How to treat

Post Finasteride Syndrome treatment
Unfortunately there is still no treatment that has managed to reverse all the symptoms of Post-Finasteride Syndrome. However, it is possible to improve your health and minimize some of the side effects to improve quality of life. It is possible to reach Post Finasteride Syndrome recovery. In this section, we will display methods that can bring relief to some symptoms. These are medications, diet and lifestyle changes that helped some patients. 

1. General guidelines
2. Natural supplements that can help 
3. What blood tests to do? 
4. My doctor says it is psychological, what to do? 
5. Medicines that can help in some cases 
6. Natural methods that can bring relief, symptom by symptom  

1. General Guidelines 
Here are some general guidelines, searched in the forums in English, which may help who is suffering from Post-Finasteride Syndrome: 
a) Avoid caffeine .
If possible, remove the substance from your diet. Insomnia is a common trait of those who suffer  from finasteride persistent side effects. Having a better sleep, your body will release more growth hormone, which can help in recovery. Sleep well!Caffeine also worsens the state of anxiety in these patients, and this may have consequences on the ability to focus, memory and general well-being.
b) Do regular aerobic exercise, but don't over exercise.
Exercise is a great ally against depression and may bring momentary relief of some symptoms of Post-Finasteride Syndrome. In addition, physical activity also increases production of growth hormone. However, in many accounts researched in, patients report that excessive exercise worsened their general states. If you feel bad in the days following the exercise, slow down, until you reach the intensity that improves your well being, but doesn't make you feel worse the next day.
c) Improve your diet.
Include most vegetables and fruits in your dietAt this time of recovery you need to expose your body to a maximum of vitamins and nutrients. Avoid processed foods that are rich in preservatives and artificial substances. It is also advisable to reduce the amount of fat in the diet. Some patients benefit in energy and feel their metabolisms are faster when they cut off dairy from the diet. 
d) Avoid the use of medication for some time, if possible .
Several patients in Propeciahelp describe they now react differently than before to some drugs. If it is possible to avoid the use of medicines during this phase it will be beneficial. There are many natural ways to treat a headache or heartburn, without requiring you to take a drug, for example. The intention, in the recovery phase, is not to overload the liver.
e) Most antidepressants cause sexual side effects, avoid them if possible.
Look for natural alternatives to cope with depression, such as exercise and activities that improve your well-being. There are reports of patients with PFS that were treated with SSRI-type antidepressants and this has worsened the sexual side effects they had from finasteride. 
f) Avoid alcohol.
Alcohol is toxic to the liver and its digestion and elimination demands a lot of body energy. At this time of recovery, you need to save your body energy, and create a healthy routine. In this routine, your body will improve slowly, day by day. But you need to have discipline and should not interrupt the recovery cycle.
g) Stay  positive.
Place in your mind that you will return to the level of health you had before taking finasteride. Positive thinking and discipline are fundamental to improve your health right now.
h) Simplify your life for a while.
Avoid stress and situations that change your mood.
i) Observe your reactions and write a journal.
Observe your reactions to food, physical activity and sex interest, mood, etc ... It is essential to know yourself well during this period, so you can create a routine and avoid foods or activities that make you feel worse.
j) There is NO proven case that Testosterone Replacement Therapy has solved the persistent sexual problems caused Finasteride . Do not accept this suggestion from any physician if you suffer from Post-Finasteride Syndrome. There are many stories in Propeciahelp of patients who were treated with testosterone gel (which is converted to DHT in contact with skin), or testosterone injections and treatment did not cause any sexual improvement in them. And in many cases made it worse.
So be careful! The administration of exogenous testosterone (not produced by the body), cause the reduction of testes and disruption of testosterone production in the body . A man who  initiates treatment with testosterone replacement therapy needs to do this for life. For men in andropause it may be a great treatment and can restore sexual function. It is also a great treatment for man who lost his testicles due to an accident or disease. But it is not the recommended procedure for fighting the persistent sexual side effects from Finasteride.

