Warning: Your Hair Loss Rx is a Sexual Side Effect Nightmare
Did you know that hair loss therapy could cause permanent sexual dysfunction?
Oral finasteride can lead to Post Finasteride Syndrome. Oral finasteride causes erectile and ejaculatory dysfunction, decreased libido, depression, and suicidal thoughts. Symptoms can be permanent.
Perhaps oral finasteride users don’t know about the therapy that prevents hair loss and regrows hair with no side effects. Red light therapy works as well as oral finasteride, with virtually no side effects.
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Oral Finasteride is an FDA Approved Hair Loss Treatment from Hell
I don’t know about you, but I used to believe the FDA’s job was to protect the consumer.
The FDA approved the use of oral finasteride as an effective hair loss treatment in 1984.
You probably know finasteride by its trade name “Propecia.”
The drug works best on men at preventing hair loss and at stimulating about a 30% effective hair regrowth.
Several studies support using finasteride to stop hair loss and to regrow hair[1],[2],[3].
Finasteride/Propecia has almost no short-term side effects.
In the long-term, however, finasteride can cause erectile dysfunction, inability to eja*ulate, loss of sexual desire, depression, and suicidal thoughts.
And yes, the depression and suicidal thoughts are a direct result of the sexual dysfunction finasteride causes.
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If this is not bad enough, it does get worse.
Sometimes, in some people, the symptoms do not go away, even after stopping the drug.
In some people, the sexual symptoms are permanent.
It makes me question how this therapy is even legal, much less OK’d by the world’s largest health agency.
As a red light therapy expert, I’m able to guide people to red light therapy hair regrowth devices that have no side effects.
Plus, these red light devices work as well as oral finasteride. Using them causes no side effects.
I can’t imagine why one would choose finasteride over red light therapy.
[1] Munck A, Gavazzoni MF, Trüeb RM. Use of low-level laser therapy as monotherapy or concomitant therapy for male and female androgenetic alopecia. Int J Trichology. 2014 Apr;6(2):45-9. doi: 10.4103/0974-7753.138584. PMID: 25191036; PMCID: PMC4154149.
[2] “Finasteride Monograph for Professionals”. Drugs.com. American Society of Health-System Pharmacists. Retrieved 5 March 2019
[3] Gupta AK, Charrette A (April 2014). “The efficacy and safety of 5α-reductase inhibitors in androgenetic alopecia: a network meta-analysis and benefit-risk assessment of finasteride and dutasteride”. The Journal of Dermatological Treatment. 25 (2): 156–61. doi: 10.3109/09546634.2013.813011
What is Finasteride?
While you might not have heard of finasteride, you probably have heard of Propecia hair loss therapy.
The FDA approves of Procecia’s use for:
- stop hair loss in men
- enlarged prostate
- excessive hair in women
Finasteride/Propecia treats male pattern baldness, also known as androgenetic alopecia.
It is 80% effective in white men, less so in women and in other ethnic groups.
Propecia is an antiandrogen. It decreases production of DHT, a hormone that causes hair loss.
As of 2019, Propecia and its generic varieties were the 86th most prescribed drugs.
Finasteride and minoxidil are the only FDA-approved hair loss oral drugs.
Another drug that is not FDA approved is more effective than finasteride. Dutasteride (known as Avodart on the market) grows more hair and has proportionately worse side effects than finasteride.
What are Finasteride Side Effects?
Finasteride can cause potentially permanent side effects including:
- erectile dysfunction[4]
- ejaculatory dysfunction
- decreased fertility
- decreased libido
- depression
- suicidal thoughts
- orthostatic hypotension (severe low blood pressure)
- dizziness
[4] Nestor MS, Ablon G, Gade A, Han H, Fischer DL. Treatment options for androgenetic alopecia: Efficacy, side effects, compliance, financial considerations, and ethics. J Cosmet Dermatol. 2021 Dec;20(12):3759-3781. doi: 10.1111/jocd.14537. Epub 2021 Nov 6. PMID: 34741573; PMCID: PMC9298335.
Are There Any SAFE Hair Loss/Hair Growth Therapies?
For safe and effective hair growth therapy, see my article: Hair Loss Sucks. How Light Can Help, According to Science
A “hair loss” therapy slows or prevents future hair loss.
A “hair growth” therapy improves future hair growth.
Finasteride is a hair loss therapy with about a 30% ability to restart hair growth.
Whether you are trying to stop hair loss or start hair growth, the goal is to have a healthy head of hair.
