Author: Dr. William Rassman

I have been off of finasteride for about 7 days and I’m scared of PFS. I have been taking Propecia for 9 months. How common is it for guys to get permanent side effects?

Do you now have sexual side effects? If you have made the decision to stop the finasteride, then it is highly unlikely (statistically) that you will get PFS. Your sex drive should come back after a month or possibly two. Don’t talk yourself into a problem as the placebo effect is real.

It is not safe . I know a guy that took 3 pills and have been messed up for years. Check out a site called Propecia help and see the thousands of men there with horrific ongoing symptoms that have not went away even years after stopping this medication. I’ve read one guys post that says he would rather lose a limb than have post finasteride syndrome.

I have 25 years of experience prescribing finasteride so I know first hand what the risks have been. I have been managing finasteride with my patients and am always responsive when they develop side effects. I can’t explain why a man who took any drug that has a half life of 6 hours with just three pills, can have long term side effects, so I can’t help explain this to you.

PFS patients often don’t follow up with their original doctors (as was the case here). There’s not much of a point really other than to inform the doctor what happened. Sometimes they do and the original doctors downplay the situation, tell the patient it will go away, and when it doesn’t they don’t bother following up. The doctor will often assume the problem went away even though it didn’t. Even worse they say the problems weren’t caused by finasteride and they should seek help from a specialist. Here are just some of the dynamics that play out when patients get PFS. It is getting better now that people are more aware but it is taking far too long and it is all because Merck lied to doctors, the public, and maybe the FDA over 20 years ago.

I never followed up with my original doctor beyond an initial email because he didn’t know any more than what was on the product label. This was over a decade and he probably thinks I’ve recovered. Merck’s warning label basically encouraged doctors to keep patients on the drug because it said side effects discontinued in “most” cases for men who continued the drug and “men who discontinued”. They just lead you to believe it was “all men”.

I make sure to bond with my patients. For example, I will often spend 30-60 minutes with each patient who comes in and it is always free. That establishes a bond between doctor/patient and I believe almost every patient follows up with me because they know that I listen to them.

One doctor told me this story as he believes that PFS is totally a nocebo effect. This is how he proved it to himself.

His brother was going to have a second hair transplant and believed that the finasteride caused him sexual side effects the first time he took it. So he refused to take the medication in preparation for a second surgery a few months down the road. His sister-in-law (the man’s wife) put two finasteride 1mg tablets into his daily shake which she prepared after he went to the gym without telling her husband.

So he took 2 mg per day for 3 months and told his surgeon brother that his hair miraculously was thicker and laughed that he didn’t have to take finasteride and experience side effects. At the three month mark, his surgeon brother told him that his wife had put double the dose of finasteride into his daily shake without telling him, in other words 2mg of finasteride per day. Not knowing that he was taking the finasteride, he had no side effects at all. So the idea that you can talk yourself into side effects was raised here. I know that there are sexual side effects with finasteride and I have seen that with my patients, so I am not suggesting anything to the contrary; however, there are some people who are just highly suggestive and worrying alone, can bring on side effects. No surprise.

17M Hey yall, I took 1mg of proscar 2 weeks ago, I think I still have brain fog. Haven’t been able to sleep more than 5 hours this past week no matter what I did. Also haven’t been able to enjoy or laugh at the things I could just before taking fin. All of that might be completely unrelated to taking fin. Have there ever been cases of PFS or persistent side effects after just a single dose, and how does being as young as 17 affect the chances? It could be just in my head, I hope that’s the case, but I really just want to know how likely it is that taking a single pill of a hair loss drug could be divine retribution for my vanity.

Not possible. It has to be in your head, a Nocebo effect

I got a prescription of fin filled but it’s just sitting in my room. Been balding for a few years now but I still have a hairline that’s receded in the temples. I’m not scared so much as about the side effects but the stories I’ve heard/read about permanent side effects that last even after you stop using fin.

Post finasteride syndrome (PFS) is very rare. The best way to avoid it is if you are taking finasteride and have significant eD, then stop the medications before it goes on too long.

Amazing and complete reversal of frontal thinning on oral minoxidil. About 40+ percent of patients may be candidates for this drug.

Thanks for lifting your eyebrows and allowing your forehead to show the creases. 1.5 months is too early to see results but there are small hairs on the left side which appear stronger than they were in the before picture so this is a hopeful sign.

The pictures say it all.

Fantastic results from just finasteride and microneedling for one year.