Propecia (finasteride) and Rogaine are, as you know, and have known for the last 13 plus years, the only “FDA approved” treatments for hair loss. Propecia was approved in 1998, and is a 1 mg version of the 5 mg prostate drug, Proscar which came out in 1992. Since Proscar’s and subsequently Propecia’s arrival in 1998 there has been much misconception and confusion about its purported efficacy and side effects, ranging from 1 dose permanently destroying your mood, libido and sexual function to it being a completely side effect free, easy to take pill that is a permanent cure for baldness. To confuse the matter further it has been found that the majority of the studies conducted assessing its safety and efficacy have been industry sponsored. Here we will objectively evaluate finasteride, its efficacy and side effect profile for hair loss in an unbiased manner, and review some actual health promoting alternatives that share the same mechanism of action.

My Personal Experience
      I personally used finasteride when it came out in ’92 at the full 5 mg dose, and I will tell you my hair significantly improved to the point of ameliorating my hair loss issue after several years. I was simultaneously using many other compounds personally recommended to me by Durk Pearson (author of Life Extension, a Practical Scientific Approach) including Saw Palmetto/Pygeum, Taurine, Cysteine, and loads of other anti-oxidants, and integrated a plethora of others as the years went on. My extensive approach notwithstanding, I likely have to give some credit for my astounding hair loss reversal to Proscar (which I eventually cut into ¼’s after ’98). Several years into my Proscar use, reports , both anecdotal and published, began to appear regarding its side effects. After careful consideration and concern about its estrogenic side effects in men, I dropped finasteride from my regime in 2004, after 12 years.

      Subsequent to dropping it, I have had no detectable increase in shedding, which had already become minimal to non-existent. My hair if anything has slightly improved. This is likely due to the presence of other, more effective, (perhaps in their totality), interventions that address not only as finasteride does, the lowering of DHT, but multiple other mechanisms as well. 

      Had you asked me while I was using finasteride if I had experienced any side effects, I would have very matter of factly told you “no”. After dropping it though, I felt in a generally better mood, slept much better and my libido went soaring through the roof. My body fat, which was already on the low side, dropped even more. Evidently it was having side effects that over the years that were below the radar screen of my awareness. Recent published studies pertaining to finasteride side effects regarding mood help me put my experience into physiological perspective. In fairness to Proscar/finasteride, I feel it did play a pivotal role in helping me reverse the progression of MPB at a very critical treatment juncture for me in the early 90’s, when treatment options were much more limited, and is a fairly effective, stand alone treatment. It is our contention though, that subsequent worldwide research into the varied mechanisms and interventions for MPB have made its inclusion for an effective treatment regime no longer necessitated. 

Propecia Pros

Effective in the vast majority of users.

Stabilizes further hair loss in most.

Regrowth, to some degree, in slightly more than half who use it.

Ultra convenient to use.

Almost cost negligible , if one obtains generic Proscar and quarters the tablets; less than $5.00 US/month.

Readily and legally available without prescription from multiple legitimate and reliable foreign sources.

By far the most effective FDA “approved” hair loss treatment.

Contrary to prior company reports, has been shown to be effective in women, as evidenced by several published studies.

Raises cutaneous levels of IGF-1

Propecia Cons

Substantial time needed to see stabilization/regrowth results ie 6-9 months plus.

Expensive if you buy brand name Propecia in US, average $65.00 US a month.

Reduction in libido in a several physician estimated 30% of users (forget what’s in the PDR- i.e. less than “2%”).

Reported erectile dysfunction.

Gynocomastia, (male breast enlagement) reported as a side effect in PDR-we hear A LOT of this one from clients emailing and calling in.

Reported body fat accumulation –makes sense given its effects on estrogen.

Depression-due to its documented damaging effects on the neurosteroid, Pregnenolone. Now an officially documented side effect in the Physicians Desk Reference (PDR).

Reduced Cognitive Function- due to same effects on Pregnenolone.

Possibility , though not documented yet, of long term side effects.

Significantly less effective in those over 26 years old, according to 1 study.

Considered by some Physicians to be too dangerous to prescribe.

Upregulates expression of Androgen receptor activity.

      After reading the “cons” you may be asking why anyone in their right mind would get near this stuff. The fact is, based upon years of feedback we have received, is that slightly over half the users report zero side effects. Keep in mind my experience, though, that I didn’t “notice” any side effects while on it – just a dramatic improvement for the better when I went off of it.

Propecia Alternatives

      The mechanism of finasteride in regards to hair growth is that it drops serum DHT by approximately 70%. Fortunately there are several other ways to lower serum DHT, in ways that confer anti-aging benefits, and that are side effect free.

Black Tea (Theaflavin) Extract- lowers serum DHT by 72% in mammal models. Proscar, 5 mg finasteride, lowers DHT by 71%.

Soy Isoflavone/Green Tea combo- lowers serum DHT by 80% in animal models.

Progesterone Cream-inhibits 5 alpha reductase (5AR) far more effectively than finasteride.

Coconut Oil- consumed in high doses, strongly inhibits 5AR due in part to its lauric acid content.

Soy Isoflavones-lowers serum DHT.

Soy Isoflavone/Cayenne combo-like Propecia, increases cutaneous IGF-1.

Flax Lignans-inhibit 5AR.

Curcumin-Inhibits both 5AR type 1 and 2, documented hair growth effect with Resveratrol.

      When I dropped finasteride in 2004, I was using all of the above alternative compounds , with the exception of Theaflavin extract, which was not yet commercially available. As mentioned, stopping finasteride has not cost me a single strand of hair. 

      If you use Propecia, it would be prudent, based upon some recent findings that finasteride up-regulates Androgen receptor activity, to concurrently use an androgen receptor blocker, such as critical extracts of Beta Sitosterol and Saw Palmetto (Ultra Natural Prostate Formula). Concurrently addressing this mechanism will likely enhance any obtained benefit.