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Skeletal formula for Finasteride
Drug class: Anti-androgen
Dosage range: Oral: 1mg - 5mg[1]
Brand names: Proscar, Propecia

I'm growing pretty concerned about finasteride. It seems to increase the risk of high Gleason-score (aggressive, dangerous) prostate cancers, even though it reduces the risk of low-grade ones. In fact, it was unanimously rejected by the FDA for treatment of prostate cancer.

It's also implicated in Post-Finasteride Syndrome, which can cause:

  • Lowered sex drive.
  • Reduced energy.
  • Brain fog / depression.


The 5α-reductase enzyme is responsible for the production and lifecycle of many crucial neurosteroids such as progesterone and allopregnanolone.[2] Finasteride blocks this enzyme. In trans health, finasteride is used to block the metabolic conversion of testosterone to Dihydrotestosterone, which has a higher binding potency[3].

Unfortunately, the machine that finasteride *breaks* is how these natural, mind-helping steroids are produced and interconverted!

Why long-term side effects happen

There are only three brands *(isoforms)* of this enzyme. Each has a different structure, and plugs into different things with different adapters. Since finasteride blocks 5-AR forms 2 and 3, the cells decide to replace it with 5-AR form 1 instead.[citation needed] This is really bad news, because that isoform *simply wasn't designed* to work in those other gene regulatory circuits! This could be the reason behind PFS and the increased cancer risk.

Finasteride has demonstrated long-term effects well after discontinuation,[4] so this may even be *irreversible.*[citation needed] Isoforms 2 and 3 don't get manufactured again once you withdraw the drug.[citation needed] Your cells keep churning out isoform 1!

I highly recommend everyone start pressing their doctors for answers about finasteride. Don't trust it. The doctors *simply don't know this research.*

Effects on hormone levels

Finasteride decreases scalp and serum DHT levels by about 70%:[5]

As a result decreased DHT levels, PSA levels are also decreased by about 50%.[6]

Related Papers


  1. | Transgender Health Primer
  2. Traish AM, Hassani J, Guay AT, Zitzmann M, Hansen ML. Adverse side effects of 5α-reductase inhibitors therapy: persistent diminished libido and erectile dysfunction and depression in a subset of patients. J Sex Med. 2011 Mar;8(3):872-84.
  3. Handbook of Drug Interactions: A Clinical and Forensic Guide (2011) p. 656
  4. Joseph M Unger et al (2018). "Using Medicare Claims to Examine Long-term Prostate Cancer Risk of Finasteride in the Prostate Cancer Prevention Trial". JNCI: Journal of the National Cancer Institute. 110 (11): djy035. doi:10.1093/jnci/djy035. PMID 29534197. ISSN 0027-8874.
  5. Lynn Drake et al (1999). "The effects of finasteride on scalp skin and serum androgen levels in men with androgenetic alopecia". Journal of the American Academy of Dermatology. 41 (4): 550–554. doi:10.1016/S0190-9622(99)80051-6. PMID 10495374. ISSN 01909622.
  6. "FDA Drug Safety Communication: 5-alpha reductase inhibitors (5-ARIs) may increase the risk of a more serious form of prostate cancer". Retrieved 2018-03-07.