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.

Study of depression from prostate drugs loses the signal by including past users

This study fails to assess the risk of depression associated with using finasteride or dutasteride because past users of 5-ARIs were counted as cases. 37% of cases in the 5-ARI group had stopped taking the drug 181 days or more prior to initial diagnosis or treatment for depression. Only slightly more than half of cases were current users at the time of initial diagnosis or treatment for depression. Moreover, the control group was taking ⍺-blockers.

Study of ED risk loses the signal by including past users of finasteride

There is a major limitation: the analysis included past and recent users of 5ARIs, as well as current users. Past users are defined as those who stopped taking a 5ARI at least 91 days before getting diagnosed or treated for ED. Recent users are those who last took the drug 31-90 days before diagnosis or treatment for ED.

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

2023 – year in review

Fitness influencers and physicians raised alarms about risks of finasteride for hair loss this year, reaching millions of people through tweets, videos and podcasts. On the regulatory front, in France boxed warnings were added to finasteride packaging. Health Canada added a warning about suicidality while the UK regulator launched a safety review. Forty-four relevant research … Read more

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

Response to Dr. Ralph Trüeb’s writings on post-finasteride syndrome

A drug-induced syndrome is all in the mind, a Swiss doctor wrote. Editors of the journals had past ties to the drug maker.

Seeking a medical sign of genital numbness

Some post-5ARI patients experience genital numbness. This symptom can be assessed, but the tests are not easily accessible. This post gives an overview of medical tests which could yield signs of genital numbness and other abnormalities.