Propecia, Finasteride, and Proscar, which are all the same medication, have potential side effects in both women and men. While the medications are only FDA approved for men to use for male pattern baldness hair loss or prostate problems, some doctors will also prescribe them to treat genetic female hair loss (androgenetic alopecia). Since I recently started taking Propecia, I’ve delved in deeper to discover all potential side effects, and I’m slightly freaked out by what I’ve found. All medications, of course, come with risks and side effects, so Propecia is no different.
• Propecia vs Finasteride vs Proscar
I use these medication names interchangeably because they’re all basically the same thing. Propecia, which is made by Merck, is the brand name of the FDA approved male pattern hair loss drug, and its active ingredient is 1mg of Finasteride. Right now Propecia doesn’t come in a generic form, so if your doctor gives you a Propecia prescription, you will be forced to pay about $70 each month for it. Proscar, which is also made by Merck, is the brand name of the drug that is FDA approved to treat an enlarged prostate gland in men. Its active ingredient is 5mg of Finasteride. Proscar also comes in a generic form – Finasteride 5mg, which sells for about $4!
So whether you’re taking Propecia, Finasteride, or Proscar, they all contain the same active ingredient. The difference is that Proscar and Finasteride are five times the strength of Propecia, so if your doctor prescribes it for hair loss, he or she will probably tell you to cut the pill into four equal pieces and to just take 1/4th of a pill each day. That is 1.25mg of Finasteride, which is close enough to Propecia (1mg of Finasteride). Yep it’s complicated, and the only reason to get a prescription for Finasteride instead of Propecia is to save a ton of money. But cutting up that tiny pill is sort of a pain, and it’s hard to slice it evenly.
• Why Propecia is not FDA approved for women to use
Propecia has the potential to cause birth defects, so pregnant and breast feeding women should not take the medication, or even handle crushed or broken tablets. If you are trying to get pregnant, you should not take the medication, and you should wait a few months after stopping Propecia before trying to conceive. If a doctor does prescribe Propecia to a woman, the doctor will probably insist that the woman take the pill, or another solid form of birth control to prevent pregnancy while on the medication. If she does happen to get pregnant while taking Propecia…that’s a whole other issue, but most doctors won’t prescribe Propecia unless the woman agrees she would terminate the pregnancy in that unfortunate event. This scenario is similar to the issues surrounding the acne drug Accutane, but that drug is actually FDA approved for women to use.
From what I gather, another reason Propecia is not FDA approved for use in women is that Merck only cites one study of Propecia’s effect in women, and the 137 women in the study were all postmenopausal. The study concluded Propecia did not benefit postmenopausal women with androgenetic alopecia. They never even tested premenopausal women (because of the whole pregnancy thing). I have read about some Propecia success stories in premenopausal women, which is why I want to try the medication. I’ve also read some women need more than the standard Propecia dose to work, and I’ve read that Avodart works better than Propecia in women (I’ll write about that sometime in the future).
• Propecia, Finasteride, and Proscar’s other side effects in women
I recently started on 1/4th pill per day of generic Proscar (Finasteride), and finding a doctor to prescribe that was a huge challenge! Yay for a $4 prescription! Do I think Propecia will work on my hair loss? I am guessing there’s a 10% chance it will help me, and as I’ve recently written on hairlosshell.com, my hair loss is in a male pattern, and genetic (thinning and receding at my hairline, temples, and on top of my head). I just need to find out for myself if it will help. I am hoping it will decrease my crazy shedding.
So far I’ve been on Finasteride for a week and the worst of the side effects are over for now. The first few days I felt really crappy – like I was getting a cold, or the flu. I had a lot of pressure in my ears, jaw, and throat, and I felt like my head was swollen. This coincided with there being lots of ragweed in the air (which I’m allergic to), so my side effects could have been made worse by my allergies. The sick, swollen feeling is gone now. Yay! My other issue, which started around the third day, is painful breasts. Ow. They constantly hurt, so that freaks me out. I hope the pain goes away! Since Finasteride isn’t FDA approved for women, there aren’t official side effects listed that are exlusive to women. All of the listed side effects are ones that are reported in men, which I will list next.
