FINASTERIDE IN MODERN MEDICINE: THERAPEUTIC APPLICATIONS AND SYSTEMIC HEALTH IMPLICATIONS
DOI:
https://doi.org/10.31435/ijitss.1(49).2026.4993Keywords:
Finasteride, Androgenic Alopecia, Drug-Related Side Effects and Adverse Reactions, Health Behavior, Modern CivilizationAbstract
Finasteride, a 5α-reductase inhibitor, is widely used for the treatment of androgenetic alopecia and benign prostatic hyperplasia. Its ability to reduce dihydrotestosterone (DHT) levels and promote hair growth has been well documented, making it a common therapeutic option among men. However, growing attention has been given to reports of persistent adverse effects affecting sexual, psychological, and metabolic health, which require further investigation. This review summarizes current findings on the dermatological and systemic effects of finasteride, emphasizing the need for comprehensive risk assessment and continued research. The literature review was conducted using the PubMed database, analyzing English-language studies published mainly between 2023 and 2025, identified with the keywords „finasteride”, „androgenetic alopecia”, „post-finasteride syndrome” and „adverse effects”. Despite these concerns, finasteride remains a clinically valuable and frequently prescribed medication for both androgenetic alopecia and benign prostatic hyperplasia. Reported persistent symptoms highlight the importance of proper patient education, informed consent, and individualized therapy. Further studies are required to clarify the mechanisms, prevalence, and management of these effects, ensuring safer and more informed clinical use of finasteride in both therapeutic and aesthetic contexts.
References
Cilio, S., Tsampoukas, G., Morgado, A., et al. (2025). Post-finasteride syndrome—A true clinical entity? International Journal of Impotence Research, 37, 426–435. https://doi.org/10.1038/s41443-025-01025-6
Meenrajan, S. R. (2024). Using 5 alpha reductase inhibitors safely: What primary care physicians need to know. Journal of Family Medicine and Primary Care, 13, 4797–4799. https://doi.org/10.4103/jfmpc.jfmpc_575_24
Ntshingila, S., Oputu, O., Arowolo, A. T., et al. (2023). Androgenetic alopecia: An update. JAAD International, 13, 150–158. https://doi.org/10.1016/j.jdin.2023.07.005
Panuganti, V. K., Madala, P. K., Grandhi, V. R., et al. (2025). A randomized, double-blind, placebo and active controlled phase II study to evaluate the safety and efficacy of novel dutasteride topical solution (0.01%, 0.02%, and 0.05% w/v) in male subjects with androgenetic alopecia. Cureus. https://doi.org/10.7759/cureus.89309
Kaiser, M., Abdin, R., Gaumond, S. I., et al. (2023). Treatment of androgenetic alopecia: Current guidance and unmet needs. Clinical, Cosmetic and Investigational Dermatology, 16, 1387–1406. https://doi.org/10.2147/CCID.S385861
Kim, J., Song, S.-Y., & Sung, J.-H. (2025). Recent advances in drug development for hair loss. International Journal of Molecular Sciences, 26, 3461. https://doi.org/10.3390/ijms26083461
Santana, F. D. F. V., Lozi, A. A., Gonçalves, R. V., et al. (2023). Comparative effects of finasteride and minoxidil on the male reproductive organs: A systematic review of in vitro and in vivo evidence. Toxicology and Applied Pharmacology, 478, 116710. https://doi.org/10.1016/j.taap.2023.116710
Brezis, M. (2025). Failing public health again? Analytical review of depression and suicidality from finasteride. Journal of Clinical Psychiatry, 86. https://doi.org/10.4088/JCP.25nr15862
Traish, A. M. (2020). Post-finasteride syndrome: A surmountable challenge for clinicians. Fertility and Sterility, 113, 21–50. https://doi.org/10.1016/j.fertnstert.2019.11.030
Chen, S., Li, L., Ding, W., et al. (2025). Androgenetic alopecia: An update on pathogenesis and pharmacological treatment. Drug Design, Development and Therapy, 19, 7349–7363. https://doi.org/10.2147/DDDT.S542000
Keerti, A., Madke, B., Keerti, A., et al. (2023). Topical finasteride: A comprehensive review of androgenetic alopecia management for men and women. Cureus. https://doi.org/10.7759/cureus.44949
Piraccini, B. M., Blume-Peytavi, U., Scarci, F., et al. (2022). Efficacy and safety of topical finasteride spray solution for male androgenetic alopecia: A phase III, randomized, controlled clinical trial. Journal of the European Academy of Dermatology and Venereology, 36, 286–294. https://doi.org/10.1111/jdv.17738
Van Neste, D., Fuh, V., Sanchez-Pedreno, P., et al. (2000). Finasteride increases anagen hair in men with androgenetic alopecia. British Journal of Dermatology, 143, 804–810. https://doi.org/10.1046/j.1365-2133.2000.03780.x
Low, P., Li, K. D., Hakam, N., et al. (2022). 5-alpha reductase inhibitor related litigation: A legal database review. Andrology, 10, 470–476. https://doi.org/10.1111/andr.13145
Zhong, X., Yang, Y., Wei, S., et al. (2025). Multidimensional assessment of adverse events of finasteride: A real-world pharmacovigilance analysis based on FDA Adverse Event Reporting System (FAERS) from 2004 to April 2024. PLOS ONE, 20, e0309849. https://doi.org/10.1371/journal.pone.0309849
