Doctors Are Warning Men of Rare Side Effects From Popular Hair-Loss Drug
Finasteride prescriptions have spiked in recent years, as has its link to sexual dysfunction.
For young men experiencing early signs of hair loss, telemedicine companies like Hims and Keeps are an open door for preventive and long-lasting treatment plans for androgenetic alopecia, or male-pattern baldness. According to an Epic Research report conducted by NBC News, finasteride is the most popular hair-loss drug on the market for men. In the last seven years, finasteride prescriptions have increased by nearly 200 percent—and consequently, brought some of its more troubling side effects to light.
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"It's like water in my clinic," Jerry Shapiro, MD, a dermatologist at NYU Langone Health, told NBC News. "I'm prescribing it all the time."
Many patients begin taking finasteride in their mid-to-late twenties, but doctors are now seeing young men in their late teens seeking help for hair loss, too. Although the oral drug is considered highly effective, the surge in finasteride prescriptions has raised eyebrows in the medical community, prompting warnings from doctors about the drug's rare yet potentially adverse health effects.
Finasteride is an oral daily pill used to treat an enlarged prostate. However, about 30 years ago, the Food and Drug Administration (FDA) also approved finasteride for treating hair loss, per NBC News. According to the American Osteopathic College of Dermatology (AOCD), androgenetic alopecia affects 50 percent of men by age 50.
Androgenetic alopecia becomes noticeable via a receding hairline and thinning at the back of the head. This happens when hair follicles' growth cycles are slowing, and the follicles themselves are shrinking, Maria Colavincenzo, MD, a dermatology professor at Northwestern Feinberg School of Medicine, explained to NBC News.
High levels of dihydrotestosterone (DHT) can stunt the hair growth cycle and contribute to low hair density, giving the appearance of balding. Finasteride works to block this enzyme from populating at a rapid speed.
"If you block that signal telling the hair to shrink, then the hair doesn't shrink, and it might even unshrink a little bit," Colavincenzo said. "That's how finasteride works."
Finasteride has an 80 to 90 percent effective rate, according to a study published in the journal Drugs. However, it's better at preventing hair loss rather than treating it, Shapiro noted. So, once you stop taking the medication, its benefits wear off.
Additionally, the oral pill has some concerning side effects.
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In 2022, the FDA announced it would be "requiring the addition of suicidal ideation and behavior" on the drug's warning label based on past patients' reports, per Reuters.
In some patients, finasteride can also cause a low libido, erectile dysfunction, and loss of sexual ability, desire, drive, or performance, according to the Mayo Clinic. Though rare, some patients also reported a decrease in the amount of semen they produce, said a recent review article published in the International Journal of Impotence Research.
However, according to NBC News, "These adverse sexual side effects are typically seen in less than 5% of men on the drug."
Temporary decreases in sex drive are normal and can be due to a number of environmental factors like stress. But if this is common for you, Colavincenzo warns against using finasteride as it could worsen the issue.
"I'm very cautious if a person tells me they're having issues with sexual function," she said. "I usually say I don't think this is a good idea and I wouldn't recommend it for them."
That said, permanent mental health and sexual function side effects with finasteride are "so, so rare," that Shapiro said it shouldn't deter one from speaking with their doctor about the medication.
"I've never seen it in a patient, and I've treated thousands of patients," Shapiro shared.
Colavincenzo agreed: "Certainly the vast majority of my patients have no such side effects and are fine and do pretty well with it."
Best Life offers the most up-to-date information from top experts, new research, and health agencies, but our content is not meant to be a substitute for professional guidance. When it comes to the medication you're taking or any other health questions you have, always consult your healthcare provider directly.
