Rena Malik, MD Podcast Tamsulosin and Finasteride SIDE EFFECTS that will SHOCK YOU! | Are they reversible?! (YouTube Replay)
Oct 13, 2025
Tamsulosin and Finasteride are discussed as treatments for benign prostatic hyperplasia but come with shocking side effects. Sexual dysfunction, linked to Finasteride’s impact on neurosteroids, has been reported to persist for up to 40 months. The potential nocebo effect can shape patient perceptions of these side effects. Additionally, Tamsulosin may cause ejaculatory dysfunction due to its physiological impact on ejaculation mechanics. Alternatives with lower risks are suggested, urging patients to consult their doctors.
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Finasteride Affects Brain Steroids
- Finasteride blocks 5-alpha reductase and crosses the blood-brain barrier, impacting neuroactive steroids linked to sexual desire.
- Studies (mostly animal) suggest reduced brain DHT and related steroids may lower libido and cause long-lasting sexual dysfunction.
Reported Sexual Effects Can Be Long Lasting
- Labeling lists sexual side effects under 10%, but surveys of affected men report much higher rates of dysfunction.
- In one survey, symptoms persisted on average ~40 months and 20% had symptoms longer than six years after stopping finasteride.
Risk Drops After One Year
- If you've taken finasteride for over a year without sexual side effects, you're unlikely to develop them later.
- Monitor symptoms early; most new-onset sexual effects appear within the first year of use.