Talk:Finasteride

Long-Term Section - Flaws in studies cited

In the study "Sexual dysfunction in men taking systemic dermatologic medication: A systematic review" that is cited in the Long Term section of the Finasteride Wiki. Only level 1 evidence of Finasteride potentially causing long-term side effects is cited. This is very weak evidence and it far from being a double-blinded control study. In addition, there are no double blinded control studies currently that prove that Finasteride causes long-term side effects after the drug has stopped circulating in the blood.

In fact, in a double blind long-term control study there was no evidence of side-effect continuation after cessation of the drug: https://www.jaad.org/article/S0190-9622(98)70007-6/abstract

"These adverse events (Sexual dysfunction) also resolved in many of the patients who reported them but who remained on the finasteride regimen and continued in the study."

" a few men in the current studies experienced reversible impairment of sexual function, but only 11 men receiving finasteride, compared with 8 men in the placebo group, discontinued treatment for this reason, with resolution in all."

In conclusion, I feel that the evidence cited here is extremely flimsy and is contradicted by studies with better methodology, study design and far more subjects. Thus this entry should be removed as there is far stronger evidence to the contrary of what this study and entry claims. Zpalmati (talk) 19:48, 16 June 2024 (UTC)

No side effects data for women?

Finasteride is prescribed to women for excess hair growth but there is no mention of side effects on women. Is there none at all? That is hard to believe... ~2025-41970-67 (talk) 00:12, 22 December 2025 (UTC)

Finasteride in treating gender dysphoria among transgender women.

what is seen by some as a side effect is actually important in the treatment of transgender women. It has been used for this purpose for many decades. Testosterone must be decreased for the body to absorb estrogen the primary female hormone. All the information I've seen is about its use for hair loss in men. ~2026-37249-7 (talk) 23:00, 17 January 2026 (UTC)

Someone removed the section. This seems to happen a lot here on Wiki, e.g. people trying to remove the relevant section on the spironolactone article as well. I've restored it, but rewritten with higher-quality refs. – AlyInWikiWonderland (talk, contribs) 00:28, 24 April 2026 (UTC)

"This treatment may result in development of non-alcoholic fatty liver diseases (NAFLD), insulin resistance (IR), type 2 diabetes (T2DM), dry eye disease, potential kidney dysfunction, among other metabolic dysfunctions."

Health Risks Associated with Long-Term Finasteride and Dutasteride Use: It's Time to Sound the Alarm Abdulmaged M Traish 1,✉ PMCID: PMC7308241 PMID: 32202088

"Recent emerging literature supports a role for 5α-DHT in the physiological function of liver, pancreatic β-cell function and survival, ocular function and prevention of dry eye disease and kidney physiological function. Thus, inhibition of 5α-reductases with finasteride or dutasteride to reduce 5α-DHT biosynthesis ... my induces(sic) a novel form of tissue specific androgen deficiency and contributes to a host of pathophysiological conditions, that are yet to be fully recognized."

Liver:

" In the animal model, inhibition of 5α-Rs types 1 and 2 impeded glucocorticoids and androgens metabolism and contributed to the pathogenesis of nonalcoholic fatty liver disease (NAFLD) [13,14]."

Type 2 diabetes:

" In humans receiving dutasteride, impaired insulin sensitivity in peripheral organs, including skeletal muscle and/or adipose tissue were recorded. The authors suggested that the adverse changes in IR may, in part, be mediated by impaired glucose disposal, mainly in muscle where 5α-R types 1 is expressed [16]."

Dry eye disease:

" Finasteride administration significantly downregulated androgen receptors (ARs) in the lacrimal gland the significance observed with tear film break up time (TBUT) and tear flow could be attributed to the lack of 5α-DHT in the lacrimal glands [20,23]. "

Kidney function:

" Recently, it was shown that finasteride downregulated AR expression in the cortical region of the kidney [18]. Finasteride treatment resulted in reduction in AR-positive cells in the renal corpuscle (0.06%±0.03%) as compared with untreated animals (0.14%±0.12%). Similarly, the percentage of AR-positive cells in the proximal convoluted tubule of finasteride treated animals also demonstrated marked reductions compared with control animals (0.16%±0.17% vs. 0.69%±0.32%, respectively). Furthermore, the percentage of AR-positive cells the distal convoluted tubule (DCT) of finasteridetreated rats was markedly reduced compared to controls (0.50%±0.26% vs. 0.91%±0.12%, respectively) [18]. The decrease of AR expression lead to histopathological changes in the kidney cortex, such as apoptosis (Fig. 4), fibrosis (Fig. 5) and infiltration of mononuclear cells [18]. Finasteride treatment increased glomerulosclerosis, tubulointerstitial fibrosis, and the infiltration of mononuclear cells. "

Original study: Finasteride-Induced Inhibition of 5α-Reductase Type 2 Could Lead to Kidney Damage—Animal, Experimental Study by Mirza Saim Baig 1,Agnieszka Kolasa-Wołosiuk 1,*,Anna Pilutin 1,Krzysztof Safranow 2, 2, 3 and 1

Associations of endogenous androgens and sex hormone-binding globulin with kidney function and chronic kidney disease, Front. Endocrinol., 18 December 2022 Sec. Renal Endocrinology Volume 13 - 2022

" Conclusion: Suggestive associations are observed of androgens and SHBG with kidney impairment among men (T/DHT) and women (reverse J-shaped associations was observed between DHT). However, larger well-phenotyped prospective studies are required to further elucidate the potential of androgens, SHBG, and T2D as modifiable risk factors for kidney function and CKD."

My understanding: Mechanism of kidney damage from long term finesteride usage would be from its downregulated AR expression in kidney cells, which DHT interacts with to offer protection. This is my personal interest having been on Finesteride to control 'watch-and-wait' prostate cancer symptoms. Over the last 4 years my kidney function has steadily worsened. Now I have to decide on complete discontinuation of Finesteride.

More studies are needed on humans with larger N's. Editors are encouraged to do further searches of the medical databases on these potential effects on liver, eyes, kidney and type 2. The Abdulmaged M Traish 1,✉ PMCID: PMC7308241 PMID: 32202088 is an overview with many references to other studies. Good luck. Finesteride has been known as "no effects on the kidney or liver; very safe drug" narrative for over a decade. These entries will face much opposition. ~2026-40899-39 (talk) 23:07, 21 July 2026 (UTC)

Notable or not?

In the recent months, there has been ample news coverage about Donald Trump having taken finasteride in his First Presidency and that it's been ommitted in his medical report this year. Is this relevant to be added to the article in the Society and culture section? Appu (talk) 01:25, 24 July 2026 (UTC)