how to reverse post finasteride syndrome
Merck developed finasteride in the 1980s. Crazy. Plentiful in opinions, short on facts. Your doctor will ask you questions about your health and symptoms. At some point you just cant store it all or want to use old drug. PDF | Finasteride was patented in 1984 and approved for medical use in 1992. Unable to load your collection due to an error, Unable to load your delegates due to an error. | How To Diagnose And Reverse It. Create an account to follow your favorite communities and start taking part in conversations. I know it's been a LONG time and also want to tell everyone that I'm cured from PFS great news. sharing sensitive information, make sure youre on a federal I'm not a gym rat, I just make sure to walk 3-5 miles a day and do my best to watch what I eat (that's always been the case.) Tamoxifen I did 20mg during the four weeks every day. This is to be expected because you are messing with a hormone (DHT) that is very important for sexual function. I did three months on testosterone injections and muscle building. Partin AW, et al., eds. Andracim Gel (small 2 eminem size, 1 on each size of rib cage, less is more with this stuff). What websites do you recommend visiting? The common denominator in how I feel is Tribulus, period, end of sentence. Studies show it can help slow or reverse the process of hair loss. Sometimes, more-advanced assisted reproductive techniques are needed. To be honest, I think for the most part these recoveries werent PFS but rather hormonal imbalances. Epub 2016 Jul 27. They have some pretty smart people and are open to trying about anything, and isnt as negative as the other forum. Epub 2010 Dec 22. Diviccaro S, Giatti S, Cioffi L, Falvo E, Herian M, Caruso D, Melcangi RC. Disorders of male orgasm and ejaculation. J. Environ. Examine your urine for the presence of semen after you have an orgasm. His article with all the studies hes referencing: Post Finasteride Syndrome can be manually corrected by interpreting blood work and implementing an appropriate lifestyle and/or pharmacological protocol. WebPost-finasteride syndrome (PFS) is a constellation of serious adverse side effects manifested in clinical symptoms that develop and persist in patients during and/or after discontinuing finasteride treatment in men with pattern hair loss (androgenetic alopecia) or Depending on the likely cause of your dry orgasms and whether you need evaluation and treatment to help you get your female partner pregnant, you might need to see a urinary and reproductive specialist (urologist). At higher doses, finasteride (Proscar) can also treat benign prostatic hyperplasia (BPH). Toxicol. If a high volume of sperm is found in your urine, you have retrograde ejaculation. Im talking about the physical inability to have erections and sex drive". Inability to concentrate. Would you like email updates of new search results? All of that changed in three days. The drug reduces a testosterone-related hormone in certain tissues, including skin and the prostate gland. Advertising revenue supports our not-for-profit mission. https://forum.propeciahelp.com/t/joekool-s-story-long-term-hcg/46717. However, the side effects of a medication usually go away when you stop taking it. Therefore, I cut the pills in half (2.5mg) and toss the other half. I suggest you see an expert for internal workup, we do this frequently in our practice. 