Is your hair therapy so effective that you’re willing to trade your sexual health for the hair it will help you grow?
I hope the irony of this is not lost on anyone.
Many men opt for hair therapy to maintain sexual attractiveness.
Finasteride gives them back their hair but robs them of their sexual function.
I’ve seen stories about deals with the devil that were less O. Henry than this crime against humanity.
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Which Hair Loss Treatments are Effective?
An article in the Journal of Cosmetic Dermatology details the effectiveness of the hair regrowth remedies available, based on science. The study was published in 2021[5].
How well do these therapies work, and what are the tradeoffs of each one?
The researchers detailed the effectiveness, side effects and costs associated with the hair regrowth therapies listed below:
- topical minoxidil
- topical finasteride
- oral finasteride
- oral dutasteride
- oral minoxidil
- spironolactone
- flutamide and bicalutamide
- cyproterone acetate
- low level laser therapy (red light therapy using laser diodes)
- light-emitting diode devices (red light therapy using LEDs)
- platelet-rich plasma injections
- exosomes injections
- microneedling
- oral nutraceutical (Synergen Complex)
- marine complex supplement (Viviscal, Lifes2good)
- saw palmetto (Serenoa repens)
- rosemary oil, tea tree oil, pumpkin seed oil, coconut oil, castor oil and alma oil
- topical ketoconazole
- hair transplantation
- oral acne medication Clascoterone
- oral JAK inhibitors
- prostaglandin analog glaucoma medication Latanoprost
- combining topical minoxidil with oral finasteride
- combining topical finasteride, dutasteride, and minoxidil
- combining topical minoxidil and spironolactone gel
- combining LLLT (red light therapy) and topical minoxidil
- combining hair transplantation and platelet rich plasma and microneedling
The authors searched for evidence of how well each therapy works.
They assigned “weak” confidence in therapies with only case reviews to support them.
They gave non-placebo-controlled clinical trials a score of moderate confidence.
They assigned strong confidence to those therapies with randomized, placebo-controlled trials backing their use.
Notice the “oral finasteride” row below? The researchers assigned strong confidence in how well the therapy grows hair.
Hair regrowth therapies with the best studies support their use, according to science, are:
- topical minoxidil
- oral finasteride
- platelet-rich plasma
- light devices
- hair transplantation
Table: Evidence Supporting Topical Hair Growth Remedies, According to Science |
|
| Hair Growth Therapy | Evidence Supporting its Use |
| topical minoxidil | strong |
| topical finasteride | weak |
| oral dutasteride | weak |
Table: Evidence Supporting Oral Hair Growth Remedies, According to Science |
|
| Hair Growth Therapy | Evidence Supporting its Use |
| oral finasteride | strong |
| oral minoxidil | moderate |
Table: Evidence Supporting Hormonal Hair Growth Remedies, According to Science |
|
| Hair Growth Therapy | Evidence Supporting its Use |
| spironolactone | weak but strong clinical use |
| flutamide & bicalutamide | weak |
| cyproterone acetate | not stated |
| platelet-rich plasma | strong |
| exosomes | moderate |
| microneedling | weak to moderate |
| Synergen Complex | moderate |
| Marine complex | moderate |
| Serenoa repens | weak |
| rosemary oil, tea tree oil, pumpkin seed oil, coconut oil, castor oil and alma oil | weak |
Table: Evidence Supporting Light Therapy Hair Regrowth, According to Science |
|
| Hair Growth Therapy | Evidence Supporting its Use |
| light devices | strong |
Table: Evidence Supporting Transplantation Hair Regrowth, According to Science |
|
| Hair Growth Therapy | Evidence Supporting its Use |
| hair transplantation | strong |
[5] Nestor MS, Ablon G, Gade A, Han H, Fischer DL. Treatment options for androgenetic alopecia: Efficacy, side effects, compliance, financial considerations, and ethics. J Cosmet Dermatol. 2021 Dec;20(12):3759-3781. doi: 10.1111/jocd.14537. Epub 2021 Nov 6. PMID: 34741573; PMCID: PMC9298335.
Which Hair Growth Therapies are Safe
The researchers then described the short-term and long-term side effects of most items on the list.
Two therapies have no short-term side effects.
Ironically, one is oral finasteride.
Unsurprisingly, the other is red light therapy.