2. Natural supplements that can help
If you decide to try a natural supplement, start with the lowest dose (or even less than that) to see how you will react. Then increase the dose if needed.
Peruvian Maca (Lepidium meyenii)  - Peruvian Maca is a cruciferous plant native to the Andean region of Peru. It is sold as natural supplement and has a stimulating action on libido. Some forum members  from Propecia Help have tried the supplement and reported some improvement. 
Tribulus Terrestris - It is a supplement made ​​from a herb that has been used as a sexual stimulant for centuries - to increase sex drive and performance and to treat impotence. It acts by stimulating the production of LH hormone in the Pituitary (It is common for Post-Finasteride Syndrome patients to show low levels of LH). LH is the hormone that induces production of testosterone in the testes. Tribulus Terrestris is sold as a supplement and can improve libido and erection. Worth a try. 

3. What blood tests do? 
Total Testosterone 
Free Testosterone 
3 Alpha Androstenediol Glucuronide 
Estradiol (E2) 
Vitamin D 
Liver tests

4. My doctor says it is psychological, what to do? 
Argue that there are medical studies published about this problem in reputable scientific journals. If necessary, take copies of the studies published here on the site.Argue that many patients had altered levels of sex hormones from the use of finasteride, and so you need to do these tests. The 3 Alpha Androstenediol  Glucuronide is a byproduct of DHT, and is the best indication that you may have developed PFS. It is converted by 5 alpha reductase, the same enzyme that Finasteride blocks. Argue  that DHT testing is not very accurate, but 3 Alpha Androstenediol Glucoronide test is reliable, so you will be able to measure your 5 alpha reductase activity by doing this test. If necessary, switch to another doctor.

5. Medicines that can help in some cases 
Caution: Any medication must be prescribed by a doctor. Do not take medications without medical supervision.

Alprazolam or Bromazepam - ​​If you have stopped finasteride recently, and feel that your metabolism is in a state of chronic anxiety (insomnia, poor sleep, panic attacks, irritability, mood swings, extreme anxiety, restlessness, difficult concentration - a set of symptoms known as post-finasteride crash), the use of one of these medications can help. Finasteride blocks the conversion of progesterone to allopregnanolone, which  has a calming effect in the brain. Allopregnanolone acts by modulating a neurotransmitter called GABA-A. Therefore, the use of finasteride can affect the level of GABA-A in brain. Since these drugs act on GABA replacement, they are beneficial to these patients. Furthermore, by acting on the anxiety and improving sleep quality, the use of one of these drugs will help reverse another problem common in some men with Post-Finasteride Syndrome. Many complain their penises display a much smaller size and more rigid consistency when flacid than before finasteride (known as shrinkage in Propeciahelp forum). It is a dramatic change and usually patients who are in this state after finasteride usage also present lack of nocturnal erections and smaller erections. It is important to break this cycle, because if a man is not having nocturnal erections for a long time, this can lead to structure problems in the penis. When one of these medication is used to treat the post-finasteride crash, penis returns to normal size and consistency when flacid. The quality of sleep is restored, so this will also favour the reestablishment of normal nocturnal erections. It is really important to stop the crash symptoms and these medications work well in the matter.
It should be used for a short period (few months) and only if necessary, under the supervision of a psychiatrist. The withdrawal has to be gradual. 

Clomid - (Clomiphene citrate)  - It can help men who have had a dramatic drop in testosterone production and present a profile of hypogonadism (total testosterone levels below the minimum of the scale). The problem of living with a very low level of testosterone is that the patient tends to develop a series of problems such as osteoporosis, heart problems, diabetes, among others  (see more about hypogonadism on the "importance of DHT" page).  Clomiphene Citrate stimulates the production of FSH in the pituitary gland and it also raises the level of LH hormone, which is the hormone that induces testes to secrete more testosterone.This method was developed to treat athlete bodybuilders who abused the use of testosterone and it affected the body's own production.
It should be used under medical supervision  and is only indicated for patients who have testosterone levels below the minimum scale. Many patients were able to "rewire" the pituitary-testes axis, secrete higher amounts of testosterone, and avoided having to do testosterone replacement therapy for life (which is a complex treatment). 

Viagra, Levitra or Cialis - Some men with PFS benefit from these drugs to improve erection. Others do not get improvements, even using these drugs. A third group shows worsening of physical symptoms of PFS when using prescription drugs in general. If you decide to try, take note of your reactions to make sure that the medicine is not making matters worse. Start at the lowest possible dose and increase if necessary. It should also be used under prescription. 

