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How really safe is finasteride?


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I was thinking about starting taking up finasteride - I am aware of the sight effects like lowering libido but I am fine with them as long as it is reversible after you stop taking it. However reading through forums I found many people warning that side effects can be permanent and involve erectile dysfunction, problems with concentration, motivation, mood - in general really awful psychological changes. Some of these claims looks pretty exaggerated, my suspicion is that part of those claims may come from hypochondria as common theme there is that they made multiple tests and those couldn't detect anything wrong about their hormones etc. On the other hand I've never before encountered so much widespread negativity about any drug so it really gave me a pause.
Any of you took a closer look at this drug?

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You did not give your reason for taking it.  The most compelling I am aware of is for prostate cancer where there are trials finding benefit.  But even there I think it is questionable as the benefits on tumors may be of short duration.  It appears there is no significant mortality benefit due to a high percentage of cases where cancers eventually come back very aggressively.

The most common use I think is for hair loss.  I don't understand this at all.  Why risk potentially severe side effects for so trivial a benefit?

Myself, I have SBMA a supposedly progressive degenerative neuromuscular wasting disease with androgens essential to the pathology.  There have been numerous trials of androgen blockers such as leuprorelin, dutasteride and finasteride but the results are always mixed without a significant signal of net benefit.  My DHT, T and free T are all about 3 times the upper limit of their reference ranges and I have lost interest in this approach to managing my condition.  I think the most promising approach to manipulating sex hormones is using factors with which we evolved.  Caloric restriction and becoming very lean will dampen sex hormones and can do so in a gradual fashion minimizing risk of abrupt, irreversible adverse consequences.

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Actually the reason is a receding hair line - might be a trivial thing but I want not only be biologically young but also looking young. Side effects are in vast majority reversible and the longterm complications seem to happen only in around 1% of users - which don't seem to have any objective differences in regards to hormone levels and other things that were tested with people who never took it. So my hypothesis is that problems with erectile dysfunction or depression could happen to them even if they had never took it in the first place.

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On 12/26/2022 at 1:51 PM, tanuki said:

might be a trivial thing but I want not only be biologically young but also looking young

The desire may be significant but I consider the benefit trivial in that the gain of youthful appearance of hair due to the drug is probably no better and possibly worse than the gain one might achieve by a hairpiece.  Many believe sex hormones contribute to ones sense of youthful vitality and the drug may reduce it possibly resulting in one both feeling and being perceived as older despite having more youthful hair.

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  • 2 weeks later...

Good to see you back Matt, I hope you get better soon

I was reading a bit more about Finasteride and my conclusion is that it's a bit of russian roullette and risk is really skewed - vast majority of users don't have any issue whatsoever but for 1-2% , probably having some unfortunate genotype it might turn out to have really awful side effects, most likely untreatable for now.
My hair loss issue is not very serious, it's more like mature hairline and my intention was to get it back to more juvenile stage.  I am not even sure if finasteride would be effective for that.

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