Cilio Simone, Tsampoukas Georgios, Morgado Afonso, Ramos Pedro, Minhas Suks
U.O.C. Clinica Urologica, A.O.U. San Giovanni di Dio e Ruggi d'Aragona "Scuola Medica Salernitana", Salerno, Italy.
Department of Urology, Homerton University Hospital NHS Trust, Homerton, UK.
Int J Impot Res. 2025 Feb 14. doi: 10.1038/s41443-025-01025-6.
This review critically examines Post-Finasteride Syndrome (PFS), a condition eventually reported by men who have used finasteride for androgenetic alopecia or benign prostatic enlargement and experienced persistent adverse effects after discontinuation. We explore the clinical manifestations, including sexual dysfunction, neuropsychiatric symptoms, and physical changes, that collectively challenge both diagnosis and management. This review evaluates the evidence for PFS, discusses potential mechanisms including neurobiological alterations, genetic predispositions, and addresses the controversies surrounding its existence and recognition by the medical community. Emphasis is placed on the role of patient education and the need for thorough risk assessment before prescribing finasteride. Although contrasting data from literature, men treated with finasteride could develop a plethora of non-neglectable physical and psychological symptoms identifying PFS. A multidisciplinary approach to research, policy-making, and patient advocacy is essential to better understand, diagnose, and manage PFS, underlining the necessity for greater awareness and scientific inquiry into this contentious and impactful syndrome.
本综述批判性地审视了非那雄胺后综合征（PFS），这是一种最终由使用非那雄胺治疗雄激素性脱发或良性前列腺增生的男性报告的病症，他们在停药后经历了持续的不良反应。我们探讨了其临床表现，包括性功能障碍、神经精神症状和身体变化，这些症状共同对诊断和治疗构成了挑战。本综述评估了PFS的证据，讨论了潜在机制，包括神经生物学改变、遗传易感性，并探讨了围绕其存在以及医学界对其认可的争议。重点在于患者教育的作用以及在开处非那雄胺之前进行全面风险评估的必要性。尽管文献数据存在差异，但接受非那雄胺治疗的男性可能会出现大量不可忽视的身体和心理症状，从而确定为PFS。采用多学科方法进行研究、制定政策和为患者维权对于更好地理解、诊断和治疗PFS至关重要，这凸显了提高对这一有争议且影响重大的综合征的认识和进行科学探究的必要性。
