Propecia is a treatment for hair loss in men. It contains the active ingredient finasteride, which works by inhibiting 5-alpha-reductase enzyme and prevents testosterone converting into dihydrotestosterone (DHT). It's an effective treatment for male pattern baldness; a condition that affects the mid scalp area and across the vertex that results in a bald patch at the top of the head or a receding hairline.

Propecia can lower the DHT levels in the scalp by as much as 60% when used daily, and it has been reported in clinical trials to stop the progression of hair loss in 86% of men, with 65% of trial participants experiencing what was considered considerable hair growth.

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Propecia

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  • Even encourages regrowth
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Known side effects

Propecia has limited side effects. In fact, initial trials show that more participants stopped taking the placebo sugar pill (1.6%) due to "side effects" than taking Propecia (1.4%). But, as with many medications, it is possible to experience side effects when taking Propecia. Some known side effects of taking finasteride include:

  • Headaches, dizziness or weakness
  • Light-headedness when standing up
  • Swelling in your hands or feet
  • Breast tenderness or swelling
  • Running nose or sneezing
  • Skin rash, itching or redness
  • Chills or cold sweats
  • Unusual weight gain or weight loss
  • Abdominal or back pain

Side effects impacting on sexual function

Propecia, or finasteride, can also impair sexual function. However, the initial clinical trials showed this increased risk to be relatively small, with 36 out of 945 men reporting adverse sexual side effects while taking Propecia (3.8 %), versus 20 out of 924 (2.1%) who were taking a placebo.

This can be experienced even after you've stopped taking it and includes side effects such as:

  • Impotence or erectile dysfunction
  • Decreased libido and sex drive
  • Problems ejaculating
  • Reduced volume of semen when ejaculating

Rare side effects

It is also possible to experience some rarer side effects when using the medication

  • Allergic reactions to Propecia

As with many medications, it is also possible to have an allergic reaction to one of the ingredients contained in Propecia. Signs of an allergic reaction include swelling of the face, throat or tongue, hives or difficulty breathing.

Propecia and cancer

Another form of finasteride is used as a treatment for a condition where the prostate becomes enlarged, known as benign prostate hyperplasia (BPH), therefore it can also increase the risk of developing high-grade prostate cancer. Use of Propecia may also affect the results of prostate specific antigen (PSA) tests, which are a key screening marker for prostate cancer.

In 2009 the UK Government issued a drug safety update, having reviewed the increased risk of breast cancer with Propecia. 50 cases of breast cancer worldwide had been reported and associated with men taking the 5mg dosage, three cases worldwide for those taking the 1mg tablet. No definitive link was found, but it also concluded that it couldn't be ruled out that there was an increased risk.

Other risks

Propecia is only prescribed for men. Women and children should not only avoid consuming it, but they should also avoid handling the tablets, especially pregnant women. Finasteride can be absorbed through the skin and can cause birth defects if pregnant women are exposed to it, including abnormalities of the external genitalia in a male foetus.

For men taking Propecia trace amounts of the finasteride have been detected in their seminal fluid – 0.001% per ejaculation for men on the 1mg dosage. Studies on Rhesus monkeys have been carried out, and so far there is no research to suggest these levels provide any risk to a developing male foetus. Any long term impact on fertility is not yet known, but there is no evidence currently to suggest that it has any negative impact.

How to prevent the risk of side effects

During your consultation process it is important to fully disclose your medical history so your doctor can assess whether Propecia is a suitable treatment for you, or if something in your medical history would put you at a higher risk of experiencing side effects. In particular, you should tell your doctor if you've ever had:

  • Abnormal liver enzymes or liver disease
  • Any bladder or urination problems
  • If you've had an allergic reaction to similar medication known as Avodart or dutasteride.

Dealing with Propecia side effects

There is a protective film around the tablets that should protect women who do come in contact with it from absorbing finasteride. However, if a pregnant woman accidently comes in contact with a broken or crushed tablet, they should wash their hands with warm soapy water immediately after handling.

It is recommended that men contact their doctor if they notice any changes in their breasts including lumps, pain or discharge. Most other side effects are minor, but if you have any symptoms you are concerned about you should speak to your doctor immediately. If you notice any signs of an allergic reaction such as swelling of the throat or face you should seek emergency medical attention.