Are There Any Long Term Side Effects of Propecia? Does Propecia Harm The Liver?
August 27, 2008 by Spencer Kobren
If you're new here, don't forget to check out the Bald Truth Talk Forums to ask your hair loss questions, view videos, create your own blog, and interact with others in the community. Register Now. Thanks for visiting!
I have been using Propecia since it became available on the market, which is quite a few years. Have there been any adverse effects of using Propecia over a long period of time? Does this medication harm the liver in anyway?
Concerned,
Jason
- - - - - - - - - - -
Dear Jason,
Finasteride was first approved by the FDA in 1992 as Proscar. As you’re probably aware, Proscar is a 5 mg dosage of Finsateride that is proscribed for the treatment of BPH or prostate enlargement. The 1 mg dose of finasteride, approved as Propecia in December of 1997, was the first truly effective treatment for male pattern hair loss.
To my knowledge, in the sixteen years that finsateride has been on the market there have been no reports of any adverse effects on the liver of those using the drug for an extended period of time. As always, I have to state clearly that I am not a physician and that my opinions and knowledge concerning hair loss and its treatments are based on extensive research and reporting on the subject as a consumer advocate and hair loss educator.
With this said, it’s important to note that Propecia cuts PSA levels in half after one year of use. PSA stands for prostate-specific antigen and is a protein produced by the cells of the prostate gland. The PSA blood test is commonly used to check for signs of prostate cancer and other related prostate problems. According to experts, men with prostate cancer often have elevated PSA levels because cancer cells make excessive amounts of this protein, Generally higher PSA levels are indicative of more cancer cells being present in your body. Now this isn’t always the case, it is possible to have prostate cancer without having elevated PSA levels, but the PSA test has been shown to significantly increase the ability for physicians to make an early diagnosis of the disease which is paramount for early intervention.
Since Propecia is prescribed to young men in their 20s, 30s and 40s it is important to tell your doctor that you are taking the medication so that PSA levels can be more accurately determined. The general rule of thumb is to double the levels of those using Propecia for more than a year. It’s also imortant to note the the PSA blood test is not the only way for doctors to determine the presence of prostate cancer.
Another long term concern that has been discussed in literature is the relationship between long term use of finasteride and male breast neoplasia or breast cancer.
During a 4 to 6 year placebo-controlled study testing finasteride 5 mg on 3,047 men, there were 4 cases of breast cancer in men treated with Proscar but no cases in men given placebo. In another 4 year placebo controlled study testing Proscar using 3,040 men, there were 2 cases of breast cancer in placebo treated men, but no cases were reported in men treated with Proscar. To my knowledge there have been no significant reports that can directly connect long term use of finasteride to male breast cancer.
As far as prostate cancer, the long term use of finasteride has recently been linked to a significant decrease in the risk of developing prostate cancer. Finasteride is also now being prescribed as a preventative treatment to some high risk patients, such as those with a strong family history of prostate cancer.
On a personal note, I have been using the drug for more than fourteen years and at this point have experienced no adverse side effects that I am aware of. There are countless men all over the world who are successfully treating their hair loss with Propecia. In my opinion, at this point there is no known reason to be concerned about long term adverse side effects.
Hope this helps,
Regards,
Spencer Kobren
Host of The Bald Truth Radio Show
Founder, American Hair Loss Association
Founder and Director of Consumer/Patient Affairs, International Alliance of Hair Restoration Surgeons (IAHRS.ORG)
Though I have been using Propecia for many years, my hair on the top and crown area appear thinner as opposed to the thickness I had ten years ago when I first started the drug. I have been contemplating a hair transplant procedure but am unsure if I am a suitable candidate.
Is it possible to receive a transplant just to thicken the hair you already have or do you have to have a total bald spot to have the procedure done. The reason I ask is because I heard that if you get a transplant done you end up harming the existing hair that is already in place. Is that accurate?
Hi Jason,
Hair transplant surgery is a good option for many men experiencing male pattern hair loss, but there are several factors that make a good candidate.
From what you are describing, it sounds like you still have a significant amount of hair. Attempting to simply “thicken” up your hair by undergoing a hair transplant procedure is not a good idea in my opinion. Shock loss from the trauma of surgery is a very real concern.
Surgery will always be there. When the time is right check with The International Alliance of Hair Restoration Surgeons in order to find a reputable hair transplant surgeon. In the meantime you might want to try a cosmetic concealer to help camouflage the thinner appearance of you hair.
Sincerely,
Spencer Kobren
Spencer, What do you recommend for woman for hair loss. So far after many test the only thing they have found is a extremely high dhea with no reason given except that my enzymes have changed and there is nothing I can do to lower my dhea which is 1200. So I am assuming that is what has been causing my hair to fall out constantly for 1.5 years now. Started after a big stress along with dermititis both at the same time. I have been thinking about spiro but am so afraid of the DREAD SHED. Do you know what percentage of people get this? Do you know of anything else that has been succesful for woman with hair loss due to hormones? Thank you. K
Just looking for your honest opinion based on your own results, and those of people you know.
I’ll start off by saying I’m a guy in my early 20s, and have most likely been experiencing hairloss since i was 18 or so. It never really bothered me untill college, when i really started to notice that my hair was getting somewhat thinner on the top and the temples were receding. Still, I did nothing.
Now I have noticeably thin hair, impossible to style so that it looks 100% normal. My temples have receded a pretty fair amount (probably 1.5 inches or so). However, I am by no stretch of the imagination totally bald, much less have any genuine bald spots. Its a diffuse thinning, with the classic receding temples. Honestly, I am 100% a-ok with my hairline…………..provided it stays this way (yeah right if I dont get treatment). I would really like to at least maintain what I have, and hopefully re-grow a bit of hair.
I have made an appointment with my doctor (finally manned up, wish i would have done this 2 years ago) to talk about propecia. Hopefully, I am cleared and can get started on the drug.
My question to you is this: What are the reasonable results I can expect if successful? I have plenty of hair on my head still, and I have TONS of fine, thin, almost colorless hairs. Is it unreasonable to hope those hairs eventually grow as normal (and even my colored hairs that are still thinning)? If so, I think i might be in business for a suprsingly normal head of hair (minus the temples, which could honestly be way worse).
Also, do you have any opinion on the long-term success of this drug? Is it expected that at some point my hair just falls out again later down the road? Or is it reasonable to expect that if I respond well to the drug for 5+ years, that I can mostly hold on to what I have for “life”?
Thanks a bunch if you managed to read all that, haha.