Propecia (1mg finasteride) is arguably the most effective medical hair loss treatment currently available. Though not a hair loss cure, countless men have used the drug to effectively slow the progression of balding and regrow hair since its approval for the treatment of androgenic alopecia (male pattern baldness) by the FDA in 1997.

Propecia works by inhibiting the conversion of testosterone to Dihydrotestosterone (DHT). Studies conducted by pharmaceutical manufacturer Merck & Co showed that almost 80% of men using Propecia stopped or even reversed their hair loss to some degree, while fewer than 2% exhibited “Drug-Related Adverse Experiences” or side effects. These side effects were said to be temporary and to subside upon discontinuation of the drug.

However, in the years since Propecia first entered the market as a hair loss treatment, numerous complaints have arisen from men who claim to have suffered severe and irreversible sexual side effects attributed to finasteride use. This has come to be known as “Post Finasteride Syndrome” or “PFS”.

Side Effects

As a result of these complaints, in April of 2012, the FDA mandated labeling changes to finasteride related products. Labeling changes to Propecia include “libido disorders, ejaculation disorders, and orgasm disorders that continued after discontinuation of the drug”. Labeling changes to Proscar include “decreased libido that continued after discontinuation of the drug”. Labeling changes to both Propecia and Proscar include “reports of male infertility and/or poor semen quality that normalized or improved after drug discontinuation”

While a leap forward in terms of transparency and patient education, the list of side effects displayed on these labels is far from comprehensive. In fact, finasteride side effects can be sorted into three categories; sexual, physical and mental. The following is a comprehensive list of known and suspected symptoms:

Sexual Side Effects:

  • Decreased or complete loss of libido (sex drive)
  • Erectile dysfunction, impotence
  • Loss of morning and spontaneous erections
  • Sexual anhedonia, loss of pleasurable orgasm
  • Decreased semen volume and force
  • Penile shrinkage and numbness
  • Peyronie’s disease – scar tissue along the length of the penis, causing the penis to bend when erect
  • Scrotal shrinkage and numbness
Physical Side Effects:
  • Gynecomastia – female-like breast development and enlargement
  • Chronic fatigue, listlessness
  • Muscle atrophy, weakness
  • Muscle twitching
  • Decreased oil and sebum production
  • Chronically dry, thinning of skin
  • Melasma – brownish macules and patches that typically affect sun-exposed areas on the face
  • Tinnitus (ringing in the ears)
  • Increased fat deposition, obesity and elevated body mass index
  • Decrease in body temperature
  • Reduced HDL cholesterol, raised fasting glucose and triglycerides

Mental Side Effects:

  • Severe memory/recall impairment
  • Slowed thought processes
  • Impaired problem solving, decreased comprehension
  • Depression
  • Anxiety
  • Suicidal ideation
  • Emotional flatness and anhedonia
  • Insomnia
Conclusion

It is important to note that not all experts recognize the existence of PFS. Instead, they contend that these symptoms may be a coincidence and the result of other non-related issues.  Furthermore, most men don’t experience any side effects at all.

Be that as it may, prospective users should be aware that a small percentage of men may experience temporary side effects and an even smaller number may find that these side effects persist even after stopping treatment.

If you are taking finasteride and are experiencing any of the aforementioned symptoms, be sure to contact your prescribing physician immediately.

—-
David

Editorial Assistant and Forum Co-Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q & A Blog.

To share ideas with other hair loss sufferers visit the hair loss forum and social community.

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David aka - TakingthePlunge

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  • Sure - Contact your VA physician that lies that finasteride is a 100% safe drug and in writing in my medical record have denied me any hormone treatment or to see an outside post finasteride syndrome doctor depute two evaluations from top PFS doctors and researchers and two blood tests showing my hormones are messed up , the VA has done nothing . 20% of all vets are given this poison with no screenings and no warnings by urologists at the VA for BPH-enlarged prostate . In my medical records from the urologist at Lebanon Pa VAMC and his chief of staff are denials of my primary VA doctor for a urologist to treat me with horns and see me for PFS . These Va doctors have stated there are no permanent adverse symptomology from finasterdie as once you cease the drug all symptomology goes away. Further there is no one that specializes in or evaluates Post fomastedei syndrome while these doctors have taken one research report undocumented last page totally out of context to say such . They have also stated that PFS doesn't exist, PFS doctors and researchers are bogus doctors and that the research is bogus and lie on the FFDA warnings claiming there are no permanent adverse symptomology form the drug or no PFS Adminsitrators and patient advocates have down nothing including people at VISN4 and VHA about the matter . Veterasn it is believed have committed suicide and have sucidal ideation as myself and sever depression and course of treatment if any is anti depressants not recommended by PFS outside specialists . Please help us vets There is via coverup and discrimination out of 20% of the VA population given finasterdie by VA urologists not one adverse symptomology case reported to VA Pharmacy nor FDA nor did the VA have warning labels on finasterdie between 2009 to 2014 bearding FDA safety warnings in 2012 and 2014 . VA formulary for finasteride is from before 2004 . Please help us veterans We need lawyers and =the press to expose what the VA is doing to us PFS veterans and denying us medical help via discrimination and medical negligence and medical malpractice. Symptomology without any hormone testing is being done by VA urologists blaming it on enlarged prostate or a veterans former mental health condition .

    Please please help us veterans and get us lawyers to protect us and we need the press to investigate the medical negligence and discrimination of the VA regarding PFS and need medical help as well outside the VA by specialists in PFS

    Veteran

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