If It’s Not 30-40%, What’s Your Patient Percentages for Finasteride Side Effects?

Hi Dr. Rassman,

I just wanted to congratulate you on your site. As always, it serves as a source of reliable information with little bias.

That being said, I have a question regarding a post that appeared on your site today (Oct. 1, 2008). You say “I can say with certainty that the notion of 30-40% of patients taking this drug (Finasteride) experiencing side effects is laughable. It simply is not true.”

However, you don’t comment on what you believe the actual percentage of Finasteride users have side effects? In your clinical experience (and those of your colleagues) , is it actually 2-3%? I realize that there are lots of forums that attack Propecia, and as you have pointed out, those with a complaint often shout the loudest. However, it’s stats like these (regardless if they are unsubstantiated) that make many men who are thinking about Propecia apprehensive about initiating therapy.

I’d be interested in hearing your comments on this. There are far too many sites/forums that portray Finasteride in a less than favorable light. I’m not implying that these side effects are made up, and that they don’t exist – I think you have been quite honest with readers that they do. But I think this issue needs to be settled. Are there any studies being conducted (aside from Merck) that are looking at the percentage of users that experience side effects? I currently have a decent amount of hair, and if I were to start therapy today, and just hold on to the hair I have for a few years, I would be more than happy. I know I am candidate for Propecia (through examination by a physician). However, I have been sitting with a full box of Propecia for a couple months now because I have been too worried to start treatment. My worries about potential side effects are only exacerbated by comments like these.

Please respond when you can.

Thanks!

While I am flattered, I do not believe it is up to me to settle anything. I simply give factual medical opinions to my patients and I also write such opinions on this site. The fact is that the negative sexual side effect of Propecia is about 1 to 2%. Based on my clinical experience with many patients who have been taking Propecia for many years, that statistic seems accurate. In fact, of those with side effects at all, more patients I see report higher sex drive than lower sex drive. Most have no side effects to report.

You are a man who is obviously concerned about side effects. Look at this this way — if YOU have a negative side effect, statistics should not matter to you. If you have a side effect, your statistic is 100% (all or none). That being said, the side effect is reversible and you have the option not to take it. What are you worried about?