How Many People Take Propecia?
I have several questions. I think it’s great that a doctor with your reputation and qualifications takes the time to offer feedback to so many curious internet users–it’s truly a great service.
I’m a 23-year old male with very slight hair receding and thinning at the front and temples (not noticeable to anyone but me, and two dermatologists said they might see the early onset of recession, but it was too early to tell). Out of 2 grandfathers, my father, and two uncles, only of the uncles has a receding hairline (and he is positive his did not start until he was in his early 30’s; could mine be due to a cause other than MPB?).
Searching through the internet and your blog, I’ve found an abundance of negative subjective feedback regarding Propecia–from long-term sexual side effects to long-term disruption of various endocrine system processes. Many say the side effects are more common than the 2-3% recognized by Merck. I know from your blog that you said, in your experience at your practice, the side effects are present in about 2-3% of patients.
I’m wondering: have you ever encountered a patient who complained of negative mental side effects? I discovered a few online users who claimed to have had their hormone levels drawn before and after taking the drug, and that the differences were substantial.
Also: how many patients, per your estimate, would you say are regularly taking this drug? I ask because I look at some of the forums for people claiming to experience long-term negative side-effects, and there are hundreds to thousands of users. So I’m wondering if this is 0.001% of patients ever prescribed propecia? 0.1%? 10%?
Finally: I truly just want to avoid having to have a significant hair transplant in 5 years. I’m using 5% minoxidil 2x per day, as prescribed. In your experience, is minoxidil less effective than Propecia? I’ve only been using it about a month; do you think it should stop my hairline? Finally, if I did end up requiring a hair transplant in 5 years, is it fairly safe to say the hairline could be recreated in a manner similar to the original?
Any advice or reply is much appreciated. Thank you so much for your time!
The potential market of 33 million American men who have pattern baldness is not close to penetrated. In an informal discussion with a Merck representative a few years ago, I was told that they sell more than 1 million prescriptions, but I do not know how the generic market has hurt the Propecia market. I don’t have any real numbers on how many people taking the name brand or generic, but it is sold in many countries and I’d estimate it is in the millions.
The forums are filled with spectacular statement about side effects of Propecia and if you read them, you do not get a fair and impartial view of these side effects. I’ve pointed out before that those with complaints (real or otherwise) are going to be the most vocal. You won’t see a whole lot of posts from the vast majority of users that have their hair loss stop or hair regrowing, because they have no real reason to go out of their way to write testimonials for a medication. If you think you’ve been wronged though, you’re more likely to voice your opinions. I can not tell you what the side effect incidence of people who stop taking the drug is after a week or a month, but it must be rare.
The one thing that I want you to take away from this post is that the half life of finasteride is measured in hours… and that means that most of it is out of your blood stream in a day or so. Some residual tissue presence might be in your system for as much as a week. What does this mean? It means that if you have side effects, you can stop the medication and be free of the side effects in a week or so.
Propecia (finasteride) is a better solution to balding for the young man than minoxidil, by a long shot. The best way to avoid hair loss (and a hair transplant) is to take finasteride daily and keep your fingers crossed that you started treatment in time and that your response is a good one. I wouldn’t expect the minoxidil to do much for your hairline, and recreating your hairline from a hair transplant is possible, but it really depends on what “original” hairline you’re talking about and how much hair loss you have (you might not want to focus all of the grafts in one area if you’re thinning throughout the scalp).
Warning – the side effects of finasteride are real! I don’t care what the half life is, the side effects can last for months or years. There is not enough medical research on this. The forums are filled with men who are experiencing significant sexual problems because of this drug. Simply quitting the drug is not always an immediate help. After going through this I highly recommend not taking Fin and simply living with baldness, which is much better than these sexual problems.
Thanks for validating the point I made in the 2nd paragraph
Wholesale pricing is my guess. Perhaps the rep I spoke to counted free sample packs, too. I really don’t know. Sorry about my math, I was confused by your point. Got it now.
DO NOT TAKE THIS DRUG! My fiance took it for years, with no side effects (although we are realizing now that the emotional/mental trauma he has been suffering since he took the drug is very likely related) – but once he quit the drug he experienced genital shrinkage, low libido, trouble maintaining erections, etc. Some studies have shown that ~95 % OF MEN SUFFER these side-effects to some capacity – no long-term side-effects were studied by Merck and what makes it tricky, is that RIGHT AFTER you stop taking the drug, you go back to normal for a few days/weeks – then, the symptoms worsen!! Stay away!
“It means that if you have side effects, you can stop the medication and be free of the side effects in a week or so.”
