Propecia, also known by its generic name finasteride, is a popular medication used to treat hair loss. The active ingredient, finasteride, works by stopping the conversion of testosterone into another hormone called dihydrotestosterone (DHT). DHT reduces the growth of the hair follicle, leading to hair loss. In this way, Propecia helps to reduce and prevent hair loss.
Can Propecia be Dangerous?
Propecia, like any medication, carries risks. Before any treatment is prescribed, a doctor weighs up the risks versus the benefits for the patient. Propecia would not be prescribed to any patient if it was deemed to be dangerous for them. However, it is important to be aware of the potential risks of a treatment before you start taking it.
The most common side effect of Propecia is sexual dysfunction. Sexual dysfunction can refer to a number of different conditions, but primarily relates to reduced sex drive, difficulty reaching orgasm and erectile dysfunction. These side effects are likely related to the fact that Propecia interferes with your natural hormone levels, many of which are involved in sexual function.
A study of over 3,000 men found that up to 0.5% of them experienced difficulty achieving orgasm when taking finasteride. Additionally, 4.7% experienced decreased libido and 4.5% experienced erectile dysfunction. In clinical trials, 0.8% to 15.8% of men taking Propecia experienced erectile dysfunction. This is obviously a high level of variation, and may reflect differences in the groups of men participating in these studies.
The majority of these cases seem to resolve when someone stops taking Propecia, but there have been some reports of persistent sexual dysfunction after the treatment has been stopped. That does not mean that Propecia has caused their long term problems, but it does mean that we cannot rule it out.
Infertility is a very rare side effect of Propecia, but one that you should be aware of. Some men have reported reduced sperm quality and/or infertility whilst taking Propecia. Infertility occurs because Propecia affects the levels of hormones which are needed to produce sperm. Generally, this would resolve after the treatment is stopped. Infertility is not a common side effect of Propecia, but it may be important to consider if you are trying to start a family.
Propecia has also been associated with mood changes such as depression and, in rare cases, even suicidal thoughts. Propecia reduces DHT levels, and studies have shown that low levels of DHT are associated with depression.
Depression should not be dismissed, as it can be a very distressing condition and is potentially life-threatening if suicidal thoughts occur. With this in mind, it is important that you monitor your mood closely if you start taking Propecia, as it may be best to stop the treatment if you feel your mood is being negatively affected. If you are concerned about your mood, speak to a healthcare professional for medical advice.
Other side effects include skin reactions, allergic reactions and testicular pain. Do not take any medication if you have a known allergy to any of the ingredients it contains. If you experience any side effects from Propecia, we recommend that you speak to your doctor for further advice.
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How Effective is Propecia?
Given the potential risks of Propecia, it is important to consider how these compare to the potential benefits.
Clinical trials of over 2,500 men aged 18 to 41 have found that Propecia leads to a measurable improvement in male pattern baldness over just 3 to 6 months. Propecia was found to have slowed or reversed hair loss in 9 out of 10 men with mild to moderate hair loss over two years. That suggests that around 90% of men can expect some improvement from taking Propecia, with noticeable results in as little as 3 to 6 months.
Given how effectively Propecia treats male pattern baldness, it is worth balancing the likelihood of benefits against the smaller risk of side effects. However, it is important to remember that people weigh up the risk of side effects differently, and that alternative hair loss medications may also have side effects.
Some people are not willing to accept any risk to their fertility, no matter how small, but others may be willing to accept that given the potential effectiveness of Propecia. If you’re struggling to make a decision, you may wish to contact your doctor to discuss your options further, so you can find out which treatment is best for you.
If you choose not to take Propecia, minoxidil may be another option to consider for male pattern hair loss. Minoxidil works in a completely different way to Propecia. It works by improving blood flow to the hair follicles, which helps them to last longer and grow more.
Minoxidil is a topical treatment, applied directly to the scalp. This helps to minimise the risk of side effects. Currently, the only side effect listed for topical minoxidil is low blood pressure and this is uncommon. Given the lower risk of side effects, some patients will opt for minoxidil over Propecia to stop their hair loss.