Zhang, H., Ou, H., Zhao, P., et al. (2025). Association between finasteride with subjective memory deficits: A study from the NHANES and FAERS databases. Frontiers in Neurology, 16, 1616851. https://doi.org/10.3389/fneur.2025.1616851
Leliefeld, H. H. J., Debruyne, F. M. J., & Reisman, Y. (2025). The post-finasteride syndrome: Possible etiological mechanisms and symptoms. International Journal of Impotence Research, 37, 414–421. https://doi.org/10.1038/s41443-023-00759-5
Xia, Y., Chen, H., Chen, Y., et al. (2025). Relative efficacy of minoxidil in combination with other treatments for androgenic alopecia: A network meta-analysis based on randomized controlled trials. Frontiers in Medicine, 12, 1638496. https://doi.org/10.3389/fmed.2025.1638496
Johnson, H., Huang, D., Clift, A. K., et al. (2025). Effectiveness of combined oral minoxidil and finasteride in male androgenetic alopecia: A retrospective service evaluation. Cureus. https://doi.org/10.7759/cureus.77549
Diviccaro, S., Oleari, R., Amoruso, F., et al. (2025). Exploration of the possible relationships between gut and hypothalamic inflammation and allopregnanolone: Preclinical findings in a post-finasteride rat model. Biomolecules, 15, 1044. https://doi.org/10.3390/biom15071044
Maguire, J. L., & Mennerick, S. (2024). Neurosteroids: Mechanistic considerations and clinical prospects. Neuropsychopharmacology, 49, 73–82. https://doi.org/10.1038/s41386-023-01626-z
Melcangi, R. C., Santi, D., Spezzano, R., et al. (2017). Neuroactive steroid levels and psychiatric and andrological features in post-finasteride patients. Journal of Steroid Biochemistry and Molecular Biology, 171, 229–235. https://doi.org/10.1016/j.jsbmb.2017.04.003
Harrell, M. B., Ho, K., Te, A. E., et al. (2021). An evaluation of the federal adverse events reporting system data on adverse effects of 5-alpha reductase inhibitors. World Journal of Urology, 39, 1233–1239. https://doi.org/10.1007/s00345-020-03314-9
Chiriacò, G., Cauci, S., Mazzon, G., et al. (2016). An observational retrospective evaluation of 79 young men with long-term adverse effects after use of finasteride against androgenetic alopecia. Andrology, 4, 245–250. https://doi.org/10.1111/andr.12147
Li, X., Guo, Y., Lu, Y., et al. (2022). Case report: A study of the clinical characteristics and genetic variants of post-finasteride syndrome patients. Translational Andrology and Urology, 11, 1452–1457. https://doi.org/10.21037/tau-22-92
Lauck, K. C., Limmer, A., Harris, P., et al. (2024). Sexual dysfunction with 5-alpha-reductase inhibitor therapy for androgenetic alopecia: A global propensity score matched retrospective cohort study. Journal of the American Academy of Dermatology, 91, 163–166. https://doi.org/10.1016/j.jaad.2024.03.019
Lyakhovitsky, A., Amichai, B., Galili, E., et al. (2024). The risk of psychiatric disorders in finasteride users with benign prostatic hyperplasia and androgenetic alopecia: A population-based case-control study. Australasian Journal of Dermatology, 65, 621–629. https://doi.org/10.1111/ajd.14359
Géniaux, H., & Laroche, M.-L. (2025). Isolated depressive disorders and suicidality with finasteride use for androgenetic alopecia: A call for enhanced vigilance. Therapies. https://doi.org/10.1016/j.therap.2025.09.004
Wei, L., Lai, E. C.-C., Kao-Yang, Y.-H., et al. (2019). Incidence of type 2 diabetes mellitus in men receiving steroid 5α-reductase inhibitors: Population based cohort study. BMJ, l1204. https://doi.org/10.1136/bmj.l1204
Bose, V., & Santos Martinez, D. (2023). THU372 Finasteride induced hyperglycemia. Journal of the Endocrine Society, 7, bvad114.805. https://doi.org/10.1210/jendso/bvad114.805
McQueen, P., Molina, D., Pinos, I., et al. (2024). Finasteride delays atherosclerosis progression in mice and is associated with a reduction in plasma cholesterol in men. Journal of Lipid Research, 65, 100507. https://doi.org/10.1016/j.jlr.2024.100507
Solanki, P., Eu, B., Smith, J., et al. (2023). Physical, psychological and biochemical recovery from anabolic steroid-induced hypogonadism: A scoping review. Endocrine Connections, 12, e230358. https://doi.org/10.1530/EC-23-0358
Carrington, A. E., Maloh, J., Nong, Y., et al. (2023). The gut and skin microbiome in alopecia: Associations and interventions. Journal of Clinical and Aesthetic Dermatology, 16, 59–64.
Diviccaro, S., Giatti, S., Cioffi, L., et al. (2022). Gut inflammation induced by finasteride withdrawal: Therapeutic effect of allopregnanolone in adult male rats. Biomolecules, 12, 1567. https://doi.org/10.3390/biom12111567
Giatti, S., Diviccaro, S., Cioffi, L., et al. (2024). Post-finasteride syndrome and post-SSRI sexual dysfunction: Two clinical conditions apparently distant, but very close. Frontiers in Neuroendocrinology, 72, 101114. https://doi.org/10.1016/j.yfrne.2023.101114
An, J., Song, Y., Kim, S., et al. (2023). Alteration of gut microbes in benign prostatic hyperplasia model and finasteride treatment model. International Journal of Molecular Sciences, 24, 5904. https://doi.org/10.3390/ijms24065904
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Copyright (c) 2026 Aleksandra Kutaj, Wiktor Łapa, Tatyana Savitskaya , Maria Sobolewska, Olga Magdalena Tuleja, Dawid Wiczkowski

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