2023 by The President and Fellows of Harvard College, Do not sell my personal information | Privacy Policy. Therefore, understand that I can't promise this will work for youbut for me? This condition, termed post-finasteride syndrome (PFS) is characterized by sexual side effects (i.e., low libido, erectile dysfunction, decreased arousal and difficulty in achieving orgasm), depression, anxiety and cognitive complaints that are still present despite drug withdrawal. Being ready to answer your doctor's questions might save time to go over any points you want to spend more time on. I will tell you how I solved my problem with post-finasteride syndrome, which produces no erections or little libido even if you have stopped taking the famous drug years ago. Im glad I did. HHS Vulnerability Disclosure, Help I have had a recent report of a man who went on Human Growth Hormone and reversed his post finasteride syndrome sexual dysfunction. Keywords: Pharmacological Management of Pattern Hair Loss. Endocrinol. https://old.reddit.com/r/steroids/comments/m5m7o9/help_steroids_for_pssd/gr0uhqj/. Here's some information to help you get ready for your appointment, and what to expect from your doctor. Anejaculation and retrograde ejaculation. Write down key personal information, including prior surgeries or pelvic radiation, any major stresses, or recent life changes. Adverse effects of common medications on male fertility. Do you ever ejaculate semen when you have an orgasm, or do you have a dry orgasm every time? This area was the most recovery and reversal of symptoms. Indeed, some national agencies (e.g., Swedish Medical Products Agency, the Medicines and Healthcare Products Regulatory Agency of UK and the U.S. Food and Drug Administration) required to include multiple persistent side effects within the finasteride labels. PMC 2015;104:107. And youre competely right, they make it sound like youre doomed and you shouldnt try anything but wait for the Baylor study and fill out the surveyDo they really expect some magical cure to come out when Baylor releases or their survey has enough participants? Feeling low-grade depression constantly. Sign up to get tips for living a healthy lifestyle, with ways to fight inflammation and improve cognitive health, plus the latest advances in preventative medicine, diet and exercise, pain relief, blood pressure and cholesterol management, andmore. I cycled herbal androgen boosting supplements combined with intense workouts (I am a bodybuilder). Answer: Hormonal optimization while on finesteride there are many options including peptides, and HCG as well as clomid/arimidex. In addition, it has been also reported that persistent side effects may occur in some AGA patients. Ran [Tbol] 250mg for 2 months increased the dosages anywhere from 500mg to 1000mg. Hello, some finasteride users have reported the reversal of post-finasteride syndrome using HCG as therapy. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. Any doctor interested in giving an opinion on the case? Ketamine for treatment-resistant depression: When and where is it safe? On PFS forums, peoples dicks got 1 inch bigger when erect, here and there, they sometimes felt sexual attraction towards women. Almost starting to think like a conspiracy theorist. Palliative care frightens some people: Heres how it helps, Parents don't always realize that their teen is suicidal. Energy-boosting coffee alternatives: What to know. Very controversial topic in this forum. Your doctor will ask you to empty your bladder, masturbate to climax and then provide a urine sample for laboratory analysis. That fog, that mental barrier that kept me feeling a distance from myself had totally lifted. If youre experiencing a medical issue, please contact a healthcare professional or dial 911 immediately. Drugs to treat retrograde ejaculation are drugs primarily used to treat other conditions, including: These medications help keep the bladder neck muscle closed during ejaculation. For details,, MeSH I could be wrong but none of them seem to have anhedonia or genital numbness or fatigue or insomnia or anything, just libido and ED issues. It can prevent hair loss and decrease prostate enlargement, but not surprisingly, it can also suppress sexual function. And quite frankly, if you think big pharma doesn't have millions and millions of dollars wrapped up in trying to cover up just how severely finasteride has destroyed mens' lives, you're fooling yourself. moreplatesmoredates.com. " Your doctor might also do a physical exam that includes examining your penis, testicles and rectum. Ive seen many others who give their opinion but are banned as a result. You're right. Pharmaceuticals (Basel). 