Penile and Testicular Changes: Symptoms of Post-finasteride Syndrome

In this article we review what penile and testicular changes are, how they present in PFS, and the resources and support available for patients experiencing these symptoms. 

What do penile and testicular changes from finasteride entail?

Penile and testicular changes not only affect sexual health but can also significantly impact a person's psychological well-being and interpersonal relationships. Many PFS patients report a range of changes in the genital area. These include but are not limited to:

  • Penile atrophy: Loss of penis length or girth. 

  • Penile curvature: A bend or curve in the penis, usually accompanied by plaque (scar tissue) buildup. 

  • Penile numbness: Loss of sensation in the penis. 

  • Testicular atrophy: A reduction in volume of the testicles.

  • Perineal muscle atrophy: Loss of muscle in the perineum. 

  • Pain in the genital area: Pain in the penis, testicles, or perineum. 

It should be noted that self-reports indicate it can take up to 3 months for on-drug side effects to resolve after discontinuation of finasteride. After that, the symptoms can be considered persistent. 

How common are penile and testicular changes as a symptom of Post-finasteride Syndrome?

While there are estimations of incidence for some penile and testicular changes as a side effect of finasteride, there is limited data with which to estimate the prevalence of penile and testicular changes in PFS. 

Research findings on penile and testicular changes in PFS 

Two separate studies have found an overexpressed androgen receptor in affected tissue from PFS patients (Di Loreto et al. 2014; Howell et al. 2021), and in addition one of them examined for and found concurrent differential expression of several thousand genes (Howell et al. 2021). Notably, adequate androgen receptor function is necessary for maintenance and function of the penis, testicles, and perineum. 

It is essential to note that more research into post-finasteride syndrome is desperately needed. PFS is currently without an accurate animal model, pathomechanistic understanding, and as a result, safe and effective treatment. 

Do persistent penile and testicular changes after finasteride go away? Are they reversible?

Some patients have reported improvements in some of these symptoms over time. However, PFS is understood to persist indefinitely, and it is currently without safe and effective treatment. 

Managing and coping with penile and testicular changes

For those who may be struggling with symptoms, here are some general recommendations:

  1. Focus on self-care: Try to find routines and activities that help you personally.

  2. Be practical about your life situation and/or relationships: Try not to think too far ahead and catastrophize. PFS affects individuals to different degrees and some experience improvements over time. 

  3. Familiarize yourself with the scientific literature: Read through previous research into PFS on our website in order to better understand your condition.

  4. Support research: Further research into PFS, based on a theory and/or conceptualization of the condition that is backed by all previous research findings and can plausibly explain all symptoms reported by patients, is the only way toward a treatment.

What about supplements or other drugs to help treat symptoms

There are currently no evidence-based items recommended for treatment of penile and testicular changes stemming from PFS. In general, patients have reported worsening by attempting to treat their symptoms with anti-androgenic substances. We are obligated to make patients aware as this has preceded patient suicide.  

Next steps 

If you or a family member is experiencing persistent side effects from finasteride, there are multiple resources available to you and ways you can help:

Learn more about Post-Finasteride Syndrome 

  • Read our Frequently Asked Questions page.

  • Inform your physician. PFS Network provides resources to help patients discuss PFS symptoms with their clinicians. Not sure about how to start the conversation? Start here.

  • Read about previous studies of PFS. 

  • Experiencing other symptoms? You can find information on other persistent side effects from finasteride here.

Help us fund research 

  • Consider donating to help fund our research projects. The best and easiest way to support research into PFS is through a monthly recurring donation. Every amount matters. 

  • Learn more about our ongoing research projects.

Report your symptoms

  • Refer to your country’s pharmacovigilance organization by reviewing our regulatory list, or by consulting the World Health Organization’s (WHO) list of reporting resources here: https://who-umc.org/ (Scroll to the bottom to select your country from the map provided).

Stay up-to-date

  • Sign up for our mailing list to stay up to date on research and news related to PFS: Email sign-up

  • View and subscribe to our YouTube channel. You may also consider appearing on our patient interview series. 

Connect with other PFS patients

  • Follow our Patient Stories & Interviews to hear how others have experienced similar symptoms.

  • Join our community forums. PFS Network operates the largest and longest-running standalone patient forum, propeciahelp.com, where patients can connect with others affected by adverse reactions to finasteride. The charity also operates r/FinasterideSyndrome on Reddit.