Post-Finasteride Syndrome - When will we Get the Courage to Fight the Dictating Pharma Industry - Despite Awareness of "Sexual, Neurological and Metabolic Side Effects in Young Men for Over a Decade"

Finasteride is a 5 alpha reductase inhibitor(5-α RI) that has been used for the treatment of benign prostatic hyperplasia (BPH) as well as androgenic alopecia for relatively young men for long. That a group of side effects not only develop following its use but persist following cessation of the drug with the syndrome coined as ‘’Post Finasteride Syndrome ‘’(PFS) has been realized for long. What is the reason that we as physicians refuse to appreciate this despite serious adverse effects like persistent sexual dysfunctions, suicidal ideation, and other metabolic effects like risk of developing type 2 diabetes mellitus (DM), lacrimal dysfunction, renal abnormalities we refuse to appreciate these drug induced syndrome. Infact when rimonabant (a CB1 receptor agonist)was being studied as an antiobesity syndrome and was shown to cause suicidal ideation immediately it was with drawn from trials. What pushes us not to use the same criteria for these 5-α RI including Finasteride and dutasteride knowing that how important they are in human physiology and how severe harm we might cause to then poor unknowing man who is not even told that he might develop erectile dysfunction, loss of pleasure in life a prize he has to pay to get his hair back. This comprehensive review has been done with an effort for our medical community who took hippocratic oath to serve the humanity why they cannot get up and protest against the side effects that in a subgroup of men might get irreversible side effects rather than label the poor men as psychotic or delusional. These symptoms have been emphasized by Traish along with other groups as men who have epigenetic susceptibility. Time has come that not only we start actually looking deep down into the pathophysiology and get an insight into this mysterious, elusive diagnosis that refuses to get accepted despite a lot of body of evidence.Hopefully a change in the attitude of our community will come.

Keywords: 5-α RI; ‘’Post Finasteride Syndrome ‘’(PFS); persistent sexual dysfunctions; suicidal ideation; BPH; metabolic dysfunctions.