2008;35:211. Fertility and Sterility. Your doctor might ask: Mayo Clinic does not endorse companies or products. ._3oeM4kc-2-4z-A0RTQLg0I{display:-ms-flexbox;display:flex;-ms-flex-pack:justify;justify-content:space-between} https://forum.propeciahelp.com/t/my-story-yes-it-was-messy-and-yes-i-am-fine-now/5456. Personally, I believe its become the boogeyman for a bucket list of sexual problems. To diagnose retrograde ejaculation, your doctor may: If you have dry orgasms, but your doctor doesn't find semen in your bladder, you might have a problem with semen production. After numerous labs, I have determined that a dose of 2-3 mg is optimal for keeping my DHT within the normal range. Btw, something weird happening on propeciahelp forums. I am 100% reversed Keep in mind if I miss a dose or stop my protocol Pfs comes back full force. I understand not wanting to have a bunch of hack cures on their forum that dont really do anything or worse yet, make people worse, but at some point when theres a condition we dont know how to fix it seems like some trial and error wouldnt be the worst idea in the world. Jefferys A, et al. I have the desire for sex and intimacy but my brain simply wont communicate with my penis when its time for intercourse. Disclaimer. In some cases, sperm can be recovered from the bladder, processed in the laboratory and used to inseminate your partner (intrauterine insemination). 2019;38:762774. When you are on TRT, your DHT levels tend to go out of the normal range and finasteride is a mechanism for bringing it back into range. Pornography usually has to be in the picture but there are RARE times when I get a spontaneous boner I can play with that will stick around and I can achieve orgasm with or without pornography. The information on RealSelf is intended for educational purposes only. Why not save the other half for your next dose? Mesterolone (Proviron) is one of the best compounds that can be used for treating Post Finasteride Syndrome in my opinion. ._3Z6MIaeww5ZxzFqWHAEUxa{margin-top:8px}._3Z6MIaeww5ZxzFqWHAEUxa ._3EpRuHW1VpLFcj-lugsvP_{color:inherit}._3Z6MIaeww5ZxzFqWHAEUxa svg._31U86fGhtxsxdGmOUf3KOM{color:inherit;fill:inherit;padding-right:8px}._3Z6MIaeww5ZxzFqWHAEUxa ._2mk9m3mkUAeEGtGQLNCVsJ{font-family:Noto Sans,Arial,sans-serif;font-size:14px;font-weight:400;line-height:18px;color:inherit} Day 2 I noticed a bit more energy, but credited that to having a good night's sleep (did I mention this stuff helps you sleep better, too?) Please note the date of last review or update on all articles. ._12xlue8dQ1odPw1J81FIGQ{display:inline-block;vertical-align:middle} J. Clin. Metabolism of progesterone and testosterone, Metabolism of progesterone and testosterone into 5alpha-reduced metabolites and their mechanisms of action:, Clinical features reported in patients affected by post-finasteride syndrome. Around 8 months and i was pretty much recovered. Look, it's as simple as this. The management of retrograde ejaculation: A systematic review and update. Ive personally recovered from pfs but what worked for me may not work for you as each of our bodies react differently to this condition depending on individuals factors. With prostate cancer deaths overtaking that of breast cancer, it is important to know the side effects of finasteride. Samplaski MK, et al. Is Post Finasteride Syndrome Real? Not orgasm strength and sperm levels have returned, just waiting on my brain to communicate with my penis when its