So, what’s the real deal with finasteride?
While many men take finasteride to fight male pattern baldness, there’s also a certain stigma attached to it – namely, it can cause some unwanted side effects. How to reduce the effects of finasteride, which we’ll cover in this post, is a big deal.
After all, among those side effects is erectile dysfunction, i.e., once you start taking finasteride, your love muscle will become as limp as an overcooked spaghetti noodle.
No man wants that, right?
But there’s a lot of myth surrounding finasteride and its not-so-pleasant effects. Yes, you may find – finally – a solution for your male pattern baldness – but it’s going to come at a cost. On the other hand, how true are the “horror” stories, i.e., the stories of men at full limp in the bedroom when a more erect tool is needed?
We hope to dispel some of the finasteride myths, or at least ease your anxiety about using it to treat your thinning hair, but we’ll also discuss the very real, potential side effects that may or may not occur.
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How common are finasteride’s side effects?
The list of finasteride’s potential side effects isn’t particularly alarming if you eliminate the sexual side of things. Finasteride users may experience headaches, slight swelling in the hands and feet, a runny nose, or even some dizziness.
Then again, many medications have similar side effects, and, well, possibly putting up with a slightly runny nose seems like a fair trade-off for a revitalized head of hair that’s no longer fighting a losing battle against the dreaded MPB.
But the Big 3 of finasteride’s side effects – erectile dysfunction, a lowered libido, and ejaculatory disorders – are enough to send some men into a panic.
Keep in mind that finasteride isn’t just used to treat hair loss but also to treat an enlarged prostate – or, more specifically, benign prostatic hyperplasia (BPH). Men who suffer from BPH have difficulty urinating and often need to pee multiple times during the night.
Finasteride helps decrease BPH symptoms while reducing the chances of needing to have prostate surgery. So, considering that finasteride resolves issues associated with a man’s “parts,” it’s not surprising that it can cause some other problems down there.
But back to the original question: how common are finasteride’s side effects?
The best answer is that the side effects, particularly those involving erections and libido, aren’t that common at all. There’s plenty of science to back up that conclusion, including a 2012 study that sexual side effects such as ED and decreased libido occurred in less than 2% of all men taking the drug.
That same study referred to previous studies that “showed that the incidence of these side effects with finasteride therapy was generally comparable to that observed with the treatment of a placebo.”
Here’s the other thing: the typical dose of finasteride used to treat hair loss (1 mg) is small enough that side effects are far less likely to happen than many men believe.
Finasteride: Just the Facts
Finasteride fights hair loss by reducing the action of the enzyme called 5-alpha-reductase, which converts testosterone into dihydrotestosterone (DHT). DHT is widely believed to cause hair loss in some men. While finasteride can increase the number of scalp hair, it won’t increase the amount of hair on your body.
Finasteride does increase estrogen levels in males by up to 15%, which contributes to a potential lowered libido and ED.
The Hype Machine and How Myths Evolve
Finasteride’s side effects came under public scrutiny over 20 years ago as it continued to help many, many men deal with their thinning hair and MPB. While it’s no surprise that publicity about a drug that may negatively impact a man’s sex life can set off a cacophony of alarms, the media and other sources seemed to overlook one simple fact: those side effects aren’t very widespread.
Instead, the word finasteride (or Propecia, as it’s commonly known) suddenly became the Libido Killing Drug that could force many sexually-active men to the sidelines. Sure, they might develop a beautiful head of hair, but problems in the bedroom left them a bit limp.
Let’s not forget the psychological effects, either. Just the thought of taking a drug that could mess with their erection was enough for some men to, well, not get an erection. In other words, give them a placebo that they think is finasteride, and they may mind-screw themselves into not getting it up. Hell, it happens.
As one doctor put it, “…when they did all the trials before this subject was tainted by the media or medical-legal incentives – the problem of side effects didn’t exist. There were transient side effects, but even the percentage of these transient side effects was small.”
The bottom line is that you shouldn’t believe everything you read or hear. That’s not to say there isn’t a possibility of side effects when taking finasteride, but evidence suggests that the chances of experiencing them are right around slim-to-none.
How long do Propecia side effects last after stopping?
First, finasteride is only effective as long as you’re taking it. Once you stop taking it, the amount of medication in your body slowly declines, until it’s completely gone with several days.
Without finasteride in your body, there’s no blocking the 5-alpha-reductase enzyme which, in turn, means that your body will again convert a small amount of testosterone into DHT and cause thinning of the hair on your scalp. If your long-term goal is to prevent hair loss, however, you’ll probably need to take it for years.
