Finasteride, a well-known drug for the treatment of hair loss in men (androgenetic alopecia), is under the scrutiny of medicines regulatory agencies for possible side effects that can have a major impact on social and personal life.
Finasteride, a hair loss drug in men also used by former President Donald Trump, can cause sexual dysfunction and psychiatric disorders
There finasteridea well-known drug against hair loss in men, also used by the former president of the United States, Donald Trump, is under the scrutiny of drug regulatory agencies for possible side effects that affect sexual function and mental health. Authorized for the treatment of androgenetic alopecia (in the 1 mg dosage) and also used for the treatment of benign enlargement of the prostate (in the 5 mg dosage), the drug finasteride can cause “depression, suicidal thoughts and sexual dysfunction, including decreased desire and difficulty achieving an erection” as reported by the Medicines and Healthcare products Regulatory Agency (MHRA) in the United Kingdom.
Also in Italy, finasteride was the subject of a safety communication from the Italian Medicines Agency (AIFA), which had drawn attention to the medicine. According to the MHRA, there is “a lack of awareness” of these risks, which is why the British Agency issued a safety alert, asking to men taking finasteride Of “stay vigilant” about the drug’s potential side effects.
What is finasteride, the drug against hair loss
Finasteride is a drug which, in the 1 mg dosage, is used for the treatment of hair loss in men (androgenetic alopecia), the most common form of baldness, caused by hormonal and genetic factors. The drug was also reportedly used by former US President Donald Trump and – in the 5 mg dosage – is also used to treat enlarged prostate.
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Finasteride, specifically, belongs to the category of 5α-reductase inhibitors and works by blocking the enzyme (5α-reductase type 2, present in hair follicles) that converts testosterone into dihydrotestosterone (DHT).
What is androgenetic alopecia and why does hair fall out
Androgenetic alopecia, commonly known as baldness, is the most common hair disease, mainly due to an excess production of androgens, in particular of dihydrotestosterone (DHT), which helps to shorten the hair growth phase and thin hair. This form of alopecia can occur in women but especially in men, in whom the areas of the scalp affected by baldness present smaller (miniaturized) hair follicles and increased amounts of dihydrotestosterone.
Progression of Hair Loss in Men and Women Affected by Androgenetic Alopecia / MSD Manuals
Hair loss can occur at a variable rate (in men even at a young age) and occurs with a progressive retreat of the frontal hairlinealthough hair loss can also occur in specific areas of the scalp, particularly the top of the head.
How finasteride works and what are the side effects
Finasteride is a drug that counteracts progressive hair loss in men androgenetic alopecia: as indicated, it is a 5α-reductase inhibitor, an enzyme that converts testosterone to dihydrotestosterone. Finasteride, specifically, mainly inhibits type 2 5α-reductase present in hair follicles, thus blocking the peripheral conversion of testosterone to the androgen dihydrotestosterone. That is stops the responsible process of the miniaturization of the hair follicles of the scalp, which can make the baldness process reversible: for this reason, the drug is indicated in early states of androgenetic alopecia in men aged between 18 and 41.
The effectiveness of the drug was demonstrated in three studies, in which the treatment was shown to stop hair loss in 90% of men with androgenetic alopecia in 5 years and promote regrowth in at least half of the cases. However, the possible side effects of the drug, already reported by AIFA and now also the subject of a safety review by the MHRA of the United Kingdom, end up under the scrutiny of medicines regulatory agencies.
“Has been reported – highlights the British Agency – ch and finasteride, a medicine used by men to treat hair loss (1 mg dose) and benign (non-cancerous) enlargement of the prostate (5 mg dose) causes depression, suicidal thoughts and sexual dysfunctionincluding a decrease in sexual desire and difficulty achieving an erection”.
In some cases, the agency said, sexual dysfunction persisted even after stopping treatment. AIFA had also highlighted that adverse effects can persist even after suspension of treatment and, in some cases, the Italian Agency specified, for an indefinite period.
According to the MHRA database, since 2020 there have been five reports of “suicidal and self-harming behavior” with fatal outcome and 41 reports with non-fatal outcome associated with treatment with finasteride, which led the Agency to review the safety profile of the drug and introduce a patient alert cardin order to raise awareness of these risks.
“It is vital that patients are aware of vital information about the medicines they are taking – said Dr Alison Cave, head of safety at the MHRA –. The new patient alert cards aim to raise awareness among men taking finasteride about potential psychiatric and sexual side effects, so they can make an informed decision about their treatment and know what to do if they experience these side effects”.
