Doctors expressing concerns about adverse effects of finasteride

Following are excerpts of articles, videos and tweets of doctors expressing concerns about harms of finasteride. (A separate page on doctors who question whether finasteride can cause long-term harms is in preparation.)

Articles & comments

I am writing to increase awareness regarding finasteride, a medication with several under-recognized and under-reported adverse effects.

Patients and doctors remain largely unaware of the long term consequences of this drug on the nervous system and mental health. Unfortunately, some of the side effects of finasteride are more serious and persistent than the original condition it is intended to treat. Neurotoxicity is likely more common than reports would suggest.

In my San Jose, California ophthalmology clinic, we encountered a surprising association between finasteride use and presence of optic neuropathy or retinopathy…

It is especially important that physicians recognize the potential for this drug to impact optic nerve function. This is a medication that patients may conceal or leave off their lists of medications since it is marketed separately via the internet directly to patients. We have made it a point now to ask every patient about finasteride use.

Excerpt from: Keshav Narain, MD. A Letter regarding Finasteride. Website of South Bay Retina, an ophthalmology clinic.

5-alpha reductase is not only used to convert testosterone to dihydrotestosterone. 5-alpha reductase converts androstenedione to dihydroandrostenedione; progesterone to dihydroprogesterone; [and numerous other biochemical conversions]. Every one of those events is blocked by finasteride. Every one of these agents goes to make neurosteroids that are participating in the patient’s thinking, decision-making, executive function. We are voluntarily making people block all these things with the hope that they’re going to shrink their prostate or grow some hair. It’s ridiculous.

With Hims and Keeps and Roman, the number of patients getting on these crazy drugs is exponentially increasing, despite all the evidence and all the discussions. There are dozens of PFS articles out now. The statement that “Oh this doesn’t really exist,” that’s just nonsense.

Dr. Irwin Goldstein, Director of San Diego Sexual Medicine, in the Q&A portion of a webinar held by the Sexual Medicine Society of North America (SMSNA) on 27 Jul 2021. Webinar description | Full video (link goes to Goldstein comment at 54:33)