If you’re worried about finasteride side effects after stopping its use, the data is a bit mixed. For most men, Propecia’s side effects cease once they stopping take it – including ED and libido side effects. Moreover, side effects sometimes subside as treatment continues and the body adjusts to the medication.
But there is some evidence that there’s a small risk of Propecia’s sexual side effects continuing after the patient stops taking it. In 2012, the FDA changed the labeling on Propecia to say that adverse reactions like ED and libido disorders may continue after the treatment has ended.
While it’s not fully understood whether finasteride can lead to permanent sexual side effects, there seems to be a very minimal chance that it could happen. Physicians, meanwhile, are encouraged to inform patients about the potential for long-term consequences.
What Are Some Other Finasteride Side Effects?
As mentioned, you may experience some other side effects while taking finasteride, such as dizziness or lightheadedness when getting up from a sitting or lying position, cold sweats, and chills. Less common side effects – besides ED and libido issues – may include itchy skin, bloating or swelling of the face, arms, hands, lower legs and feet, hives, tingling of the hands or feet, or even unusual weight gain and loss.
The key phrase here is “may experience,” because most Propecia users experience few, if any, side effects, while a very small percentage of men (under 2%, as mentioned) experience sexual side effects. And the side effects may go away as your body adjusts to the medication. Consult your doctor if you should experience side effects of any kind, however.
How to reduce side effects of finasteride using these 7 methods
1. Decreasing Estrogen (Estradiol)
First things, first: the level of estrogen in a man’s body increases by as much as 15% when taking Propecia, and an increase of estrogen can mean a decrease in your libido. It also can increase a man’s chances for developing gynecomastia – which is an abnormal enlargement of the breasts (think man boobs, but not the kind caused by excess weight and a flabby chest).
When we eliminate DHT in our bodies, estrogen becomes more potent, creating hormonal imbalances which lead to erectile dysfunction, dry skin, weight gain, and even depression.
On the flip side, however, decreasing estrogen too much can have detrimental effects. The good news is that there are natural ways to reduce estrogen levels without going overboard:
- Aromatase and Aromatase Inhibitors
Aromatase is the enzyme responsible for synthesizing estrogen. Aromatase inhibitors are drugs used to treat gynecomastia in men, as well as ovarian and breast cancer in postmenopausal women, and these work by preventing testosterone from converting to estradiol.
More good news: there are many natural sources of aromatase inhibitors, including:
- Cruciferous vegetables – Examples of cruciferous vegetables include broccoli, Brussel sprouts, bok choy, cabbage, cauliflower, garden cress, kale, and other similar green, leafy vegetables. Cruciferous vegetables contain Diindolylmethane (DIM), a compound that regulates estradiol.
- Zinc – Zinc plays several roles in the body’s functioning, including that it allows the body to create testosterone, helps support immune function, and aids in protein production. High doses of zinc are used as an aromatase inhibitor, and it’s also an aphrodisiac.
- Grapeseed extract – Grapeseed extract has countless benefits and also serves as a potent aromatase inhibitor. It’s a derivative from whole grape seeds.
- Lose weight – You can lower your estrogen while increasing your testosterone levels by losing weight.
2. Boosting Libido, Increasing Semen Volume, and Improving Erectile Function
To summarize, the three most commonly reported Propecia side effects are lowered libido, erectile dysfunction, and ejaculatory disorders. Be aware, however, that not all of them may be caused by finasteride in every case. Men may encounter these kinds of conditions at several points in their life, and sexual dysfunction also can be the result of overuse of pornography, a stressful and unhealthy lifestyle, poor diet, and the natural effects of aging.
Fortunately, there are many ways to improve sexual disorders naturally:
- Exercise & stress relief – Proper fitness, cardiovascular health, playing sports, and Kegel exercises can significantly boost your sexual health. Most of us also are aware of the negative impact excess stress has on our lives, including on our sexual performance. Walking, taking time off, meditation – all are great ways to relieve stress. Simple relaxation can make all the difference.
- Male libido supplements – Supplements such as ginseng, maca, Muira puama, and tribulis terristris help to improve your libido and have scientific evidence to back them up.
Among other common testosterone boosters is vitamin D. There’s a strong link between vitamin D deficiency and low testosterone levels, as well with low sperm quality. An easy way to get more vitamin D is through increased sun exposure because it’s a fat-soluble vitamin that’s produced in the skin when exposed to sunlight.
- Ginger, a common household spice, also may help boost testosterone levels, according to various studies.
- Aphrodisiac foods – Foods such as honey, bananas, chocolate, avocado, chili peppers, oysters (which are high in zinc), arugula, pomegranate, and watermelon help boost your libido and help you perform better in bed.
