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Androgenetic alopecia: observational retrospective evaluation of 79 young men with long-term adverse effects after use of Finasteride

Concern regarding adverse effects of Finasteride ( Propecia ) is increasing. The aim of a study was 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% ).

Researchers contributed to inform patients about symptoms of post-Finasteride syndrome; 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. ( Xagena )

Chiriacò G et al, Andrology 2016; Epub ahead of print