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Hair Loss Treatments

Does Propecia Have Permanent Side Effects?

Dealing with hair loss can be devestating for some and the amount of useless "snake oil" treatments out there is dumbfounding. Unfortunately, the most effective medication for hereditary hair loss called Propecia (finasteride) is not perfect and some say that the adverse effects that many suffer are worse than the hair loss itself. In this article, we will be discussing the potential for long-term side effects with the usage of finasteride.

What Is Propecia (finasteride)

Propecia (finasteride) is a 5-alpha reductase inhibitor, the 5-alpha reductase enzyme is responsible for converting testosterone in to dihydrotestosterone (DHT) through the blood stream. DHT is the hormone responsible for triggering male pattern baldness. Finasteride is classified as an anti-androgen, the drug was initially created to treat benign prostatic hyperplasia (BPH). However, many reported that their hair loss halted, as a result of the medciation. Some even claimed their hair regrew after starting the medication. This prompted the makers of Propecia (finasteride) to submit clinical trials to the FDA, the results were impressive and in 1997 Propecia (finasteride) became the second medication to be approved to treat androgenic alopecia (genetic hair loss).

How Does Propecia Work

Finasteride works by inhibiting the 5-alpha reductase enzyme. The 5-alpha reductase enzyme is responsible for producing DHT. Inhibition of of the enzyme results in decreased conversion of testosterone in to DHT. Thus, preventing, slowing and even stopping genetic hair loss completely. Propecia is a 1mg pill of the active ingredient finasteride, the pill is to be taken everyday for the best results.

Finasteride and Adverse Effects

Propecia (finasteride) is no stranger to controversy and many men are scared away from using the medication, because of the reports they read online. While anecdotal reports are helpful they do not and will not replace clinical research and data. To date, the incidence of side effects with the usage of Propecia (finasteride) is relatively low. However, the FDA has added a warning concerning the potential for high-risk prostate cancer in some men. Propecia (finasteride) lowers the prostate-specific antigen (PSA) that is used to detect aggressive prostate cancer.

In 2010 the Cochrane review found that men who take finasteride are at an increased risk for impotence, erectile dysfunction, decreased libido, and ejaculation disorders. That said, the review found that the side effects became better over time and were virtually indistiguishable from the placebo after a few years. There are case reports of persistent side effects including diminished libido, erectile dysfunction and other sexual disorders. As a result, the label now mentions that the drug may cause persistent side effects however, this has never been confirmed in a clinical setting.


To date, Propecia (finasteride) is the most effective drug for combating androgenic alopecia (genetic hair loss). Unfortunately, the drug has been a contreversial subject in the hair loss community and especially online. That said, it does appear like thousands of men have complained about persistent side effects, so much so that the Post-Finasteride Syndrome Foundation was created. However, millions of men take this drug without experiencing any negative adverse effects from the medication. It is crucial to consult with a physician before taking Propecia (finasteride) or any other anti-androgen medication.