Does the PFS ever go away?
I had personal experience with this before "finasteride syndrome" had a name.
In my early 20s Propecia was being heavily advertised and celebrated as the first effective anti-hair loss treatment to be developed. In my early twenties I was always being complemented on my hair, but noticed my hairline was receding so I got a prescription and started 1mg / day.
Long story short, a sexual and psychological disaster, It was horrible. Borderline suicidal, Doctor was skeptical of these symptoms, but I dropped it.
It took a solid 2 months to return to baseline. I wondered if I'd ever get back to normal. At least some part was likely psychological and a loss of confidence.
As years went by those effects went from rumors, to research confirming them, to a panic about it being permanent.
I became like Dan Frank above, cursing that poison every chance it came up.
No evidence has ever emerged that Fin "breaks" anything. It has no basis after 30 years of lawsuit hungry lawyers pushing for research to find something.
But I can appreciate the effects instill so much terror initially, and ED, depression, and lack of motivation can also be induced psychologically, that it becomes "permanent" for those guys who convince themselves it is. I think if I had heard about its "permanence" I would've suffered much longer too.
I recently returned to it. It took that long to get over the trauma, for me to be convinced by the data biologically based "permanence" isn't a thing. The surprising effectiveness of very low dose fin was a relatively recent advance too opening a new option.
I quartered a bunch of pills, took .25mg, planning eod, and within 24 hours could feel the effects. Very slightly depressive. Semen volume reduced by maybe 1/3. Braced for it to get worse with subsequent eod doses it didn't. The slightly depressive effect eased off. Everything continued to function like before. Went to every day. same thing, hit a little harder, then eased off. I feel no different now and decided to stay at .25mg ED for now.
I went from regular shedding to only very rarely finding a hair after shampooing. I seem to be filling in, slowly, My scalp feels better, vs an irritation / burning sensation that I've gotten my whole life and always associated as a sign of further hairline recession coming.
I understand it's been banned in some places for causing suicide in rare instances. I could totally see that happening to the underprepared who don't get off or drop the dose.
My very bad reaction puts me in the small minority of hyper responders who have every reason to be afraid. Most guys take 1mg with no problem. Dudes with prostate issues take 5mg for a lifetime with no ill effects.
I wish I had gotten back on before I lost as much ground as I did, because without a DHT blocker as the base everything else isn't going to keep your hair around if DHT is killing off stem cells.
Play it safe. Start at .25mg ed. If things are fine, try .50, and if nothing bad happens congrats, you're probably one of the 95% that can take 1mg without issue.
But if you start to notice sides, go back to .50 or .25 ED, or even .25 EOD if you have to avoid anything intolerable. You'll still enjoy 85-95% of the protection with far less risk of sides, If you decide to come off, accept it takes a few weeks to wash out of your system, just like many of the AAS we use, or recovery after crashing E2, and then you'll be back to normal.
There's no reason to fear this drug imo, has an excellent chance of preserving your hair for a lifetime, and if you choose the dose carefully, you can dodge the sides even if you're prone to them like me.