Osteopenia and Osteoporosis: Symptoms of Post-finasteride Syndrome

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

What do persistent changes in bone density from finasteride entail?

Osteopenia is characterized by a reduction in bone density but not to an extent that the bone becomes substantially more prone to fracturing or breaking. Osteoporosis is characterized by a reduction in bone density such that the bone becomes much more prone to breaking. Osteopenia is the initial stage of bone loss. Some PFS patients report diagnoses of osteopenia or osteoporosis.

How PFS patients describe the effects of osteopenia and osteoporosis

Here are some descriptions from patients based on documented interviews and stories: 

“I have been recently diagnosed with osteopenia, despite the fact I am only 35 years old.“

“I have had a bone density scan, which showed that I have osteoporosis. I’m a 33 year old man, so that is unusual.“

How common are osteopenia and osteoporosis as symptoms of Post-finasteride Syndrome?

Currently, there is limited data with which to estimate the prevalence of osteopenia or osteoporosis in PFS. 

Research findings on osteopenia and osteoporosis 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 bone development and maintenance of bone mass. 

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. 

Does osteopenia or osteoporosis after finasteride go away? Is it reversible? Does it progress?

Some patients have reported a slowing in the rate of bone density loss over time. However, PFS is understood to persist indefinitely, and it is currently without safe and effective treatment. 

Managing and coping with osteopenia or osteoporosis

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 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 osteopenia or osteoporosis 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.