Reader Warning About Switching from Propecia to Avodart

Dear Dr. Rassman,

This is a story, not a question, but I thought you might want to put it on your site because you often talk about the unproven effects of Avodart and why you don’t prescribe it. I had a very bad experience with Avodart and wanted to put it out there where people would be able to read about it.

I took Propecia for 3 years, then switched to Avodart (at my doctor’s suggestion) because I was still experiencing some hair loss (possibly due to stress at the time). I took Avodart for about 6 months, but I developed almost total impotence during that period. I told my doctor that I wanted to go off Avodart entirely, but instead he prescribed Viagra and told me to just switch to a 1/2 dosage as “I would lose a lot of hair if I switched back to Propecia from Avodart.” However, I was still experiencing impotence after 4 months on a 1/2 dose of Avodart, though, so at this time I became so frustrated that I ignored my doctor’s advice, stopped seeing that doctor, and switched to Propecia.

Over the next 8 months I lost a *lot* of hair — substantially more than I’d ever lost before. I don’t know for sure, but I assume that it was because of the increased testosterone flowing in my body in reaction to the Avodart, and the Propecia being unable to counteract it. My sexual function has been restored, though.

Obviously I probably acted rashly and made a mistake ignoring my doctor’s advice about quitting Avodart, but I feel that Avodart put me in an unbearable Catch-22 situation: either endure partial impotence for the rest of my life (or pay for Viagra, which I felt I shouldn’t be taking as a 32-year-old man), or switch off Avodart and lose a lot of hair. I realize that many people take Avodart without any side effects, but it was a really depressing situation to be “one of the 5%.” I’d advise anyone out there who is considering Avodart to think twice and be ready for potentially devastating side effects.

Thank you for sharing your story. Sex vs hair… it’s a tough choice for some men!

Granted, many men that take Avodart (dutasteride) likely won’t see the severe effects like you saw, but until the medication and its risks are fully studied I can do not advocate the use of Avodart in my practice. It’s hard enough the dispel the distrust of Propecia’s side effects, and that is a medication with known side effect risks.