6. Natural methods that can bring relief, symptom by symptom  
Anxiety - There are several natural options to combat anxiety before taking for a tranquilizer. chamomile tea, valerian tea, valerian pills, exercise, kava ​​tea (with moderation), among others. 
Depression - St. John's Wort, fish oil pills (fish oil), Omega 3, exercise. 
Headaches - In the case of Post-Finasteride Syndrome, headaches can have a few different causes. 
Pain in the center of the head - related to the pituitary region and dopamine deficiency. Some patients have this headache always after ejaculating. Eating foods rich in tyrosine brings temporary relief (cheese, butter, meat, fish, eggs, peanuts, hazelnut, chocolate). Tyrosine is an amino acid which may accelerate the secretion of dopamine. Caffeine can worsen the problem. 
Pain around the head - some patients who developed Post-Finasteride Syndrome report this type of pain. It is indicative of allergic reactions. It is more common in the months following the crash (post-finasteride crash - right after stopping finasteride treatment). Examine your diet and eliminate allergenic foods for a period (eg, nuts, seafood, and in some cases it is necessary to eliminate gluten for a while). 
Impotence and libido  - It may help in the improvement => Exercise and any effort in order to have a faster metabolism. One of the theories about the Post-Finasteride Syndrome is that the patients body has now a low level of free cortisol (see theories on the "post-finasteride syndrome" page). Thus, if the cortisol  available is not enough, it will affect the proper use of thyroid  hormones and the patient will  have hypothyroidism-like symptoms. How to speed up metabolism? 
There are methods that require a diet change for a few days or hours to induce the metabolism to speed up. A method that works with some former finasteride users is fasting for hours or a day (one should always compensate with plenty of fluid intake - coconut water, juices, etc. - medical supervision advised). Cutting carbs can also work. Some patients choose to eliminate milk and some fruit in the diet (milk digestion is slow and some fruits also slow your metabolism). Each body reacts differently and it's worth testing what works in each. It may seem strange that changes in diet can improve one's  sexual symptom, but the point here is to have a faster metabolism and thus force the body to leave the slow metabolism state that has been established after finasteride. 
Swelling - Some patients with Post-Finasteride Syndrome develop swelling and fluid retention. This symptom is related to a slower activity in the pituitary region in these men. As the level of LH and FSH in these patients are different, another hormone secreted in the same region may have had its secretion altered after finasteride. Vasopressin or antidiuretic hormone regulates many activities of the body including the elimination of water. To address the problem, the same methods of metabolism acceleration described in above item can be helpful. Another approach is the elimination of salt from the diet. 
Insomnia - Elimination of caffeine from the diet, exercise, lifestyle changes, valerian, passion fruit, tea, etc..
Penis shrinkage in flacid state - It may seem incredible for those who are unfamiliar with Post-Finasteride Syndrome, but many of these patients complain about how different their penises are in flacid state compared to how they were prior to Finasteride use. They complain that after they stopped Finasteride intake, their penises became much smaller when flacid and also its consistency is not as soft as it was. The cronic anxiety state caused by the post-finasteride crash, associated with the consequences of 5 alpha reductase inhibition lead to this penis shrinkage state. It makes it harder to obtain an erection and it may prevent the former finasteride user to have normal nocturnal erections when still in that state. The most effective way to deal with this problem is not natural, it is to stop the chronic anxiety symptoms, by taking a benzodiazepine tranquilizer for some time. Alprazolam and Bromazepam work well in the matter. See more on item 5.


  1. Superb !!!

    Who ever put this together deserves a pat on the back and I congratulate you on your information.

    I can relate to almost all of it as I suffer from PFS having taken Propecia.

  2. Thank you so very much for this wealth of information.

    My husband was taking generic Propecia for just over three weeks and the change in him is significant and dramatic.

    I only hope that the relatively brief time it was in his system may mean less of a long-term impact. Do you know of any forums where PFS sufferers share ideas and experiences?

  3. Great Article. I've been trying to find more information on this problem forever and this was a big help. I found after I read this article and they do mention other lab test that they suggest you get along with a short list of doctors that are familiar with the problem.

    Recommended lab tests:
    Total Testosterone
    Free Testosterone
    Bioavailable Testosterone
    DHT (not accurate compared to Adiol-G)
    3alpha-diol G (Androstanediol glucuronide-- "Adiol-G" for short): metabolite of DHT, measures 5AR-II activity
    Androsterone glucuronide (another metabolite of DHT that measures 5AR activity)
    Estradiol (E2)
    Estrone (E1)
    Total Estrogens
    17-OH Progesterone
    17-OH Pregnenolone
    Free T3
    Free T4
    CBC or FBC (Complete Blood Count/Full Blood Count)
    LFT (Liver Function Tests - AST, ALT, GGT, Bilirubin, etc.)
    Androgen/Estrogen ratio
    Testosterone/DHT ratio
    17-ketosteroids (24-hr urine sample)

    I'm getting them done just a few at a time because its hard to get any doctor to order that many labs all at once. Most of them don't take the condition that seriously.