Table: Hair Regrowth Therapy Short Term Side Effects |
|
| Hair Growth Therapy | Likelihood of Happening/Short-Term Side Effects |
| topical minoxidil | unlikely: scalp irritation, allergic contact dermatitis, itchiness, excessive facial hair (in men and women) |
| topical finasteride | unlikely: red skin, contact dermatitis, increased liver enzymes, night peeing, testicular pain, feeling faint, and back of mouth/throat pain |
| oral finasteride | none listed in this study but drugs.com lists “breast cancer” as a known side effect[6]. |
| oral minoxidil | unlikely: irritant dermatitis, allergic dermatitis, itchiness, irritation, excessive facial hair |
| spironolactone | unlikely: electrolyte imbalance, liver damage and low blood pressure |
| flutamide & bicalutamide | not stated: black box warning for liver damage, raised liver enzymes, swollen legs, gastrointestinal discomfort |
| cyproterone acetate | not stated: weight gain, breast tenderness, and decreased libido |
| platelet-rich plasma | unlikely: scalp pain; people with bleeding disorders, autoimmune disease, infection, or who are taking anti coagulation drugs should not accept platelet rich plasma injections. |
| exosomes | unlikely: scalp pain |
| microneedling | Unlikely: scalp pain, bruising, inflammation, is “often painful.” |
| Synergen Complex | possible allergic reaction |
| Marine complex | unlikely: stiff joints, bloating, constipation, diarrhea, nausea, allergy |
| Serenoa repens | gastrointestinal discomfort, reduced PSA (prostate cancer indicator), i.e., causes false negative prostate cancer labs |
| light devices | none |
| hair transplantation | not stated: infection, scarring, pain, itching, swelling, bleeding |
Now, here is the fun. Wanna see something really scary? Here are the long-term side effects of hair regrowth therapies.
Oral finasteride is a nightmare dumpster fire of side effects.
Authors noted that oral dutasteride has a more severe profile than finasteride! Because it’s not as popular, it doesn’t hurt as many people.
Guess which therapy has no short term or long-term side effects.
That’s right.
Red light regrows hair with no short term or long-term side effects.
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But scanning the literature for this information can easily lead to the false conclusion that oral finasteride is safe.
In my research, I found studies that:
- failed to mention the finasteride’s side effects[7]
- referred to a 1.8% side effect rate as “rare”[8]
- referred to finasteride’s side effects as “unimportant”[9]
- focused only on the short term, thus missing the long term disaster to come[10]
[6] https://www.drugs.com/monograph/finasteride.html#cautions
[7] Van Neste D. Placebo-controlled dose-effect studies with topical minoxidil 2% or 5% in male-patterned hair loss treated with oral finasteride employing an analytical and exhaustive study protocol. Skin Res Technol. 2020 Jul;26(4):542-557. doi: 10.1111/srt.12827. Epub 2020 Jan 19. PMID: 31957152; PMCID: PMC7497182.
[8] Hu R, Xu F, Sheng Y, Qi S, Han Y, Miao Y, Rui W, Yang Q. Combined treatment with oral finasteride and topical minoxidil in male androgenetic alopecia: a randomized and comparative study in Chinese patients. Dermatol Ther. 2015 Sep-Oct;28(5):303-8. doi: 10.1111/dth.12246. Epub 2015 Jun 2. PMID: 26031764.
[9] Arca E, Açikgöz G, Taştan HB, Köse O, Kurumlu Z. An open, randomized, comparative study of oral finasteride and 5% topical minoxidil in male androgenetic alopecia. Dermatology. 2004;209(2):117-25. doi: 10.1159/000079595. PMID: 15316165.
[10] Trüeb RM, Itin P; Itin und Schweizerische Arbeitsgruppe für Trichologie. Fotografische Dokumentation der Wirksamkeit von 1 mg oralem Finasterid in der Behandlung der androgenetischen Alopezie des Mannes im Praxisalltag in der Schweiz [Photographic documentation of the effectiveness of 1 mg. oral finasteride in treatment of androgenic alopecia in the man in routine general practice in Switzerland]. Praxis (Bern 1994). 2001 Nov 29;90(48):2087-93. German. PMID: 11770252.
Which Therapies are Safe AND Effective?
We know from the effectiveness studies that the following hair therapies save and restore hair.
These therapies grow hair but are not necessarily safe:
- topical minoxidil
- oral finasteride
- platelet-rich plasma
- light devices
- hair transplantation
Topical minoxidil can cause dermatitis and itching. The worst effect is probably facial hair in women. Unfortunately, long term, topical minoxidil causes dizziness and cardiac arrhythmia. Whether that bet is worth taking might be another story.
