Finasteride: The Successes and the Side Effects

In the search for a cure for hair loss, the development of finasteride was undoubtedly an event of historical significance. For so long, researchers, inventors and various individual seekers had been looking for the Holy Grail – the magic pill -- that would make the whole problem of hair loss disappear irrevocably and forever. Finally, after many decades of careful study and experimentation backed by copious amounts of indefatigable effort, researchers announced the discovery of finasteride. This was it, according to hair loss experts: The magic pill for which everyone had been searching.

Finasteride, which is sold under the name Propecia for the treatment of male pattern baldness, was approved for sale by prescription in 1997, and tens of millions of men around the world have tried this drug over the past 14 years with varying levels of success. As it turned out, finasteride was hardly the miracle pill that had been advertised. What it has proven itself to be instead is a good, solid remedy for hair loss in approximately two out of every three men suffering the symptoms of male pattern baldness. Finasteride can help restore hair growth that has been lost on the crown of the head, but it cannot reverse the receding hairline that also accompanies male pattern baldness. The most effective way to use this hair loss remedy is proactively -- if Propecia is taken at the earliest signs of hair loss, it can stop or slow the process considerably.

The Downside of Finasteride

Like all prescription drugs, finasteride is expensive. A month's supply of Propecia for the treatment of hair loss can cost something in the neighborhood of $50, although prices may vary depending on the supplier. This means that a person treating their androgenic alopecia (the scientific name for male pattern baldness) with finasteride can expect to spend as much as $600 per year to do so, which obviously is a significant financial investment.

But this investment is not optional or temporary. Finasteride must be taken continuously for its effects to last, and if a person should choose to stop taking it, the hair they have regained will fall out again within a relatively short period of time.

While two-thirds of all men taking Propecia do report positive results, many are disappointed to find that the amount of the hair they are able to regrow after a few months of taking the drug is less than hoped for or expected. Many also complain that the quality of the new hair is inferior, including being thinner, shorter and weaker than the hair that had grown on the crown of the head before the onset of androgenic alopecia.

Finasteride works by blocking the process in the body whereby male testosterone is converted to dihydrotestosterone through the intervention of an enzyme called 5-alpha reductase. Dihydotestosterone, which is commonly known by its acronym DHT, plays an important role in normal sexual functioning and in the health of the male reproductive system. However, because of genetic factors, the body's production of this substance runs out of control in many men. When this happens, DHT accumulates in the hair follicles of the scalp and ultimately does so much damage that the follicles affected are no longer able to produce new hair growth. The distinctive thinning pattern associated with androgenic alopecia is the result. But unfortunately, the chemical process by which finasteride blocks the conversion of testosterone to DHT can have negative consequences for the body.

The Negative Effects of Finasteride

Many men report no side effects whatsoever from taking Propecia for hair loss. On the other hand, a small number of men have reported side effects such as allergic reactions, significant swelling in the area of the mouth, breast enlargement and pain, and even mood disorders, such as depression. The most commonly reported side effects are related to decreased sexual functioning.

Because finasteride inhibits the creation of a testosterone derivative that performs an important role in the male reproductive process, in some cases, the action of finasteride is implicated in sexual symptoms, such as erectile dysfunction, reduced libido and poor ejaculatory response. The severity of these symptoms varies: While some have experienced mild forms of sexual dysfunction that cleared up after they stopped taking finasteride, other men have reported that their loss of sexual ability and capacity has been total and that even ceasing to take the drug has not helped them fully restore what has been lost.

Of course, most men do not experience horror stories like this, and it is fair to say that finasteride's side effects have only caused serious health problems in a small subset of cases. Nevertheless, all prescription medicines carry a risk of side effects that can sometimes be extreme, and this is something that anyone should keep in mind before taking any kind of pharmaceutical drug for any reason, especially if that reason does not involve an actual threat to their life or physical health.