Finasteride
This is a very important topic for me as medication is only used as a very last resort.
So taking a drug (finasteride) that is prescribed for the treatment of benign prostatic hyperplasia (BPH) to treat hair loss (alopecia) was something that was totally against my way of living.
What is Finasteride?
Finasteride, sold under the brand names Proscar and Propecia among others, is a medication used mainly to treat an enlarged prostate or scalp hair loss in men. It can also be used to treat excessive hair growth in women and as a part of hormone therapy for transgender women. It is taken by mouth.
How does Finasteride work?
Taking finasteride leads to a reduction in scalp and serum DHT levels; by lowering scalp levels of DHT, finasteride can maintain or increase the amount of terminal hairs in the anagen phase by inhibiting and sometimes reversing miniaturization of the hair follicle. Finasteride is most effective on the vertex but can reduce hair loss in all areas of the scalp.
Side effects
Side effects are generally mild. It may increase the risk of certain rare forms of prostate cancer, and some men may experience sexual dysfunction, depression, anxiety, or breast enlargement. Finasteride is a 5α-reductase inhibitor and works by decreasing the production of dihydrotestosterone (DHT), an androgen sex hormone, which makes DHT less available in key tissues like the prostate gland and scalp. It inhibits two of the three forms of 5α-reductase and can decrease DHT levels in the blood by up to 70%.
Sexual dysfunction
The 2010 Cochrane review found that compared with placebo, men taking finasteride are at increased risk for impotence, erectile dysfunction, decreased libido, and ejaculation disorder for the first year of treatment; the rates of these effects became indistinguishable from placebo after 2–4 years and these side effects usually got better over time. Another 2010 review found that when used for hair loss finasteride increased rates of sexual problems. A 2016 review of 5α-reductase inhibitors for prostatic hyperplasia found that sexual dysfunction was 2.5 times more likely in those who used them. Another 2016 review, a meta-analysis found that sexual dysfunction, including erectile dysfunction, loss of libido, and reduced ejaculate, may occur in 3.4 to 15.8% of men treated with finasteride or dutasteride. This adverse effect has been linked to lower quality of life and can cause stress in relationships.[45] There is also an association with lowered sexual desire. It has been reported that in a subset of men, these adverse sexual side effects may persist even after discontinuation of finasteride or dutasteride.
The conclusion is that Finasteride causes short-term sexual dysfunction in some men and this for me raises a red flag.
My personal experience
As I mentioned above, taking medication it's only an option as a really last resort.
But as the hair loss was progressing and following my doctor advice (see my post about consultation), I decided to give Finasteride a try.
I started taking Finpecia 1mg, a cheap Indian Finasteride generic tablet daily and after 6 months I could perfectly see that the hair loss had stopped and that actually there was some regrow. There were some peach fuzz little hairs sticking out in places where there was nothing before.
The worst part was about to come. After those 6 months I started having some of the side effects that are described above. Reduced libido, anxiety etc. As soon as I started having the first symptoms I stopped taking Finasteride immediately. The doctor that recommended Finasteride told me that those cases are extremely rare but after some research I got to the conclusion that actually were not that rare and could occur in about 15% of men.
I took those first symptoms serious and never took Finasteride again in my life.
It's true that those peach fuzz hairs are gonne but also my libido is back and that's how I plan to leave it.
I was taking Finasteride along with applying Minoxidil, which I kept doing until today, so it's hard to say if the hair loss stopping was due to Minoxidil or Finasteride or the combination of both but either way for me Finasteride is a no go due to the possible side effects.