I don’t care how smart you are, but this is completelly wrong. Maybe the drug is out of the system, but the side effects remaing. I have been suffering for 3 years with little to no improvements. The symptoms arrive litterally overnight. Libido is entirely gone. I never feel the need to have sex or masterbate.. ever. Sperm is watery, and I have no ejaculation “power shot” (meaning the little sperm that gets out will only drip out of the penis). Sorry to be so graphical, but this condition requires it.
It seems unreal, and it is. But this problem is way overlooked. Nobody believes us as the blood work comes out in range .. so basically there is no way to diagnose this, so instead, doctors are telling patients that it’s all in our head.
Propecia may not be in our bodies, but it definately changed something in the way our bodies work.
I agree that it is a very very rare “disease” or syndrome (1% ? 0,1% ?). Possibly. But are you willing to take the chance? I lost my life because of this.
This is my side of the story. Now it’s up to everyone to make their own decision.
They say your condition is more prevalent in “younger users”. May i ask how old you are? Also, iam curious when you 1st started taking the drug, did you have ANY sexual side effects? was your libido, sexual function the same? I ask bc ive been on Fin for only 2 months, at only 1/2 dose, and ive actually experienced an INCREASE in libido, ejaculation strength, and volume. Oddly even a feeling of “well being” associated with the drug. Not to mention my thinning hair stopped in its tracks and grew back nearly 20% of the hair fall already…and seems to get thicker every day.
Iam cautiously optimistic but haven’t experienced any of the side effects Ive read about…although i seem to be dreaming during sleep a bit more than usual.
I guess the feeling im experiencing i would compare to maybe having low testosterone, and then boosting it…i feel better, and younger with more libido. Ive even noticed alot of my joint pain seems to be subsiding from working out. Iam 49 yrs old.
Propecia ruined my life
how lol
The fact that this poison is still being regularly prescribed undermines the legitimacy and perceived objectivity of the American medical system and the pharmaceutical industry. There have been plenty of publications that have come out over the decade that have shown 5 alpha reductase inhibitors to be dangerous, even to those who appear to respond well to them, which I’ll link at the end of this comment. I am glad that the FDA was objective enough to deny the approval of these drugs as chemo-preventative therapies – who knows how many lives would’ve been destroyed if they’d been approved for that – and that they decided to finally label the drugs with serious warnings, but it’s not enough.
The risk of full-blown Post Finasteride Syndrome, while apparently low, is not something to dismiss. Additionally, the odds of developing side effects increases with time. These drugs have been shown to chronically lower neurosteroid levels, the most significant of which being allopregnanalone, which is responsible for anxiolytic, anti-depressant, pro-sexual, and other important effects. And as it turns out, DHT isn’t useless after puberty like many people seem to claim. There is no way to screen for who is at risk for post-5ARI syndrome and who isn’t. Even if the odds are low, you’re playing with fire. And many men who don’t develop the condition will still eventually have milder side effects, like a loss of morning erections, weaker erections, lower libido, increased anxiety or depression, etc. all to save a few thousand hair follicles. How do physicians justify this? It’s one thing to prescribe it for a hyperplastic prostate (and even that’s questionable), it’s quite another to prescribe it for vanity. Any physician that considers prescribing this drug for hair loss, as far as I’m concerned, should never be allowed practice medicine again, and should be sued for malpractice and negligence. Clearly they’ve never considered “first do no harm”.
Many physicians’ ignorance of what they’re prescribing is astounding, and the denial of a very real condition when it happens is, at the very least, cruel and pathetic. This sort of science-denial is akin to climate change “skeptics” or evolution deniers. I don’t think I need to explain why this is a terrifying trait to see in a licensed physician. The science is in and has been for years now.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4064044/
https://www.sciencedirect.com/science/article/pii/S0960076017301024
https://www.researchgate.net/publication/308996540_Exploring_the_neural_mechanisms_of_finasteride_A_proteomic_analysis_in_the_nucleus_accumbens
https://www.ncbi.nlm.nih.gov/pubmed/28289563
https://link.springer.com/article/10.1007%2Fs11930-015-0061-y
There is a risk with any medication and Propecia (finasteride) is no exception. It is hard to surround the statistics on the permanent negative side effects reported here. Some say that the negative sexual side effects that are permanent are as frequent at 7000 out of the millions of men taking the drug. That is a small number, but if you are one of them, it is 100% for you. Every medication has risks and I always inform my patients of these risks and never push any medication on them. Those men with great results from taking the drug will argue with you, but everyone is empowered to make their own decisions once they know the facts.
Not every compliant about permanent sexual side effects are real. One of my patients took finasteride and reported impotence in 2 hours, before the drug peaked. Although I told him to stop the drug immediately, he refused and said he preferred impotence to hair loss. His call! Not what I would recommend.