Persistent Sexual and Psychological Symptoms After Finasteride Discontinuation: A Cross-Sectional Observational Study.
Level 4 - case-series / case-control
Cross-sectional observational study without an unexposed control group.
PubMed 42074750 · doi:10.3390/jcm15082947
What was done
A cross-sectional observational study evaluated 129 adult men with prior finasteride exposure for male pattern hair loss or benign prostatic hyperplasia. Sexual function, depressive symptoms, and anxiety were measured using the International Index of Erectile Function (IIEF), Patient Health Questionnaire-9 (PHQ-9), and Generalized Anxiety Disorder-7 (GAD-7). Univariate and multivariable regression analyses evaluated associations between clinical variables (age, treatment duration, cumulative exposure, and indication) and symptom severity.
What was found
Median treatment duration was 24 months (IQR: 12.5-36) and median time from discontinuation to evaluation was 8 months (IQR: 1-17). Mean erectile function remained stable over time (IIEF: 15.2 ± 0.46 at baseline vs. 15.4 ± 0.47 at 6 months). Depressive symptom scores decreased from 12.4 ± 0.41 to 9.1 ± 0.41 and anxiety scores decreased from 3.29 ± 0.23 to 2.54 ± 0.20 over the same period, without normalization in most patients. In multivariable analyses, higher cumulative exposure and older age were independently associated with lower IIEF scores and higher PHQ-9 and GAD-7 scores.
Why it matters
The study identifies cumulative exposure and age as factors associated with greater symptom severity among men reporting persistent sexual and mood symptoms after stopping finasteride.
Limits
The study included only symptomatic men and lacked an unexposed control group or pre-treatment baseline measurements, preventing causal conclusions or determination of symptom incidence. The cross-sectional design relies on self-reported questionnaires and is subject to selection and recall bias.
Cited by
- supports Some patients experience persistent sexual dysfunction even after discontinuing finasteride treatment for hair loss.