  4. I took propecia for 5 months in 2011. I had all kind of side effects. Fortunately, most of them disappeared now 2 years after quitting but I still suffer from insomnia. I fall asleep quickly, then sleep for 4 hours or so and wake up with a racing, heavy heart beat and sometimes some breathing irregularities. Anyone recognizes this and does anyone have any idea what I can do to resolve this? I don't drink alcohol, no coffee, no smoking, no medication, lots of yoga/sports, healthy diet...

    1. Hi Yvo,
      You are having problems with the deep stage of your sleep. Finasteride reduces the level of Alopregnanolone (ALLO) in the nervous central system. ALLO has a role in the function of a neurotransmitter named GABA. Many men post finasteride use present a number of symptoms very characteristic of low GABA. I believe that is exactly you case. The best way to fight this problem in my opinion would be using a low dose benzodiazepine - like Alprazolam ou Bromazepam for a short period of time like a week, a couple of weeks or a month depending on how bad is your lack of GABA (use under medical supervision). This kind of drug restores GABA levels. So this would work as a measure to "restock" your GABA levels. You already are taking great measures to prevent excessive GABA spending (and you should keep doing it even after using the benzodiazepine), like all the ones you described. However, finasteride left you with unaturally low levels of this neurotransmitter and the situation won´t improve much without a medication if it hasn´t reversed it two years. Don´t be afraid, in a short period of time like that, and low dose, the drug will not cause you dependency. But you will need to taper it off at the end.

  5. Hi, I am very grateful for your prompt reply, really appreciate that. Can I ask another question - if I take the Aprazolam or Bromazepam as you suggest for a couple of weeks, does it mean my GABA levels will eventually restore (as you say that I eventually will have to taper it off)? If not, do you think they will find a cure for this any time soon as the lack of sleep is really disrupting my life? Many thanks

    1. Yes, by using one of these medications you will restore your GABA levels, your sleep will go back to normal and the anxiety symptoms will stop. You only need to use it temporarily and short term. Then you reduce the dosage gradually to avoid withdrawal symptoms and stop taking it. What the benzodiazepine does not solve is the underlying issue that made you low in GABA. The change finasteride has made in your body, that caused you to have all these symptoms will still be there. What i mean to say is that by taking the tranquilizer you will feel normal again (sleep, no anxiety, etc), but you should be aware that in the future, it is possible to have another crash and have these symptoms again if you do not preserve yourself. That is the reason you should keep doing what you are doing as far as diet and lifestyle changes. But if you follow what you are doing, you will be fine.
      About a definite cure: i am sure there will be some advancements in this area, but i don't think it will be fast. It may take a few years. But trust me, take one of these medications as i told you and you will pretty normal again as far as the sleep issues and anxiety symptoms you are experiencing.

  6. I am asking the above because I thought that all benzodiazepines eventually have the effect of taking over the function of GABA and hence further reducting the natural production of GABA. But I am not a doctor so would be keen to hear your views.

    1. There is a risk of physical dependency and withdrawl symptoms when using benzodiazepines. But if you take it short term and low dosage, it is very rare to de addicted on these drugs. One benzodiazepine you should avoid though is Klonopin (clonazepam). It is very addictive even in short term use. But alprazolam and bromazepam are easy to discontinue without problems.
      You need to consider the situation you are facing. You clearly have a sleep disorder caused by finasteride that is disrupting your life. In your case, the drug benefit is much greater than the risk you might face it (as i told you, short term use is very low risk). Take it for a couple of weeks, have your sleep restored, and then gradually decrease the dosage and stop taking it. Talk to your doctor.