3. Increasing Your Nitric Oxide Levels
Consider this: nitric oxide is the basis of Viagra, that little blue pill that can raise your love life literally and figuratively. While nitric oxide can have a positive effect on your erectile function, you also can develop a tolerance for it – and become dependent on it. Your best bet, especially when you’re young, is to raise your nitric levels naturally in the following ways:
- Foods with high nitrate content – Spinach, beets, lettuce, arugula, dark chocolate, and carrots increase the levels of nitric oxide in your body.
- Nitric oxide supplements – Citrulline, a top supplement for erectile function, is an excellent nitric oxide supplement, while other supplements include vitamin C, CoQ10, Ginseng, and Pycnogenol – which all help to increase or preserve the levels of nitric oxide in your system.
- Pomegranate juice – Pomegranate juice is another powerful switch-on for your erectile function, but avoid using if it if you’re taking Viagra. Why? Because you’ll get more than you bargained for – an erection that won’t go away – and you’ll have to take a hard trip to the doctor.
4. ED Pills
Viagra, Cialis, Levitra – all are erectile dysfunction medications commonly used today, and millions of men enjoy the positive effects they have on their love lives.
Sildenafil, the active ingredient in Viagra, helps you get an erection when the time is right and should be taken approximately one hour before sexual activity (you’ll start to notice results within 30 to 60 minutes after taking it).
For Hims, a San Francisco-based company devoted to men’s wellness, offers a Sildenafil pill that helps you get it up and keep it up when things move to the bedroom, or wherever else the mood may strike.
5. Reduce the Dose
It only makes sense: lower the dose of a medication, including finasteride, and you decrease the chances of side effects. Some finasteride users say that lowering their dose from 1 mg to 0.2 mg reduced or eliminated the drug’s side effects.
But it’s not only finasteride users who say that lowering the dose lessens the side effects; the National Center for Biotechnology Information confirms that dropping down to a 0.2 mg dose reduces or eliminates side effects while remaining useful for fighting male pattern baldness. Additional studies show that a 0.2 mg dose is about 80% as effective for treating hair loss as 1 mg.
Even lowering the dose to 0.5 mg reduces your chances of experiencing finasteride side effects. DHT is still inhibited at the 0.5 doses, although not as effectively as 1 mg.
6. Reducing How Often You Take It
The recommended dosage for finasteride is 1 mg tablet per day, but some studies show that taking the same dose every other day has similar effectiveness for treating hair loss. While the research is limited, taking finasteride every other day may reduce side effects.
7. Using Topical Finasteride
Finasteride also is available in a topical form, and studies show that it’s effective in fighting MPB and decreases the likelihood of experiencing side effects. While finasteride may still find its way to your bloodstream with the topical version, it’s a lesser amount, which leads to reduced side effects.
The bad news? Topical finasteride isn’t available in the United States.
But wait … is more help on the way?
Propecia is just one of several options available for fighting hair loss, but it’s similar to the others in that it treats the symptoms of hair loss and requires ongoing use for it to remain effective, but it’s not as if scientists are sitting on their behinds on the sidelines.
Researchers continue to target the causes of hair loss, which may eventually lead to hair loss treatments that yield few if any, side effects. Scientists at the University of Texas identified a protein called KROX20 that instructs cells on the skin to become hair. The hair cells then produce a protein called stem cell factor (SCF) that plays a crucial role in hair pigmentation.
Dr. Lu Le, an associate professor of dermatology at UT’s Southwestern Medical Center, said, “With this knowledge, we hope in the future to create a topical compound or to safely deliver the necessary gene to hair follicles to correct these cosmetic problems.”
Meanwhile, a study at the University of Edinburgh in the United Kingdom discovered 287 genetic regions that play a part in male pattern baldness. Interestingly, many of the genetic signals came from the X chromosome, which men inherit from their mothers.
The University of Edinburgh research could not only help predict a male’s likelihood of experiencing excessive hair loss but also help in the development of new drugs to treat baldness.
Other ongoing research includes examining the role of faulty immune cells in the development of alopecia areata, a different kind of hair loss.
Many men who suffer from male pattern baldness seek ways to stop its progression while promoting healthy hair growth. Finasteride is one tool they can use but may come with side effects, albeit not for every man. Take heart if you’re concerned about taking finasteride because of potential side effects, however, because there are ways to lessen or even prevent those effects from happening.
Also, keep in mind that issues such as lower libido and erectile dysfunction may not be Propecia side effects at all but related to other physical and psychological problems.
Do you take finasteride? If so, have you experienced any side effects? As always, we’d leave to hear from you.