How a baldness drug Finasteride can ruin a man's love life

To many men, it's a wonder drug that has helped halt their baldness. 

Others, however, say it has had a devastating effect on their lives, causing a range of crippling side-effects including impotence, infertility, insomnia, anxiety, depression and, in some cases, suicidal thoughts — even years after they stopped taking it.

The drug is finasteride, sold under the brand name Propecia, which is used to treat male pattern baldness. Donald Trump and Wayne Rooney are reportedly two of the millions who have used it in the hope of reversing a receding hair line or bald spot.

Globally, the market for hair loss treatments is valued at an extraordinary £5.6 billion, with male pattern baldness accounting for 90 per cent of that, and finasteride the most commonly used treatment.

And finasteride does work for male pattern baldness, improving hair growth within months, according to multiple studies. The effects last as long as the man continues to take the drug.




Worth it? Although finasteride is successful at stopping hair loss, some men say it has had a devastating effect on their lives, causing a range of crippling side-effects including impotence, infertility, insomnia, anxiety, depression and, in some cases, suicidal thoughts

In simple terms, it stops hair loss by reducing the conversion of the male hormone testosterone into dihydrotestosterone (DHT). High levels of DHT cause hair follicles on the scalp to shrink, leading to hair loss. Finasteride not only prevents this, it has also been shown to encourage regrowth.

In the UK, when it comes to treating hair loss, the drug is available on private prescription only — from doctors since 1999 and, since 2014 and with a prescription, from a pharmacist. 

It is, however, available on NHSprescription under the brand name Proscar — and at a higher dose: 5mg compared with 1mg for hair loss — to treat an enlarged prostate, a common condition that affects many men with age, causing problems with urinary flow.




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That's because reducing levels of DHT can also help shrink the prostate, stopping it pressing on the bladder and urethra.

Finasteride is, by any measure, a hugely popular drug, with more than 3.3 million prescriptions issued for prostate problems alone in England and Wales in 2017, which is double the number just ten years earlier.

But there is another side to this apparent success story — the drug's potential side-effects.

DHT influences other male characteristics and interfering with its production can lead to sexual dysfunction, including difficulties achieving an erection, reduced desire and reduced semen.




Risk: In simple terms, it stops hair loss by reducing the conversion of the male hormone testosterone into dihydrotestosterone (DHT). High levels of DHT cause hair follicles on the scalp to shrink, leading to hair loss

Less frequent problems can include infertility, testicular pain and anxiety.

And since 2017, following a ruling by the European Medicines Agency, finasteride patient information leaflets must also now carry warnings about the risk of depression and, in rare cases, suicidal thoughts.

MSD (Merck, Sharp & Dohme Limited) which manufactures Propecia, says up to only one in 100 people is affected by sexual dysfunction, although it does now acknowledge in patient information leaflets that this can persist after coming off the pills. 

In the U.S., Merck & Co has paid out more than £3 million in total to hundreds of men who have claimed side-effects have persisted after they stopped taking Propecia.

Meanwhile, growing numbers of British men say they have been affected by persistent side-effects — one of them is Ryan Clark, 52, an operations manager from North Tyneside, who says the drug has wrecked his libido and left him with reduced fertility and depression.

After taking finasteride on and off for 18 years, he says he is still plagued by side-effects, despite stopping for good two years ago.

‘I QUICKLY LOST ALL INTEREST IN SEX'

Ryan started taking finasteride after noticing a tiny bald spot on his crown. ‘I was only 31 and didn't want to go bald at such a young age,' he says. He had read about Propecia and thought it sounded like ‘a miracle cure'. Ryan's GP prescribed the drug privately and he began paying £30 a month for the daily pill.

‘In terms of treating my hair loss, the drug worked brilliantly and the gaps on my crown filled in within three months,' he says. ‘However, within weeks I lost interest in sex and my libido didn't return. I didn't connect it with finasteride as this side-effect was never mentioned.

‘Within three months, I began to feel anxious and to suffer insomnia. I'd always been confident, happy and positive, but suddenly I became withdrawn and irritable.'




Devastated: Ryan Clark, 52, an operations manager from North Tyneside, who says the drug has wrecked his libido and left him with reduced fertility and depression

Ryan, who married Lyndsey, 42, in 2010, went back to his GP