Post-finasteride syndrome is a complex condition characterized by psychological, sexual, and somatic symptoms observed in patients currently or previously treated with 5α-reductase inhibitors. Although these agents are commonly used in the management of benign prostatic hyperplasia and androgenetic alopecia, an increasing number of cases report persistent adverse effects even after treatment discontinuation. The lack of clearly defined pathophysiological mechanisms and the limited availability of clinical research complicate the diagnosis and management of post-finasteride syndrome. This paper reviews the current understanding of post-finasteride syndrome, including its potential molecular pathways, clinical presentation, and therapeutic approaches. Strong evidence supports the existence of post-finasteride syndrome, and the European Medicines Agency has recognized suicidal ideation as an adverse effect of finasteride administered at doses used to treat androgenetic alopecia. Various therapies can be administered to alleviate the symptoms of post-finasteride syndrome, and effective communication with patients is essential to ensure that adverse events are recognized and addressed. An interdisciplinary framework should be used for the implementation of treatment with 5α-reductase inhibitors, with patients undergoing thorough physical and mental health assessments prior to treatment initiation.