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.

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.

5 Health Benefits Of Sex | Richrain...
5 Health Benefits Of Sex | Richrainbows

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]Opens in a new tab.,[2]Opens in a new tab.,[3]Opens in a new tab..

Finasteride/Propecia has almost no short-term side effects.

In the long-term, however, finasteride can cause erectile dysfunction, inability to ejaculate, 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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Depression over lost sexual function leading to suicidal thoughts is a real side effect of oral finasteride/Propecia.
Depression over lost sexual function leading to suicidal thoughts is a real side effect of oral finasteride/Propecia.

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.

A red light therapy cap for hair growth
A red light therapy cap for hair growth

[1]Opens in a new tab. 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: 10.4103/0974-7753.138584Opens in a new tab.. PMID: 25191036; PMCID: PMC4154149.

[2]Opens in a new tab. “Finasteride Monograph for Professionals”Drugs.com. American Society of Health-System Pharmacists. Retrieved 5 March 2019

[3]Opens in a new tab. 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 Treatment25 (2): 156–61. doi: 10.3109/09546634.2013.813011Opens in a new tab.

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]Opens in a new tab.
  • ejaculatory dysfunction
  • decreased fertility
  • decreased libido
  • depression
  • suicidal thoughts
  • orthostatic hypotension (severe low blood pressure)
  • dizziness

 


[4]Opens in a new tab. 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.14537Opens in a new tab.. 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 ScienceOpens in a new tab.

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.

How to view these devices:
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Sexy man
“The same pill that made me this sexy also broke my junk.”

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]Opens in a new tab..

Platelet rich plasma injection for hair growth
Platelet rich plasma injection for hair growth

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]Opens in a new tab. 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.14537Opens in a new tab.. 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]Opens in a new tab..
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.

How to view these devices:
To view the devices mentioned in this article, click to go to the product list:

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Table: Hair Regrowth Therapy Long Term Side Effects

Hair Growth Therapy Long-Term Side Effects
topical minoxidil unlikely: dizziness, cardiac arrhythmia
topical finasteride unlikely: [specifics not listed]
oral dutasteride more likely than oral finasteride: A worse version of Post-Finasteride Syndrome
oral finasteride Likelihood not stated: Post-Finasteride Syndrome, including low blood pressure, dizziness, erectile dysfunction, ejaculatory dysfunction, decreased libido all possibly permanent, as well as possible decreased fertility in men.

Depression — including thoughts of suicide — because of sexual dysfunction is called Post-Finasteride Syndrome (PFS). The depression is also sometimes permanent.

oral minoxidil Unlikely: “Rare, unless patients with cardiovascular comorbidities. Weight gain”
spironolactone Unlikely: “Rare, unless patients with renal failure.”
flutamide & bicalutamide likelihood not stated: black box warning of liver failure
cyproterone acetate none
platelet-rich plasma none
exosomes none
microneedling none
Synergen Complex none
Marine complex none
Serenoa repens none
rosemary oil, tea tree oil, pumpkin seed oil, coconut oil, castor oil and alma oil none
light devices none
hair transplantation none

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]Opens in a new tab.
  • referred to a 1.8% side effect rate as “rare”[8]Opens in a new tab.
  • referred to finasteride’s side effects as “unimportant”[9]Opens in a new tab.
  • focused only on the short term, thus missing the long term disaster to come[10]Opens in a new tab.

[6]Opens in a new tab. https://www.drugs.com/monograph/finasteride.html#cautionsOpens in a new tab.

[7]Opens in a new tab. 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.12827Opens in a new tab.. Epub 2020 Jan 19. PMID: 31957152; PMCID: PMC7497182.

[8]Opens in a new tab. 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.12246Opens in a new tab.. Epub 2015 Jun 2. PMID: 26031764.

[9]Opens in a new tab. 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: 10.1159/000079595Opens in a new tab.. PMID: 15316165.

[10]Opens in a new tab. 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: 11770252Opens in a new tab..

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]Opens in a new tab.. Symptoms include abnormal external genitalia, underweight prostate and seminal vesicles (semen 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 ejaculation, 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]Opens in a new tab..

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]Opens in a new tab..

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]Opens in a new tab..

Subsequent studies yielded similar results[15]Opens in a new tab.,[16]Opens in a new tab.,[17]Opens in a new tab.,[18]Opens in a new tab..

 

How to view these devices:
To view the devices mentioned in this article, click to go to the product list:

Go to the Product ListOpens in a new tab.


 

[11]Opens in a new tab. https://www.drugs.com/monograph/finasteride.html#cautionsOpens in a new tab.

[12]Opens in a new tab. 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.2017.29.6.747Opens in a new tab.

[13]Opens in a new tab. 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: 10.2165/00044011-200929050-00001Opens in a new tab.

[14]Opens in a new tab. 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.12200Opens in a new tab.

[15]Opens in a new tab. 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.22277Opens in a new tab.

[16]Opens in a new tab. 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/s40257-013-0060-6 Opens in a new tab.

[17]Opens in a new tab. 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.0000000000001114Opens in a new tab.

[18]Opens in a new tab. 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: 10.1080/14764172.2017.1326609Opens in a new tab.

Conclusion

Worried Man
“I have hair. Was it worth the price I paid?”

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 FoundationOpens in a new tab..

For safe and effective hair growth therapy, see my article: Hair Loss Sucks. How Light Can Help, According to ScienceOpens in a new tab.

How to view these devices:
To view the devices mentioned in this article, click to go to the product list:

Go to the Product ListOpens in a new tab.

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.

Caroline Bogart

I research the bloody hell out of everything that interests me, then translate it into blog posts to solidify my knowledge and share the information.

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