Finasteride for hair loss and loss of libido and ED

Resolved question:
I have been taking finesteride (a generic version of Propecia) for the past three years to combat my hair loss. I have only recently become aware of the serious potential sexual side effects of this drug, and would like to stop taking it. However, I don't know whether I should just stop taking it, or go off it gradually, or something else.

I am currently working in Ukraine for a few months. My supply of finesteride ran out about 3 weeks ago, and I went to the pharmacy to buy more. They had the same 5 mg tablets (which I break into quarters) that I've been taking the whole 3 years, but they only had a generic brand from Europe. I bought it, but did some online research to determine if the brand was reliable. Instead, I found out that the FDA had recently updated the warning on finesteride to include potential long-term adverse sexual effects, and found numerous accounts of men who have experienced severe loss of libido and erectile dysfunction as a result of the drug.

In the few weeks since reading that, I have continued taking the drug, but have experienced a distinct drop in libido and sexual functioning. I want to believe that this change is purely psychological, as I never experienced any such problems in my life until I read these articles, but I honestly don't know. Also, there are many accounts of men stopping the drug cold turkey, and subsequently experiencing a “crash” of ruined libido and other problems.

I would like to get off this medicine and accept any resultant hair loss as a fair trade for keeping my sexual functioning intact (if it isn't too late already). So should I just quit the drug cold turkey? Should I take any vitamin supplements or anything else during the transition period?

Submitted: 4 Days
Category: Family Physician-GP

Expert:  Dr. Jaydeep Tripathy replied 4 Days.

Hello,

Thank you for asking your query at DoctorSpring.

First of all let me warn you about one thing. The internet is full of propagandas, false, misguiding information regarding Finasteride side effects. I am not saying Finasteride is without side effects or siding with anyone, but it is blown out of proportion to cause paranoia. This could be part of side effects / claims support for medico legal reasons.

It’s good that you have decided to stop Finasteride. Even though FDA approved for hairloss, I personally would not recommend this medication for hair loss. There is no solid evidence based medical recommendation that the medication needs to be tapered off and stopped, so I would suggest you can stop it just like that. I recommend getting in touch with your Doctor as I have legal limitations in ordering, modifying or terminating a prescription as this is an online consultation. Even if your decide to taper it over a couple of weeks, that’s just fine. (However it might be difficult since you are using split 5mg tablets.)

The loss of libido you have experiences is seems to be psychological indeed. Only less than 3-4% of individuals complain loss of libido as side effect of long term Finasteride . And even among the vast majority will regain the sexual function in few weeks to months. (reversible) As you might be aware, hormone production is a dynamic process and the body will keep on producing the hormones. The Finasteride effect will disappear when it is withdrawn.
So it is very less likely that you will have any adverse effects from discontinuing Finasteride. You may lose some hair , as you already might be knowing that the hair gain gets reversed.

Hope this helps
Please feel free to ask followup questions.
Thank you

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