Finasteride (aka Propecia) and its side effects – is it just chitchat…? (Words from a Hair Loss Expert)

Searching the enormous World Wide Web (Google, Bing, Yahoo and other search engines), you’ll probably quickly realize that there has been a lot of negative chatter on hair loss forums discussing Finasteride and the risk of adverse effects…

Reports of persistent sexual side effects have come from a variety of sources with some internet sites attracting individuals claiming to have sexual and psychological issues related to finasteride!

At this point, please don’t get too anxious…. 😨

I mean it…

and I’ll get back to that in just a minute… 😊

Well, first of all, you should be very cautious getting your main info from forums like that,,,

And secondly, a lot of the info provided on discussion forums is more likely to be based on opinions rather than real facts backed up by medical research… 😉

So… Here is why you should not worry too much about potential side effects of oral Finasteride…

  • Millions of patients have benefitted from finasteride with no side effects at all, or minimal and reversible side effects…
  • There are very few effective alternatives to the drug on hair loss.
  • Finasteride is probably the best available drug to treat male baldness and one of few drugs to address the root of the problem.
  • Its effects are proven, and the drug is FDA-approved.
  • Several studies have shown its safety over long duration of administration. The dosage given (1 mg) is small.
  • Sexual side effects are reported in less than 2% of patients (source), and these side effects disappear not only in all men who stop the drug because of side effects but also in most of those who continue the therapy.

Let’s ask the Task Force on Finasteride Adverse Event Controversies

In view of the conflicting and continuing data and importance of the subject, the International Society of Hair Restoration Surgery (ISHRS) established a Task Force on Finasteride Adverse Event Controversies to evaluate published data and make recommendations.

The taskforce posted their update on the subject as follows:

“To date, there is no evidence-based data substantiating the link between finasteride and persistent sexual side effects in the numerous double blinded, placebo-controlled studies using finasteride 1 mg for hair loss…” (source).

So, in other words… science does not support a correlation between finasteride and persistent sexual side effects!

But the question remains… why do some men claim to experience persistent sexual side effects even after ceasing their finasteride treatment?? 🤔

Well, that’s a very good question… 😊

Could the explanation be placebo…?

Certainly, placebo have been shown in several studies to affect results… By the way, it’s very interesting to dick deeper into the current literature concerning side effects and placebo…

Placebo (or nocebo to be exact) is basically when the “negative expectations of the patient regarding a treatment cause the treatment to have a more negative effect than it otherwise would have had” (source).

Let’s take an example … 😊

In the study described below, scientists investigated atenolol which is a kind of drug called beta-blockers frequently administrated to patients with cardiovascular diseases (i.e. heart disease and high blood pressure).

In terms of side effects, patients with cardiovascular diseases often complain of erectile dysfunction, especially when treated with beta-blockers!

In order to assess whether the effect of beta-blockers on erectile dysfunction was in part related to patient knowledge of the drug side effects, the scientists included 96 men in the study…

These men were all newly diagnosed with cardiovascular disease and did not suffer from erectile dysfunction when they entered the study.

During the study, patients received atenolol 50 mg daily.

To asses the effect of patient knowledge of the drug side effects, 32 patients were blinded on the drug given (group A), 32 were informed on the drug given but not on its side effects (group B) and 32 took A after being informed on its side effects on erectile function (group C).

And here comes the interesting part… 😊

After 3 months the incidence of erectile dysfunction was 3.1% in group A, 15.6% in group B and 31.2% in group C…!!! (source)

Wow!! A staggering 31.2% of patients who were informed on the drug’s side effects on erectile function experienced erectile dysfunction. That is massive… In comparison, only 3.1% of the patients who were not informed on the side effects experienced erectile dysfunction.

In other words, knowing about the side effects made the incidence of erectile dysfunction skyrocket… 🚀

Likewise, the placebo effect plays a role when it comes to sexually related side effects of finasteride (source)…

But again, I really have to stress the important fact that millions of men suffering from hair loss have benefitted from finasteride with no side effects at all or minimal and reversible side effects…

The conclusion (oral Finasteride)…

Basically, when it comes to finasteride, the effect of finasteride on sexual functioning is minimal for most men and should not impact the decision to take finasteride.

However, if you still worry a lot about the risk of sexual side effects, I’d strongly suggest that you go for topicals instead such as topical Finasteride or the more potent topical Dutasteride … there are no risk of sexually related side effects whatsoever when applying topicals to the scalp 😊

Both topical Finasteride, as well as topical Dutasteride, can be combined with other ingredients such as Minoxidil to increase the effectiveness on hair growth…

If you’d like to try out either topical Finasteride or topical Dutasteride, please go to our online shop to learn more about the individual products 😉…

By the way…If you want to get a complete overview of finasteride and other hair loss therapies, you should consider to read the article: Hair Loss Treatments that Work – the Complete Guide… 😊

…This will expand your knowledge about hair loss treatments and give you the best tools to make the right choice for you 😉


What I’ve written in this article is just the beginning of your path to regrowing your hair.

Please leave a comment below if you have any kind of question you would like me to answer.


Best regards,

Dr. Knap, MD, Hair Loss Expert


Last Updated On April 13th, 2019

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Dr. Knap, Hair Loss Expert

Dr. Knap is one of the very few absolute experts in the field of hair loss treatment. His medical background and subspecialization in hair loss in both men and women make him a valuable team member in our clinic.