Merck’s former physician-allies sowed doubt while Propecia litigation was pending

After FDA approved finasteride for male hair loss in 1997, the drug’s reputation stayed untarnished for a dozen years in the United States. However, the tide shifted in the 2010s: label warnings were added about risks of depression and lasting sexual dysfunction. Lawsuits about persistent sexual dysfunction were filed against Merck. These were later consolidated … Read more

The most far-fetched theories of post-finasteride syndrome

The two most far-fetched theories of post-finasteride syndrome were proposed by a dermatologist and a hair transplant surgeon. Physicians in these specialties tend to fervently deny that the syndrome is a valid medical condition, pointing instead to co-occurring conditions such as diabetes, anxiety, depression or, according to the theories below, delusions or sleep apnea. Theory … Read more

Firsthand experiences XIII: Recent reviews on Drugs.com & Ask a Patient

More reviews have been posted online since a compilation was published in 2023. While some are positive, others are alarming and consistent with adverse event reports submitted to FDA as well as media reports and some research. Find recent negative reviews from the Drugs.com and Ask a Patient websites below. Emphasis has been added in … Read more

New bibliography of case reports and series

A new bibliography of case reports & series is available. The papers come from a wide range of medical specialties including dermatology, hematology, hepatology, neurology, ophthalmology, pediatrics and andrology. Most were already in the main bibliography, but a few new ones were discovered. View the new bibliography: Case reports & series

Reckoning with underreporting—response to Lauck et al, 2024

We do not know if the medical records used in this study are sensitive to sexual dysfunction in healthy men, and especially in men taking these drugs for hair loss. Since the study includes men taking 5-ARIs, the results do not shed light on why sexual dysfunction might persist after stopping these drugs.

Mind the gaps: remarks on the evidence base

This post makes a few not-so-obvious points about the sprawling literature on finasteride and 5-alpha syndrome. If you are new to this literature, consider starting with a brief history of the research and a guide for researchers. Those pages describe what is in the literature, but it is also important to discern what is not … Read more

Stanford urologist discusses risks of finasteride on Huberman Lab podcast

On November 6, Dr. Andrew Huberman spoke to guest Dr. Michael Eisenberg, a urologist and professor at Stanford Health Care in California. In one segment, they discussed post-finasteride syndrome.

Temperature check on recent literature

5-alpha syndrome (post-finasteride syndrome) is appearing more regularly in the medical literature. Recent articles show slightly more openness to the syndrome as legitimate, especially in the fields of andrology and sexual medicine. But they continue to recycle old arguments that pin the problem on the patient, such as pre-existing psychological and sexual disorders, a nocebo … Read more

Urology professor Dr. Ted Schaeffer on Attia Drive: Post-finasteride syndrome is real, drug-related and can be permanent

Dr. Schaeffer, Chair of Urology at Feinberg School of Medicine, does not recommend finasteride for any man. The prostate cancer expert says he knows people who have post-finasteride syndrome “permanently.” Dr. Edward Schaeffer recently spoke about post-finasteride syndrome on The Peter Attia Drive Podcast, in an episode on prostate health. Dr. Schaeffer is Chair of … Read more