Finasteride (tradename Propecia) is a drug prescribed for benign prostatic hyperplasia and androgenic alopecia. A number of problems may affect a man who is taking finasteride, and these may persist after therapy is stopped.
Mechanism of action of finasteride: 5-alpha reductase inhibitors
Pathogenesis of post-finasteride syndrome: uncertain
Complaints may include:
(1) sexual side effects: decreased libido, erectile dysfunction, decreased volume of ejaculate
(2) neurologic findings: mental cloudiness or cognitive impairment
(3) physical side effects: rash, pruritis, testicular pain, breast tenderness
(4) mental side effects: depression, anxiety, suicidal ideation
Theories for occurrence:
(1) coincidental depression and stress
(2) self-delusion
(3) altered steroid metabolism
(4) altered gut microflora