Oral finasteride causes abnormal genitalia in babies born to pregnant women who come in contact with the drug, according to the drugs.com Finasteride monograph[11]. Symptoms include abnormal external genitalia, underweight prostate and seminal vesicles (se*en producing glands), delayed genital development, and feminine nipple development.
Long-term, oral finasteride can cause Post Finasteride Syndrome, a sexual nightmare that deserves its own name. Post Finasteride Syndrome symptoms include decreased fertility, low libido, poor eja*ulation, and erectile dysfunction.
And suicidal thoughts.
Platelet-rich plasma can cause scalp pain, which is really the best news we’ve heard so far. But hold tight, because it gets much better than that.
Hair transplantation can cause infection, scarring, pain, itching, swelling and bleeding. Fortunately, all are short-term side effects.
— drum roll please —
Light devices have no short term or long-term side effects.
Studies show that red light therapy (a catchall term for the low energy use of red, infrared, blue, green and yellow light) stops hair loss and regrows hair.
Blue 415 nm, green 525 nm, red 660 nm and infrared 830 nm have shown in clinical trials to be effective as hair regrowth wavelengths[12].
The HairMax LaserComb increased hair density by 11.9 hairs per sq. cm. in a double blind, sham-controlled multi-center 26 week trial. Subjects were 110 men with Norwood Hamilton hair class types IIA-V that was diagnosed as androgenetic alopecia[13].
Researchers tested 630 nm and 660 nm red light LEDs, and a 650 nm laser light on 26 men and 14 women with androgenetic alopecia. After 24 weeks of treatment every other day the subjects gained 17.2 hairs per sq. cm. and a significant increase in hair thickness[14].
Subsequent studies yielded similar results[15],[16],[17],[18].
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[11] https://www.drugs.com/monograph/finasteride.html#cautions
[12] Joo HJ, Jeong KH, Kim JE, Kang H. Various wavelengths of light-emitting diode light regulate the proliferation of human dermal papilla cells and hair follicles via Wnt/beta-Catenin and the extracellular signal-regulated kinase pathways. Ann Dermatol. 2017;29:747–754. doi: 10.5021/ad.2017.29.6.747
[13] Leavitt M, Charles G, Heyman E, Michaels D. HairMax LaserComb laser phototherapy device in the treatment of male androgenetic alopecia: a randomized, double blind, sham device-controlled, multicentre trial. Clin Drug Investig. 2009;29:283–292. doi: 10.2165/00044011-200929050-00001
[14] Kim H, Choi JW, Kim JY, Shin JW, Lee SJ, Huh CH. Low-level light therapy for androgenetic alopecia: a 24-week, randomized, double blind, sham device-controlled multicenter trial. Dermatol Surg. 2013;39:1177–1183. doi: 10.1111/dsu.12200
[15] Lanzafame RJ, Blanche RR, Chiacchierini RP, Kazmirek ER, Sklar JA. The growth of human scalp hair in females using visible red light laser and LED sources. Lasers Surg Med. 2014;46:601–607. doi: 10.1002/lsm.22277
[16] Jimenez JJ, Wikramanayake TC, Bergfeld W, et al. Efficacy and safety of a low-level laser device in the treatment of male and female pattern hair loss: a multicenter, randomized, sham device-controlled, double-blind study. Am J Clin Dermatol. 2014;15:115–127. doi: 10.1007/s40257-013-0060-6Â
[17] Friedman S, Schnoor P. Novel approach to treating androgenetic alopecia in females with photobiomodulation (low-level laser therapy). Dermatol Surg. 2017;43:856–867. doi: 10.1097/DSS.0000000000001114
[18] Barikbin B, Khodamrdi Z, Kholoosi L, et al. Comparison of the effects of 665 nm low level diode laser hat versus and a combination of 665 nm and 808nm low level diode laser scanner of hair growth in androgenic alopecia. J Cosmet Laser Ther. 2017. doi: 10.1080/14764172.2017.1326609
Conclusion
FDA approved oral finasteride for hair loss and hair growth has multiple sexual side effects that can become permanent.
Red light therapy is an at-home or in-clinic modality that significantly increases hair density and thickness with no side effects.
For those who are already caught in the finasteride net, you might find this link helpful: The Post-Finasteride Syndrome Foundation.
For safe and effective hair growth therapy, see my article: Hair Loss Sucks. How Light Can Help, According to Science
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