time for sexual intercourse. The Baylor study STILL hasnt been released? Brain Res Bull. Just bombarding their bodies with strong androgens. I have not made any drastic life changes since beginning this. ._9ZuQyDXhFth1qKJF4KNm8{padding:12px 12px 40px}._2iNJX36LR2tMHx_unzEkVM,._1JmnMJclrTwTPpAip5U_Hm{font-size:16px;font-weight:500;line-height:20px;color:var(--newCommunityTheme-bodyText);margin-bottom:40px;padding-top:4px;text-align:left;margin-right:28px}._2iNJX36LR2tMHx_unzEkVM{-ms-flex-align:center;align-items:center;display:-ms-flexbox;display:flex}._2iNJX36LR2tMHx_unzEkVM ._24r4TaTKqNLBGA3VgswFrN{margin-left:6px}._306gA2lxjCHX44ssikUp3O{margin-bottom:32px}._1Omf6afKRpv3RKNCWjIyJ4{font-size:18px;font-weight:500;line-height:22px;border-bottom:2px solid var(--newCommunityTheme-line);color:var(--newCommunityTheme-bodyText);margin-bottom:8px;padding-bottom:8px}._2Ss7VGMX-UPKt9NhFRtgTz{margin-bottom:24px}._3vWu4F9B4X4Yc-Gm86-FMP{border-bottom:1px solid var(--newCommunityTheme-line);margin-bottom:8px;padding-bottom:2px}._3vWu4F9B4X4Yc-Gm86-FMP:last-of-type{border-bottom-width:0}._2qAEe8HGjtHsuKsHqNCa9u{font-size:14px;font-weight:500;line-height:18px;color:var(--newCommunityTheme-bodyText);padding-bottom:8px;padding-top:8px}.c5RWd-O3CYE-XSLdTyjtI{padding:8px 0}._3whORKuQps-WQpSceAyHuF{font-size:12px;font-weight:400;line-height:16px;color:var(--newCommunityTheme-actionIcon);margin-bottom:8px}._1Qk-ka6_CJz1fU3OUfeznu{margin-bottom:8px}._3ds8Wk2l32hr3hLddQshhG{font-weight:500}._1h0r6vtgOzgWtu-GNBO6Yb,._3ds8Wk2l32hr3hLddQshhG{font-size:12px;line-height:16px;color:var(--newCommunityTheme-actionIcon)}._1h0r6vtgOzgWtu-GNBO6Yb{font-weight:400}.horIoLCod23xkzt7MmTpC{font-size:12px;font-weight:400;line-height:16px;color:#ea0027}._33Iw1wpNZ-uhC05tWsB9xi{margin-top:24px}._2M7LQbQxH40ingJ9h9RslL{font-size:12px;font-weight:400;line-height:16px;color:var(--newCommunityTheme-actionIcon);margin-bottom:8px} https://www.hairlosstalk.com/interact/threads/how-i-cured-my-problem-with-post-finasteride-syndrome.125634/. Stopping finasteride treatment can cause post-finasteride syndrome. This may result in side effects such as memory problems or sexual dysfunction (problems that affect the desire for or ability to have sex). Post-finasteride syndrome wasnt reported in clinical studies, but it has been reported since the drug was approved. This is a summary of the protocol which I followed for 6 months which eventually cured me. I'll be interested to see if this has any effects on my weight loss endeavors. Press question mark to learn the rest of the keyboard shortcuts. This content does not have an English version. In addition, molecular mechanisms and/or genetic determinants behind such adverse effects have been poorly explored both in patients and animal models. Management of the dry ejaculate: A systematic review of aspermia and retrograde ejaculation. Amedical opinion on this procedure would be important, because we do not have scientific evidence about HCG and PFS, but it would already be a start. These hippocampal neurogenesis changes after finasteride treatment have been linked to emotional behavior and this might contribute to the pathophysiology of affective disorders in humans. Some people had to use anabolic steroids because herbs weren't strong enough. In such cases, treatment depends on the underlying cause. Mod also deleted my second post where I said he indeed has affiliate links to herbs but doesnt even believe that will be enough for pfs patients, the real cure is proviron. Mild side effects that have been reported with finasteride include: ejaculation problems. .Rd5g7JmL4Fdk-aZi1-U_V{transition:all .1s linear 0s}._2TMXtA984ePtHXMkOpHNQm{font-size:16px;font-weight:500;line-height:20px;margin-bottom:4px}.CneW1mCG4WJXxJbZl5tzH{border-top:1px solid var(--newRedditTheme-line);margin-top:16px;padding-top:16px}._11ARF4IQO4h3HeKPpPg0xb{transition:all .1s linear 0s;display:none;fill:var(--newCommunityTheme-button);height:16px;width:16px;vertical-align:middle;margin-bottom:2px;margin-left:4px;cursor:pointer}._1I3N-uBrbZH-ywcmCnwv_B:hover ._11ARF4IQO4h3HeKPpPg0xb{display:inline-block}._2IvhQwkgv_7K0Q3R0695Cs{border-radius:4px;border:1px solid var(--newCommunityTheme-line)}._2IvhQwkgv_7K0Q3R0695Cs:focus{outline:none}._1I3N-uBrbZH-ywcmCnwv_B{transition:all .1s linear 0s;border-radius:4px;border:1px solid var(--newCommunityTheme-line)}._1I3N-uBrbZH-ywcmCnwv_B:focus{outline:none}._1I3N-uBrbZH-ywcmCnwv_B.IeceazVNz_gGZfKXub0ak,._1I3N-uBrbZH-ywcmCnwv_B:hover{border:1px solid var(--newCommunityTheme-button)}._35hmSCjPO8OEezK36eUXpk._35hmSCjPO8OEezK36eUXpk._35hmSCjPO8OEezK36eUXpk{margin-top:25px;left:-9px}._3aEIeAgUy9VfJyRPljMNJP._3aEIeAgUy9VfJyRPljMNJP._3aEIeAgUy9VfJyRPljMNJP,._3aEIeAgUy9VfJyRPljMNJP._3aEIeAgUy9VfJyRPljMNJP._3aEIeAgUy9VfJyRPljMNJP:focus-within,._3aEIeAgUy9VfJyRPljMNJP._3aEIeAgUy9VfJyRPljMNJP._3aEIeAgUy9VfJyRPljMNJP:hover{transition:all .1s linear 0s;border:none;padding:8px 8px 0}._25yWxLGH4C6j26OKFx8kD5{display:inline}._2YsVWIEj0doZMxreeY6iDG{font-size:12px;font-weight:400;line-height:16px;color:var(--newCommunityTheme-metaText);display:-ms-flexbox;display:flex;padding:4px 6px}._1hFCAcL4_gkyWN0KM96zgg{color:var(--newCommunityTheme-button);margin-right:8px;margin-left:auto;color:var(--newCommunityTheme-errorText)}._1hFCAcL4_gkyWN0KM96zgg,._1dF0IdghIrnqkJiUxfswxd{font-size:12px;font-weight:700;line-height:16px;cursor:pointer;-ms-flex-item-align:end;align-self:flex-end;-webkit-user-select:none;-ms-user-select:none;user-select:none}._1dF0IdghIrnqkJiUxfswxd{color:var(--newCommunityTheme-button)}._3VGrhUu842I3acqBMCoSAq{font-weight:700;color:#ff4500;text-transform:uppercase;margin-right:4px}._3VGrhUu842I3acqBMCoSAq,.edyFgPHILhf5OLH2vk-tk{font-size:12px;line-height:16px}.edyFgPHILhf5OLH2vk-tk{font-weight:400;-ms-flex-preferred-size:100%;flex-basis:100%;margin-bottom:4px;color:var(--newCommunityTheme-metaText)}._19lMIGqzfTPVY3ssqTiZSX._19lMIGqzfTPVY3ssqTiZSX._19lMIGqzfTPVY3ssqTiZSX{margin-top:6px}._19lMIGqzfTPVY3ssqTiZSX._19lMIGqzfTPVY3ssqTiZSX._19lMIGqzfTPVY3ssqTiZSX._3MAHaXXXXi9Xrmc_oMPTdP{margin-top:4px} I need to get back over there and check it out I guess. doi: 10.1007/s00213-014-3567-5. Write down any symptoms you're experiencing, including any that might seem unrelated to the reason for which you scheduled the appointment. Before Gained 25 pounds of mostly muscle. Authors received funding from the Post-Finasteride Foundation in order to study PFS symptomatology of patients and in experimental models. Elsevier; 2021. https://www.clinicalkey.com. After stopping 7 weeks later (when I ran out of my proviron), things felt off for a few weeks but then after around two months I got back to my pre-PFS state. Sign up now and get a FREE copy of theBest Diets for Cognitive Fitness. I did the first day 300 mg clomid, then 100mg for the first two weeks, 50mg for the third week, and none for the forth week. My hair loss is back full force, but so is my libido and so are my erections. Its on an auto refill and I get 90 day supplies sent to me in the mail. Since it only comes in 5 and 1 mg pills, there isnt much of a choice. Bookshelf It is available as a generic. I took a large amount of DHT (proviron) for 7 weeks at 200 mg per day to reduce receptor sensitivity to DHT. In: Campbell-Walsh-Wein Urology. Althof HE, et al. Finasteride blocks the metabolism of testosterone. In this review, we focused our attention on adverse events related to 5 alpha-reductase (5-R) inhibitors (i.e., finasteride and dutasteride), approved for the treatment of benign prostatic hyperplasia and androgenetic alopecia (AGA). The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Will medications help me ejaculate normally? Am I at risk of complications from this