Dr. Sam Lam Reviews the Latest Information on Finasteride
Finasteride has unfortunately gotten a bad rap of late in the media due to the release of the article, “Persistent Sexual Side Effects of Finasteride for Male Pattern Hair Loss”, in the Journal of Sexual Medicine (Volume 8, Issue 6, June 2011) written by lead author, Michael S. Irwig MD.
Coming back from the 2012 Bahamas International Society of Hair Restoration Surgery (ISHRS) meeting, I sat through several hours of lectures on finasteride’s side effects and learned a lot of interesting data. First, in the study Irwig concludes that he had no definitive proof and cautioned readers to take too much information from his article, which truly in my opinion lacked rigorous scientific data. In my experience, I have had one patient out of thousands who reported persistent sexual side effects from finasteride in his 40s who lives in England. What is interesting is another statistic I learned that 40% of men in their 40s have some kind of sexual dysfunction/erectile dysfunction; and 60% of men in their 60s do; pretty easy numbers to remember. That high prevalence clearly could account for some overlap between those taking the medication and those who suffer from sexual side effects. Further, taking 0.2 mg can still reduce DHT by 51%, as compared with 68% for those who take the 1 mg and 5 m doses. Accordingly, I have seen in men who reduce their dose by half or who take it every other day that they still get very good effects on their hair but with elimination of the sexual side effects. Another interesting report is that men who knew that finasteride could cause sexual side effects had a four time higher likelihood of experiencing the problem than those men who did not know about it. Another interesting statistic is that a large number of men who took the placebo also experienced sexual side effects. This is known as the nocebo effect when someone believes they will experience a problem, and then they do. Do permanent sexual side effects occur with finasteride? Obviously, the jury is still out on this one but the media tends to portray things with a heavy bias and it is worth evaluating the truth behind the hype and at least portray the other side of the media hysteria on the subject.