Can we identify a post‐Serenoa syndrome (PSS)? A case series on sexual and psychiatric side effects of <scp> <i>Serenoa repens</i> </scp>

The study investigates the potential existence of a post-Serenoa syndrome (PSS) characterized by persistent sexual and neuropsychiatric symptoms following the use of Serenoa repens, commonly used for benign prostatic hyperplasia and androgenetic alopecia. The case series involved individuals who self-reported symptoms on an Italian online forum and underwent clinical evaluations. Adverse effects were noted to emerge within 1 month in 61% of cases, with symptoms persisting for an average of 4.7 years. Only 3 patients experienced complete remission. The Naranjo Scale indicated a 'probable' causality in 54% of cases, with combined therapies increasing symptom severity. The study suggests that the perceived safety of S. repens may lead to underreporting of adverse effects, highlighting the need for further pharmacovigilance and clinical research.