condition? -, Baas W.R., Butcher M.J., Lwin A., Holland B., Herberts M., Clemons J., Delfino K., Althof S., Kohler T.S., McVary K.T. PFS is a very real, complex and multi-faceted thing - as is the human body. All rights reserved. I cannot say enough about this. However, some men report persistent sex drive and ejaculation problems after stopping the medication. Are there other possible causes for my symptoms or condition? Unauthorized use of these marks is strictly prohibited. ._2a172ppKObqWfRHr8eWBKV{-ms-flex-negative:0;flex-shrink:0;margin-right:8px}._39-woRduNuowN7G4JTW4I8{margin-top:12px}._136QdRzXkGKNtSQ-h1fUru{display:-ms-flexbox;display:flex;margin:8px 0;width:100%}.r51dfG6q3N-4exmkjHQg_{font-size:10px;font-weight:700;letter-spacing:.5px;line-height:12px;text-transform:uppercase;-ms-flex-pack:justify;justify-content:space-between;-ms-flex-align:center;align-items:center}.r51dfG6q3N-4exmkjHQg_,._2BnLYNBALzjH6p_ollJ-RF{display:-ms-flexbox;display:flex}._2BnLYNBALzjH6p_ollJ-RF{margin-left:auto}._1-25VxiIsZFVU88qFh-T8p{padding:0}._2nxyf8XcTi2UZsUInEAcPs._2nxyf8XcTi2UZsUInEAcPs{color:var(--newCommunityTheme-widgetColors-sidebarWidgetTextColor)} 5alpha-reductase; Androgenetic alopecia; Depression; Finasteride; Neuroactive steroids; Sexual dysfunction. Mehta A, et al. The https:// ensures that you are connecting to the WebIn addition to the sexual, mental and physical side effects, PK suffers from miscellaneous issues connected with PFS. Incredible! A single copy of these materials may be reprinted for noncommercial personal use only. ._3Qx5bBCG_O8wVZee9J-KyJ{border-top:1px solid var(--newCommunityTheme-widgetColors-lineColor);margin-top:16px;padding-top:16px}._3Qx5bBCG_O8wVZee9J-KyJ ._2NbKFI9n3wPM76pgfAPEsN{margin:0;padding:0}._3Qx5bBCG_O8wVZee9J-KyJ ._2NbKFI9n3wPM76pgfAPEsN ._2btz68cXFBI3RWcfSNwbmJ{font-family:Noto Sans,Arial,sans-serif;font-size:14px;font-weight:400;line-height:21px;display:-ms-flexbox;display:flex;-ms-flex-pack:justify;justify-content:space-between;-ms-flex-align:center;align-items:center;margin:8px 0}._3Qx5bBCG_O8wVZee9J-KyJ ._2NbKFI9n3wPM76pgfAPEsN ._2btz68cXFBI3RWcfSNwbmJ.QgBK4ECuqpeR2umRjYcP2{opacity:.4}._3Qx5bBCG_O8wVZee9J-KyJ ._2NbKFI9n3wPM76pgfAPEsN ._2btz68cXFBI3RWcfSNwbmJ label{font-size:12px;font-weight:500;line-height:16px;display:-ms-flexbox;display:flex;-ms-flex-align:center;align-items:center}._3Qx5bBCG_O8wVZee9J-KyJ ._2NbKFI9n3wPM76pgfAPEsN ._2btz68cXFBI3RWcfSNwbmJ label svg{fill:currentColor;height:20px;margin-right:4px;width:20px;-ms-flex:0 0 auto;flex:0 0 auto}._3Qx5bBCG_O8wVZee9J-KyJ ._4OtOUaGIjjp2cNJMUxme_{-ms-flex-pack:justify;justify-content:space-between}._3Qx5bBCG_O8wVZee9J-KyJ ._4OtOUaGIjjp2cNJMUxme_ svg{display:inline-block;height:12px;width:12px}._2b2iJtPCDQ6eKanYDf3Jho{-ms-flex:0 0 auto;flex:0 0 auto}._4OtOUaGIjjp2cNJMUxme_{padding:0 12px}._1ra1vBLrjtHjhYDZ_gOy8F{font-family:Noto Sans,Arial,sans-serif;font-size:12px;letter-spacing:unset;line-height:16px;text-transform:unset;--textColor:var(--newCommunityTheme-widgetColors-sidebarWidgetTextColor);--textColorHover:var(--newCommunityTheme-widgetColors-sidebarWidgetTextColorShaded80);font-size:10px;font-weight:700;letter-spacing:.5px;line-height:12px;text-transform:uppercase;color:var(--textColor);fill:var(--textColor);opacity:1}._1ra1vBLrjtHjhYDZ_gOy8F._2UlgIO1LIFVpT30ItAtPfb{--textColor:var(--newRedditTheme-widgetColors-sidebarWidgetTextColor);--textColorHover:var(--newRedditTheme-widgetColors-sidebarWidgetTextColorShaded80)}._1ra1vBLrjtHjhYDZ_gOy8F:active,._1ra1vBLrjtHjhYDZ_gOy8F:hover{color:var(--textColorHover);fill:var(--textColorHover)}._1ra1vBLrjtHjhYDZ_gOy8F:disabled,._1ra1vBLrjtHjhYDZ_gOy8F[data-disabled],._1ra1vBLrjtHjhYDZ_gOy8F[disabled]{opacity:.5;cursor:not-allowed}._3a4fkgD25f5G-b0Y8wVIBe{margin-right:8px}
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how to reverse post finasteride syndrome