I had an interesting email correspondence with a reader recently. The subject was Propecia. He was curious about the consequences when long-term Propecia users stop taking the drug. Unfortunately, there isn’t a lot of data on this subject at this point. And as I point out in my in-depth article on Propecia, the unknown is one of the downsides of the drug.

As the first generation of users begin to age, stop caring so much about their hair, and accordingly, quit Propecia, I imagine we’ll start learning more about its long-term effects, if applicable. Here’s the conversation:

Original Question

“Do you have any info or how guys do when they come off long term (say 5 years+) finasteride?

Another thing I’ve found curious in my reading is this. Plenty of information is available on the side effect profile, and how they are typically reversible if you get them in the short term. But there’s less info on guys that have taken it 5-10 years (or much longer) and decided to stop and how this impacts them?

There are clearly some vocal PFS cases out there, of course….”

My Response

This is actually a topic I’ve been meaning to delve into more, so thanks for the reminder! According to most of the studies and long-term research, the side effects pretty much always cease after a person stops using the medication. But there’s some (a fair amount actually, how much of it is legitimate is another question) anecdotal evidence to suggest that side effects may affect long-term users who quit the drug as well.

Basically every person who’s ever had side effects with Propecia seems to post about it on the web. People who have no major issues with the drug (undoubtedly, the vast majority of users) rarely offer their perspective on the subject, so it’s hard to draw conclusions given the massive imbalance of data available .

Many of the doctors who prescribe Propecia also seem a bit biased and even defensive at times to me, often citing those same old 2-4% side effect figures that they’ve been providing to their patients since 1997, which, in my opinion are ridiculous. Then there’s the nocebo effect to throw in there as well. It’s a big BS storm of complication basically, and probably the hardest thing I’ve had to analyze thus far.

And Back to the Reader…

“I think you’ve put in bluntly but very fairly Robert – very hard to get to the bottom of it isn’t it.

My personal fear with this drug would be less the short / medium term side effects that are noted – assuming ultimate reversibility of course – but more what happens if you take it for 10-15 years and then think “I’ve had my day, I’ll let nature take its course now and grow old gracefully” ….what happens having intervened in the body’s natural hormone balance for that period of time only to “switch it back on”, and does anything fundamentally change during that time.

I’m not as well versed as you in this topic but it seems more endocrinology based studies alongside basic mechanistic research would be needed versus the dermatologist perspective.

I guess we’ll know more naturally in 20 years or so as more long term users cease using….”

My Closing Thoughts

I like his analysis and perspective here! I haven’t replied to his (Ross is his name by the way) email yet but I plan to in the near future. I too would like to see some studies that follow the progress of long-term finasteride users as they quit the medication.

While some men may view their hair like Ennis viewed Jack in Brokeback Mountain while in their 20s, they may stop giving a shit about it as they get old and gray and less gay (or straight) with time.

 I believe our sexuality reaches its peak in our 20s, and that’s why it’s understandable why 20-something men want to enjoy their hair while they’re in their romantic prime!  

Propecia can probably help you keep your hair, but what are the potential, long-term costs? I can’t say that I’ve found a satisfying answer to that question at this juncture. The unknown. It’s definitely one of the 10 things I hate about Propecia. 

Robert Price

Robert Price is a writer, consumer advocate, and hair loss researcher with thousands of hours of experience in the field. His goal is to keep you out of the hair loss rabbit hole, underworld, or whatever you want to call it. He founded Hair Loss Daily, the unbiased hair loss blog, in 2016. You can learn more about Robert in the my story section of this website.