Why are doctors still prescribing Finasteride for hair loss? Is it worth the side effects?

Question

There’s over a thousand lawsuits across the country against Merck and after digging into the pharmacology I was horrified by the side effects people experienced. I noticed after two weeks on the drug myself, my libido diminished and I felt super jumpy and anxious. While it’s proven to grow hair is it really the best choice for men with science today? I stopped taking mine and flushed it down the toilet. Thanks for your help!

Ross A. Clevens, MD, FACS · Answer

Thank you for your question. I suggest that you consult with a board certified facial plastic surgeon and consider NeoGraft Hair Restoration.  The results of our NeoGraft Hair Restoration method are extremely natural, and patients enjoy a shorter, more comfortable recovery period to hair transplant surgery. Always work with a board certified facial plastic surgeon.
Best wishes,

Robert Nettles, MD · Answer

I would recommend looking into alternative options. 
There are several known problems that exist when using Finasteride as a hair loss medication, lets take a look at each one:
Finasteride only works for a short
period of time.  It works for just a few hours a day (its half-life is 6 hours).Finasteride
 does a poor job of
actually blocking DHT production. In fact, it only blocks 1 out of 3 
types of DHT receptors. That means hair loss is
STILL taking place while you are using the medication. This combined 
with the short half life means that Propecia is about 60% effective at 
stopping DHT from thinning your hair. Finasteride
 is not customized to the
individual. Like millions of Big Pharma medications out there, the exact
 same dose of Finasteride is given to people who have different heights,
 weights and
biochemistry. This means that men who want to stop hair loss for good 
can take the recommended
dose of Finasteride every day, and experience nasty side effects for no 
good
reason! While for other's their dose may be insufficient to even reduce 
DHT by the 60% it is rated at.It
 is also worth noting that any medicine that actually can make changes 
inside your body, are required under the FDA to be available by 
prescription only. This therefore means that it is not possible for 
anything that does not require a prescription to cure or prevent hair 
loss or regrow thinning hair. Thus, a personalized medicine will be the 
best choice because instead of a "one size fits all" approach, you will 
be taking something which is truly catered to your body's needs.

The number one first step I recommend is a
 comprehensive consultation with a hair regrowth specialist who will 
perform lab tests to determine  the underlying cause of your thinning. 
Without labs, no-one can really know what your true cause is and any 
treatment will be temporary at best. From here, you can receive the best
 treatment for your case.
The treatment is out there. Good luck on your search.

Matt Tahsini, MD · Answer

Hello, thank you fo your great question. As with most medications, most people have great results while a minority have adverse side effects. Finasteride does work very well for the majority of my patients.

David Perez-Meza, MD, FISHRS · Answer

No question that Finasteride may cause some side effects in a very low percentage of patients. I prescribe the medication to my patients. It is the best oral medication for Male pattern Hair Loss and FDA approved. The other FDA approved medication with excellent results is topical Minoxidil 2 % and 5%. I will suggest you to schedule an appointment with a local hair loss specialist to review the possible hair loss treatments.

Arbella Sarkis, MD · Answer

Great question!
Not everyone experiences adverse side effects to Finasteride. Finasteride does demonstrate efficacy in regard to hair loss and has demonstrated efficacy in cases of enlarged prostate and recent clinical studies suggest it will help prevent most forms of prostate cancer. 
Thus, it appears to have its' place in conventional medicine until such time something better replaces it. Doctors attempt to strike a balance between benefit of treating the indication and side effects.       
Therefore, most doctors will prescribe and monitor patients for adverse side effects and when they occur the doctor will normally change you to something else.
Personally, Finasteride is certainly not my first go to medication for hair loss. This is demonstrated in the many times I have written on hair loss and Finasteride herein Realself. This is especially true for younger patients of childbearing years and women in general. 
Medications such as Finasteride and Minoxidil treat only the general symptoms of a problem. It is far better to accurately identify the root issues and specifically address them. Complementary Alternative Medicine and Precision Medicine as I practice, offer a wider array of solutions and produces greater efficacy with no to far fewer side effects.    
There are now many alternatives to Finasteride. For some, it may remain as easy as taking a pill a day, and for others its' a bit more complicated. Some alternatives are low cost and others are more expensive. Your individual condition is the determining factor.
There are treatments such as Bioidentical Hormone Replacement Therapy (BHRT) that not only safely provide good to great efficacy, but also improve one's overall health and wellness.
New peptides are now demonstrating good efficacy with no to far fewer side effects. Regenerative medicine techniques such as PRP (mild to moderate efficacy), PRP with cocktails of medications or biologics are demonstrating stronger efficacy than PRP alone with nearly zero side effects. 
Patient safety is always my first concern and then attempt to balance cost considerations with the budget of the patient. 
I hope I've helped answer your question.
Warmly,
Arbella Sarkis, MD

Taleb Barghouthi, MD - Account Suspended · Answer

Finasteride is a prescribed medication. This means that it should be prescribed by a qualified doctor in order to be able to follow up both the desired and any adverse effects. While many patients definitely notice the positive effects of taking, a minority could report some various adverse effects. Once these are addressed and acted on, by altering the dose, frequency or stopping the medication, those adverse effects are managed. I haven’t come across cases of post finasteride syndrome in my time prescribing it.

William Rassman, MD (retired) · Answer

I have prescribed finasteride for many years. When a patient report sexual side effects or any other side effects, I address the problem as any good doctor does. Because I am prompt with responding to my patient's needs, I have never seen a case of post finasteride syndrome as many other doctors reported recently in an article (see below)

Why are doctors still prescribing Finasteride for hair loss? Is it worth the side effects?

Answers (7)

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Dissolving finesterid 1mg tablets in topical minoxidil - Is there any complications in that or any other side effects.

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Answers (7)

More Hair Loss Treatment Questions

Dissolving finesterid 1mg tablets in topical minoxidil - Is there any complications in that or any other side effects.

Is my crown thinning at 24 y.o.? I've been using Finasteride for 4 years and Minoxidil for 1 year. (photos)

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