Hutch study taps big data to tease out extended cancer-prevention benefit of drug used for enlarged prostate, hair loss.

Finasteride harms and benefits compared to alpha-blockers

Finasteride improves long-term urinary symptoms compared to placebo, but is less effective than doxazosin. Long-term combination therapy with alpha blockers (doxazosin, terazosin) improves symptoms better than finasteride therapy alone.

Finasteride in the treatment of patients with benign prostatic hyperplasia: a review

This article reviews the literature for finasteride used in the treatment of BPH and provides evidence for its efficacy, safety and tolerability, applicability for combination therapy, and considerations of its effects on prostate cancer risk.

Finasteride-Its Impact on Sexual Function and Prostate Cancer

Finasteride, a specific and competitive inhibitor of 5α-reductase enzyme Type 2, inhibits the conversion of testosterone to dihydrotestosterone (DHT). In adults, DHT acts as primary androgen in prostate and hair follicles. The only FDA-approved dermatological indication of finasteride is androgenetic alopecia. But, apprehension regarding sexual dysfunction associated with finasteride deters dermatologists from prescribing the drug and patients from taking the drug for androgenetic alopecia.

Finasteride: A Drug with Several Side Effects

Finasteride use has been associated with long-term and persistent endocrine, neurological, sexual, and ocular side effects.

Learn finasteride side effects and how to avoid them

The sexual side effects that are commonly experienced with finasteride are big cons to be weighed against the benefits of use of the medication, especially since there is concern that these side effects may also cause or exacerbate additional mental health conditions such as depression or suicidal ideation.

Panel Opposes Avodart, Proscar to Prevent Prostate Cancer

A federal advisory panel said drugs currently used to treat enlarged prostates in men shouldn't be used as a treatment to prevent prostate cancer due to concerns that the drugs didn't cut the risk of aggressive prostate tumors.

Prostate Drugs May Raise Diabetes Risk

Compared with those using Flomax, men using Avodart had a 32 percent increased risk for developing diabetes, and those using Proscar a 26 percent increased risk. The study carefully controlled for body mass index, other drug use, smoking, alcohol consumption, hypertension and other health and behavioral characteristics.

Should I worry about finasteride side effects even after stopping the drug?

It can prevent hair loss and decrease prostate enlargement, but not surprisingly, it can also suppress sexual function. However, the side effects of a medication usually go away when you stop taking it. However, some men report persistent sex drive and ejaculation problems after stopping the medication. This is not proof that finasteride is to blame, since a variety of medical conditions and other prescription drugs could explain the sexual symptoms. But it is a risk men should discuss with their doctor prior to starting finasteride.

Study Finds Popular Prostate Drug Has Serious Side Effects

Treatment of benign prostatic hyperplasia (BPH) with the commonly prescribed Avodart (Dutsteride) may put men at an increased risk for diabetes, elevated cholesterol levels, non-alcoholic fatty liver disease (NAFLD) and worsening erectile dysfunction.

What do recent studies tell us about finasteride and PCa?

Finasteride (Proscar) and other 5-alpha-reductase inhibitors (5-ARIs) are most commonly used for the treatment of obstructive urinary symptoms due to enlarged prostate. Despite Level I evidence, the use of finasteride for prostate cancer prevention has not been widely adopted by the medical community.

What is Post-Finasteride Syndrome?

Post-Finasteride Syndrome (PFS) encompasses a constellation of adverse symptoms that can affect a man physically, neurologically, psychiatrically, and sexually when taking finasteride.

Resources

Post-Finasteride Syndrome Foundation

We understand the devastating and life-altering impact finasteride can have on the sexual, mental and physical health of men. Our primary objective is therefore to work closely with the medical community to spur scientific interest and investigation into PFS, so that underlying biologic mechanisms for persistent finasteride side effects can be found and, hopefully, treatments identified to remedy the condition.

Proscar

The recommended dose of PROSCAR is one tablet (5 mg) taken once a day in combination with the alpha-blocker doxazosin.

MedlinePlus

Finasteride is in a class of medications called 5-alpha reductase inhibitors. Finasteride treats BPH by blocking the body's production of a male hormone that causes the prostate to enlarge. Finasteride treats male pattern hair loss by blocking the body's production of a male hormone in the scalp that stops hair growth.

StatPearls

Finasteride is an FDA-approved pharmacologic agent for treating benign prostate hyperplasia and androgenic alopecia (male pattern hair loss) in men. Finasteride has also been used to treat signs of hyperandrogenism, such as hirsutism, and may be used in transgender women in combination with estrogen for its anti-androgen properties.