PFS is a variable and potentially devastating condition, but its molecular mechanism(s) are currently unclear. The predispositions that cause a subset of men to develop PFS from as little as a single exposure to a 5-alpha reductase inhibitor remain unknown. Reported symptoms include (but are not limited to) loss of libido, erectile dysfunction, suicidal ideation, depression, anxiety, panic attacks, cognitive impairment, Peyronie’s disease, penile shrinkage, gynecomastia, muscle atrophy, metabolic changes, digestive problems, severely dry skin and tinnitus. The condition often has a life-altering impact on victims and their families, such as job loss and the breakup of marriages and romantic relationships, while also being linked to suicides.
Elucidation of the biological mechanisms of PFS is critical to the development of treatments for the many patients suffering. It is also essential for consumers to be adequately informed of the associated risks of 5-alpha reductase inhibitor products, as the syndrome remains unacknowledged by the pharmaceutical industries and regulatory systems across the globe.
A major study into PFS is ongoing at the Baylor College of Medicine. Titled “Genetic and Epigenetic Studies on Post-Finasteride Syndrome Patients”, the research is being led by Mohit Khera, M.D., M.B.A., M.P.H., Assistant Professor of Urology in the Scott Department of Urology and Director of the Laboratory for Andrology Research, McNair Medical Institute at BCM. The objective of the study is to determine why PFS patients develop sexual dysfunction. To this end it will:
- evaluate sexual and psychological function
- assess hormone levels
- measure penile hemodynamic and sensory parameters
- study androgen receptor genetics and gene expression
- determine gene expression patterns and profiles
The second research initiative is phase two of Roberto Cosimo Melcangi PhD’s research at the University of Milano, which will build on the Neuroendocrinology Unit’s Phase I study, titled “Neuroactive steroid levels and psychiatric and andrological features in post-finasteride patients”. That study was published in the July 2017 issue of The Journal of Steroid Biochemistry and Molecular Biology. According to that research, PFS patients suffer from altered levels of critical brain-function regulators, including neuroactive steroids, and those with severe erectile dysfunction suffer from neuropathy of the pudendal nerve.
The second phase of Professor Melcangi’s investigation focuses on possible epigenetic changes in PFS patients, with a focus on the function of the 5 alpha reductase enzyme. The team will also explore the following in an animal model of PFS:
- behavioral parameters
- alterations in neurogenesis
- neurotransmitter pathways involved in the control of sexual function
- possible epigenetic changes in 5alpha-reductase
- Possible changes of the gut microbiota composition
Both of these ongoing studies and the previously published research into PFS have been funded by the PFS Foundation through direct donations. If you or a loved one are suffering from PFS, we encourage you to donate to support further research initiatives into the condition. For more information on these studies and previously published research into the condition, please visit the PFS foundation website.