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How to reduce the side effects of finasteride

Aysha

Medically reviewed on October 16, 2019

by Dr. Aysha Butt, Medical director

Dr. Aysha Butt is the Medical Director of FromMars, and is a GP Partner at Woodcote NHS Medical Practice.... read more

Your thought process might go a bit like this. Stop your hair thinning. Keep your locks. Get more sex.

In reality, life isn’t always that simple. Less hair doesn’t mean less sex. You’ll probably find that there’s a real market for guys with very short cropped hair and shaved heads. Just look at The Rock or Jason Statham.

But if you’re set on doing something about it, you’ll be pleased to know that male pattern baldness is no longer the curse it once was. There are treatments available today that can stop it, like finasteride, which is also known by the brand name Propecia.

What you might not know is that finasteride can have side effects. And these can include messing with your erections and reducing your sex drive. But that doesn’t happen to everyone.

What is male pattern baldness?

Male pattern baldness (MPB) is a condition which causes men to lose hair on their head. It’s the most common cause of baldness in men, with around 50% of us developing it by age 50.

Hair loss usually follows a pattern, hence the name, with hair receding at the front and thinning at the top of the head first. Less hair is lost at the sides, and as the balding gets worse, it usually results in a a hairless head but with some hair remaining at the sides.

What does finasteride do to the body?

Finasteride, sometimes sold under the brand name Propecia, is a treatment for MPB. It’s taken as a pill, and it works by reducing the amount of male hormone DHT in the scalp which causes the hair to thin and recede. It’s one of the few treatments for MPB that actually works. Finasteride stops hair loss in around 80% of men, and around 66% see their hair returning and thickening.

Does finasteride have side effects?

Just like all medications, finasteride can have side effects. Not every man will get them, and those that do can get different ones at different strengths. It depends on how your body reacts to the meds and how much you take.

Finasteride is considered a safe medication for most men though. The good news is that it’s gone through extensive clinical trials, it’s approved by healthcare agencies all over the world, and in reality there are only a few finasteride side effects. The bad news is that some men do experience them. These were the side effects found in clinical trials:

Sexual side effects of finasteride

The most common side effects of finasteride were sexual. In trials, they’re experienced by around 1 in 100 men (1% of men) when 1 mg tablets were taken daily, and by around 1 in 10 men (10% of men) when 5 mg tablets were taken. They include:

  • Erectile dysfunction (not being able to get or maintain an erection)
  • Reduced sex drive (less desire to have sex)
  • A reduction in the amount of semen produced at ejaculation

Non-sexual side effects of finasteride

Very few other side effects were found in clinical trials for finasteride, however some men experienced rashes, and others felt tenderness and swelling in their chests.

A very small number of men experienced depression when they took finasteride. If you take finasteride and you start to feel depressed you should stop taking it and contact your doctor.

Why does finasteride cause these sexual side effects in some men?

Male pattern baldness is caused by the presence of a male hormone in the scalp called dihydrotestosterone (DHT), which is made from testosterone. Finasteride reduces the amount of DHT, but it can cause more testosterone to be converted to a hormone called estradiol. Estradiol is a female sex hormone which can cause sexual problems in some men.

Do finasteride side effects go away?

If you take finasteride and you do get some of the sexual side effects, don’t worry, you have options. Try some of the following:

Keep taking finasteride and wait

For some men, these sexual side effects reduce over time when they keep taking finasteride, even if they don’t change their dose. Research found that the sexual side effects were often felt for around one year, and then they declined and disappeared over the next two to four years. So patience may be all it takes for some men.

Reduce the dose of finasteride taken

The sexual side effects of finasteride become less common if the dose is reduced. You should talk to our doctors if you are considering changing the dose you take. They may suggest that you keep taking finasteride daily but at a lower strength pill, or they may tell you to take it less often than every day. Your side effects may vanish, and you may still be able to stop and reverse your hair loss at this lower dose.

Try erectile dysfunction medication

Erectile dysfunction medication, like sildenafil (Viagra), tadalafil (Cialis) and vardenafil (Levitra) can help many men overcome problems getting and maintaining an erection. You can order ED meds at FROM MARS if approved by our doctors following an online consultation.

Live a healthier life

Research shows that being fit, healthy, and eating a balanced diet can help improve erections and boost sex drive.

Keeping your weight down, getting regular exercise, eating foods high in vitamins and minerals, cutting back on alcohol, and giving up smoking can all help counter the side effects of finasteride. Learning more about lifestyle changes and the types of healthy foods that can help with your erections can also be beneficial. 

Can you just stop taking finasteride?

If the above advice doesn't work, and you still experience sexual side effects, then you may have to embrace baldness and go all out Statham. For most men, all sexual side effects disappear when they stop taking finasteride. Make sure you talk to our doctors before stopping.

In a nutshell

The truth is that finasteride is one of the few effective treatments for hair loss and that its side effects are uncommon. The chances are you won’t experience any sexual side effects, with only between 1% to 10% of men doing so, even at high doses. And even if you do experience sexual side effects, there are things you can do to counter them. If your hair starts to thin, you’re not facing a choice between a full head or a rewarding sex life. You can have both.