• Side effects of Propecia, Finasteride, and Proscar in men
Once you read the potential side effects of Propecia in men, if you’re like me, you’ll wonder why this is a drug for men!!! Merck, the maker of Propecia and Proscar, claim side effects from Propecia are not common, and they happen in only about 2% of men. Male side effects include: erectile dysfunction, impotence, and decreased libido. Severe side effects include: breast cancer, allergic reactions (rash, hives, difficulty breathing, tightness in the chest, swelling of the mouth, face, lips, or tongue), breast enlargement (gynecomastia), breast lumps, breast pain, breast tenderness, depression, nipple discharge, and testicular pain.
Merck claims the less severe side effects normally go away after stopping Propecia. However, if you google “Propecia side effects,” get ready to read about thousands of men that claim they’ve experienced permanent sexual side effects, even after quitting Propecia. Many men claim their lives have been ruined by Propecia, and they would gladly choose going bald over suffering from impotence, etc. Even if the risk is small, is it worth it? I have been telling my boyfriend about the success a lot of men have with keeping their hair while on Propecia, but he’s too freaked out now to try it, and he would rather go bald than face the “rare” side effects. You can read more about Propecia’s side effects on rxlist.com.
• How these side effects relate to women taking Propecia
The reason I’m freaked out is because Merck lists breast pain as a rare, severe side effect, and I’m already having that issue after only a few days on Propecia. But I think they list breast pain in association with breast cancer, and I can’t develop that overnight! Either way, I know a smart person would probably go off the medication, but since I’ve been balding, all common sense has been thrown out the window. Depression as a side effect worries me, however I’m already so fricking depressed that I doubt my depression could get worse. Just getting the prescription for Finasteride has lifted my mood because I am back to having hope that something will work to stop my hair from falling out (even if that hope is small, since nothing else has worked – minoxidil, spironolactone, etc.)
Finally, the risk of breast cancer freaks me out. Merck claims the risk is extremely slight in men, but no studies have been done, as far as I know, on Finasteride causing female breast cancer. I’ve also read other studies that say Finasteride greatly increases the chances of men getting breast cancer (but breast cancer in men is still extremely rare). I’ve researched risk factors for breast cancer, and I’m at medium risk. If I were at a high risk I definitely wouldn’t take Finasteride. If I were smart I wouldn’t take it just to be safe, but I also don’t exercise enough, or eat the perfect diet (and those two things alone can cut your breast cancer risk in half). One more thing – I’ve read that some people claim Propecia gave them wrinkles and made them age 10 years overnight. Great:((( I’ve also read the same thing about Rogaine, and personally I have become more haggard looking since using Rogaine.
• Bottom line – is Propecia worth the risks?
So many people have told me to cure my hair loss I just need do yoga, stress less, exercise more (I used to work out a lot), eat super healthy (I used to), take vitamins, test my thyroid and iron levels, use sulfate-free shampoo, blah, blah blah. Been there, done that – if they were right, I wouldn’t be balding. I still tell women to do all of these things since it really does help some women! Anyway, I’ve tried everything natural, and now I’ve weighed the risks and am hoping Finasteride works. Barring any new side effects, I’m going to give it nine months. If it doesn’t slow my shedding, or if I don’t notice my hair looking thicker, I will probably go off it. Well if my hair stays the same, maybe I will stay on it too, since otherwise I anticipate my hair will just keep getting worse on its own. There is less evidence that Finasteride causes a dread shed like Rogaine does, but of course anything is possible.
For men considering Propecia – read up on the side effects, and ask yourself if there’s a 1/1000th chance you could suffer permanent side effects from the drug, is it worth it? I don’t know exactly how common permanent side effects are, but that could be a good guess. For women, there’s a lot less evidence Propecia even works on hair loss (and if it does, it would only work on androgenetic alopecia). It’s not something you can take while pregnant, or if you’re at risk of getting pregnant, and its side effects haven’t been tested well in women. I’ll keep you updated on my Propecia/Finasteride/Proscar progress. Have you taken the medication, or would you?