  7. Are there studies that show what percentage of men have pfs that is persistent. What percent of men go back to normal after they stop taking proper is vs percentage of men that are effected by it, even after quiting

    1. Unfortunately no, there are no such studies yet.

  8. Hi, For the shorstory

    I have started taking Finasteride 1mg at the age of 22 and I'm now 34. I've realised the gravity of issues only a year ago. I have almost all the issues described above.
    The reason why I didn't realise that was the Drug is that before I was having only few and minor Side Effects ( weakness, dry skin, etc...). But now I'm experiencing all ( from shrinkage penis and nuts to lack of concentration)
    I want to really thank you to put all these informations toeghether and clearify things for us cause I'm in France and here there's almost no infos about Fina Side Effects.
    I'm making some blood test and Ecography of testicles next week. I"m very scared right now cause after all these years I'm afraid that all these side effects ( shrinkage of nuts and penis, change in the penis form ( not so straight anymore and much thinner), reduced size of the glans, no morning wood at all, low libido, weakness, low metabolism,dry skin, more fat in the abdominal area,fluid retention etc...) will never desappear.
    Any Advice is wellcome.
    Again. Fully grateful of this blog and all the useful informations you gave us.

    1. Hi Daniel,
      I am glad the blog was useful to you. I understand your concern, it must be very hard not knowing what to do and having no clear directions from doctors. What i d be most concerned of is how long you have been having shrinkage of the penis. If you have not had this for a long time, then you can reverse it with the use of the benzodiazepine. I don´t know how effective it is in men who have had shrinkage for years. Results can vary a lot from individual from individual, it all depends in which stage you are in. There is a lot that can be done to improve your state and minimize side effects. The best you can do right now is have a natural diet (free of preservatives, chemicals, and processed food), exercise regularly, avoid stress and caffeine. You can still have a good life quality. If you want more advice, feel free to write to and give me more details. I will help you if you need it.

  9. bro i am having dry skin,facial sagging and facial bloating even after quitting finasteride.What can i do to recover ??plz help

    1. Unfortunately i don´t know permanent solution for these problems if they are caused by finasteride. However, you can try a few things that might help.
      Dry skin: Mosturize daily with natural oils.
      Facial bloating: Try a gluten and dairy free diet for some time to see if it helps.

    2. and my face has taken a feminine shape.Will i ever recover from it??

    3. That is very hard to predict. Honestly, i don´t know.

  10. This is an very nice blog. Keep providing the information of Cialis / Kamagra as much as possible, so that the people will come to know more about it.disfunzione erettile

  11. Yes, a wonderful blog. My problems began with the use of Proscar, after watching my PSA climb, after a negative post-prostate-biopsy infection. My endocrinologist diagnosed my situation as hyper-hypogonadic. FSH & LH are high. I'm not suffering pain, but all the other standard symptoms described above. Writing mainly to mention that have been taking a natural GABA + B6 supplement for a couple of months and have found it to help sleep and anxiety substantially though not entirely. I take it about 2 hours before bedtime.

  12. I believe that having a healthy lifestyle and positive outlook in life can definitely help you increase your sexual desires. Dapoxetine 60 mg

  13. Anyone know how to treat frequent urination which is caused by PFS ?

    Is there any drugs that help this problem ?

  14. I took alprazolam for a month, is that enough? I feel like it worked while I was on it, but once I stopped the sides returned.

  15. Patrick have you consulted with Irwin Goldstein, MD? He is located in San Diego.

  16. This comment has been removed by the author.

  17. I need help urgently.

    Took this poyson from 2005 to 2011 (6 years) and 3 year after getting out my symptoms are:
    - lack of concentration
    - Forget symple words
    - depression
    - lack of disposition
    - Zero Libido
    - Zero nocturnal erection
    - Zero erection
    - Don´t give importance to things.. only want to stay alone
    - penile shrinkage
    - penile is totally numb (difficult to urinate)

    it´s like I´d dont have penis anymore..... I am losing my hope to find some cure for this hell.
    I tried everything.... and my last shot is to experiment DHEA.

    Can someoe help me with this hell?

  18. 500 mg Gaba + B6 (2mg) - I've been taking 1 pill an hour before bedtime. this is a health food supplement. Has really helped my sleep and reduced anxiety by 80%, and started moving things in the right direction. Also taking 2.5 mg Cialis most nights. Feeling some libido. Was on T replacement therapy for 5 months, under supervision of a neuro-endocrinologist (via phone appointments)-Dr. Alan Jacobs in N.Y.. smart, but took me off after 5 months when i didn't show the results he wanted to see. At the moment trying to get the energy to start an exercise routine. Feeling positive.

  19. Can anyone recommend a doctor familiar with this in the South Florida area??? Any help appreciated