Propecia Side Effects

As of June 30, 2024, the most commonly reported Propecia side effects are erectile and sexual dysfunction, depression, anxiety and decreased libido, according to the Food and Drug Administration’s Adverse Event Reporting System. Patients have reported just over 6,000 side effect cases.

Disclaimer: Reports sent to the FDA don’t necessarily mean the drug caused an adverse event. Consult a health care professional before stopping or changing medication.

While adverse reactions to Propecia are rare, they can become serious. Over half of the total reported number of cases turned into severe cases.

Various forms of sexual dysfunction, such as decreased libido and erectile dysfunction, make up 80% of the reported effects. Additionally, over 40% of the reports relate to having an altered mental state due to conditions such as increased anxiety or depression.

Although Propecia side effect reports have decreased by 22% annually since 2016, those who use Propecia should still promptly inform their doctor of any side effects.

Latest FDA Warnings and Actions for Propecia

In June 2022, the FDA rejected a petition from the Post-Finasteride Syndrome Foundation. The petition aimed to take Propecia off the market due to its alleged association with feelings of depression, suicidal ideation and persistent erectile dysfunction.

In response, the FDA required that the drug manufacturers add the symptoms of suicidal ideation and depression to the medication’s warning label. However, they did not agree that the foundation had enough evidence to support discontinuing the drug.

Many of the common side effects that impact mood and sexual function can significantly impact a patient’s quality of life.

In addition, less common side effects may also cause distress among people using Propecia.

Environmental and physical conditions can also cause many of these side effects. Ask a health care provider about any new or worsening ailments you experience on the medication.

Duration of Side Effects

The adverse effects of Propecia didn’t resolve immediately for most patients who stopped taking the medication. Side effects resulting from Propecia often persist well after the patient stops taking it.

Less intrusive side effects can clear up in a matter of days to a few weeks. More persistent or serious side effects can take months or even years of treatment to fully resolve.

A doctor can help adjust your dosage to manage side effects better.

Propecia’s most common side effects can also be its most serious. They include sexual dysfunction and depression along with heightened cancer risks.

Talk to your doctor if you are already at an increased risk for any of these conditions. You may be able to find a treatment that does not increase your risk of these side effects.

Propecia and Erectile Dysfunction

Various research over the past decade has pointed to Propecia and its active ingredient, finasteride, as potential instigators of erectile dysfunction. One study published in the journal PeerJ found that 530 patients in a study of 11,909 participants developed erectile dysfunction after taking Propecia. The condition was temporary in most of those patients, but 167 of those patients developed persistent erectile dysfunction. This dysfunction took an average of 3-4 years to resolve after the patients stopped taking the drug.

Drugwatch spoke with a man from Florida who claims that taking Propecia devastated his life. As a result, he had resorted to using testosterone replacements, medications for erectile dysfunction such as Viagra and Cialis, and even underwent a penile implant. He asked to be identified only as “DR.”

“Whenever people looked at me, they saw this successful, good-looking guy. But, it’s like I’ve got this secret,” he said. “I would love to be married and settled down, but I can’t enter a relationship and say, ‘Hey, you know what? I can’t have a consistent erection.’”

Another man from New York state, who asked to be identified simply as “G.M.,” initially took Propecia to address his hair loss. However, he experienced many adverse side effects, including mood problems and sexual disorders.

“I don’t know of anything that can change you so much,” G.M. told Drugwatch. “I don’t know any other pharmaceutical that basically castrates you.”

Merck, the manufacturer of Propecia, has faced numerous Propecia lawsuits. Many of the plaintiffs claimed that Propecia caused erectile dysfunction that required extensive lengths of time or medical assistance to overcome.

Depression and Suicidal Ideation

Evidence emerging over the past few years has related Propecia to various mental health conditions, such as depression, anxiety and even suicidal ideation.

A study from George Washington University in 2012 interviewed patients who had discontinued taking finasteride at least three months prior to the study. The researchers found that 44% of participants had persistent suicidal thoughts, despite discontinuing the drug. The study’s control group of individuals who did not take finasteride had a suicidal ideation rate of only 3%.

The difference regarding depressive symptoms was also significant. 10% of the control group expressed some form of depression, but that rate rose to 75% among participants on Propecia.

Organizations beyond the FDA have taken notice of the drug’s potential impacts on mental health. A press release issued by the United Kingdom’s Medicines and Healthcare products Regulatory Industries asked men currently taking finasteride to remain vigilant for any adverse effects on their mood.

If you are experiencing major depressive episodes or are contemplating taking your own life, call a mental health professional immediately.

Cancer Risks With Propecia

The label Merck puts on Propecia warns that taking the drug may increase the risk of developing high-grade prostate cancer, the deadliest form of this disease. However, there is mixed evidence for this.

While research from the National Cancer Institute has shown that taking finasteride can lower the likelihood of developing low-grade prostate cancer for men ages 55 and older, those same studies discovered a correlation between finasteride use and higher rates of high-grade prostate cancer. However, because finasteride decreases prostate size, it is unclear if the drug directly caused these higher rates. It’s possible that the smaller size made it easier to detect pre-existing cancer during screenings.

High-grade prostate cancer is an aggressive form of cancer that can attack lymph nodes and other areas of the body. Because of how widely it can spread, high-grade prostate cancer can be difficult to treat.

In 2011, Merck also added male breast cancer to its list of potential adverse effects. The label instructs those taking the medication to seek treatment if they experience lumps on their breasts, pain or discharge.

Finasteride can be found in medications other than Propecia, but any side effects you experience on Propecia are likely to be experienced from other finasteride-based medications too.

Doctors often prescribe Propecia as a tablet taken by mouth once per day. Dosage is dependent on a variety of factors, such as the patient’s age and general health. However, there are alternative medicines offered in topical and surgical forms. Your ideal treatment option is determined by your underlying condition and preferred way of taking medication.

Editor Lindsay Donaldson contributed to this article.