The wide localization of the 5-ARI enzyme in the body, including the brain, bones, and muscles, leads to the reduction of DHT in related tissues.

The exact cause of PFS is not fully understood. However, the wide localization of the 5-ARI enzyme in the body, including the brain, bones, and muscles, leads to the reduction of DHT in related tissues. Genetic variability and alterations in the gut microbiota have also been suggested as potential contributing factors… Post-finasteride syndrome is a complex condition that requires further research and understanding. Collaborative efforts among researchers, health-care professionals, and patient advocacy groups are essential to develop evidence-based guidelines and novel therapeutic approaches.

—Understanding Post-Finasteride Syndrome: A Deep Dive into a Rare Sexual Dysfunction: AskFabio, October 9, 2023