Does Finasteride really cause libido issues?

Absolutely, it seems it does. On April 11, 2012, the U.S. Food and Drug Administration (FDA) announced changes to the professional labels for Propecia (finasteride 1 mg) and Proscar (finasteride 5 mg) to expand the list of sexual adverse events reported to FDA as some of these events have been reported to continue after the drug is no longer being used. Something to note is that erectile dysfunction after stopping use of these drugs was added as a known event in 2011. What is most concerning is that the sexual adverse events (including both loss of libido and.or erectile dysfunction) seemed to continue in some patients after the use of Finasteride was ceased.

Proscar and Propecia both contain the active ingredient finasteride and belong to a class of prescription medicines called 5 alpha-reductase inhibitors. Proscar (finasteride 5 mg) was approved by FDA in 1992 and is indicated for the treatment of bothersome symptoms in men with benign prostatic hyperplasia (also referred to as BPH or an enlarged prostate). Proscar is also approved to reduce the risk of urinary retention or the need for surgery related to BPH. Propecia (finasteride 1 mg) was approved by FDA in 1997 for use in males only and is indicated for the treatment of male pattern hair loss. Anabolic and androgenic steroids are known to cause or increase the rate of onset of male pattern hair loss, so finasteride is used quite commonly as an ancillary medication in an anabolic steroid cycle.

For me, that is enough to deter me away from using the drug because even if the risk is small, the potential side effects could be harmful long term. Do all men experience sexual adverse events when using Propecia or Proscar? No. Only a small percentage of men using these drugs have experienced a sexual adverse event. The frequency of sexual adverse events is best obtained from controlled clinical trials. Analysis of these controlled clinical trials showed that during treatment with Propecia, 36 (3.8%) of 945 men had reported one or more adverse sexual experiences as compared to 20 (2.1%) of 934 men who did not receive Propecia (received placebo). Looking at the literature, the risk of these sexual adverse events seems low. However, what I see clinically, the rate of these sexual adverse events is much higher. We all want to preserve our precious hairstyle, but when the risk of side effects are this high, I would suggest an alternative option. In fact, I have one and it is not a prescription. Minoxidil 5% topical solution. It works. Keep in mind the best cure is prevention. To my knowledge, no medications are efficacious for most people once major hair loss has already taken place.