Men on Finasteride Asked to Stay Vigilant for Possible Psychiatric

Finasteride, a medication primarily used to treat benign prostatic hyperplasia (BPH) and male pattern baldness (androgenetic alopecia), has gained significant attention for its effectiveness in slowing hair loss and reducing prostate size. However, in recent years, concerns have been raised about potential side effects, particularly those related to mental health and sexual function. This article explores the known psychiatric and sexual side effects of finasteride, providing a comprehensive overview of the risks and urging men who take the drug to stay vigilant for these issues.

What is Finasteride?

Finasteride is a synthetic 5-alpha-reductase inhibitor, initially approved by the U.S. Food and Drug Administration (FDA) in the 1990s. It works by blocking the enzyme 5-alpha-reductase, which converts testosterone into dihydrotestosterone (DHT). DHT is a hormone associated with the development of male pattern baldness and the enlargement of the prostate gland.

Finasteride is commonly prescribed in two forms:

  • Propecia: Typically used for treating male pattern baldness, usually in a 1mg daily dose.
  • Proscar: Generally prescribed to treat BPH, with a typical dose of 5mg daily.

Psychiatric Side Effects

Reports of psychiatric side effects have emerged over the years, with some studies suggesting a link between finasteride use and an increased risk of mental health issues. Commonly reported psychiatric side effects include:


Some users have reported experiencing symptoms of depression while taking finasteride. Depression can manifest as a persistent feeling of sadness, loss of interest in activities, fatigue, and changes in sleep or appetite patterns. Studies have indicated that the reduction in DHT levels could potentially impact neurotransmitter regulation in the brain, leading to mood disturbances.


Anxiety, characterized by persistent worry, nervousness, or fear, has also been reported among finasteride users. This side effect could be linked to the same neurochemical changes in the brain associated with reduced DHT levels.

Suicidal Thoughts and Behavior

Perhaps the most serious concern is the potential for suicidal thoughts and behavior. Although these cases are rare, there have been reports linking finasteride to an increased risk of suicidal ideation, particularly among younger men using the drug for hair loss treatment. This has prompted increased scrutiny and calls for closer monitoring of psychiatric symptoms in patients taking finasteride.

Sexual Side Effects

Sexual side effects are among the most commonly reported adverse reactions to finasteride. These effects can be particularly distressing, as they impact both physical function and emotional well-being. Key sexual side effects associated with finasteride include:

Erectile Dysfunction (ED)

Erectile dysfunction, or the inability to achieve or maintain an erection sufficient for sexual intercourse, is one of the most widely reported sexual side effects of finasteride. Some studies suggest that ED can persist even after discontinuing the medication, leading to the term “post-finasteride syndrome.”

Reduced Libido

Many finasteride users report a significant decrease in sexual desire or libido. This reduction in interest in sexual activity can negatively impact relationships and overall quality of life.

Ejaculatory Dysfunction

Ejaculatory dysfunction, including reduced semen volume and delayed ejaculation, is another common sexual side effect. These changes can further contribute to diminished sexual satisfaction and emotional distress.


Though less common, some users have reported infertility issues, likely due to changes in semen quality and volume. This can be particularly concerning for men who are planning to start or expand their families.

Staying Vigilant: What Men Should Do

Given these potential risks, it’s crucial for men taking finasteride to stay vigilant and monitor their mental and sexual health closely. Here are some key steps to consider:

1. Regular Communication with Healthcare Providers

Men should maintain open and honest communication with their healthcare providers while using finasteride. If any psychiatric or sexual side effects occur, it’s important to report them promptly to a doctor or mental health professional. This allows for proper assessment and, if needed, adjustments to the medication or treatment plan.

2. Awareness of Early Warning Signs

Understanding the early warning signs of psychiatric and sexual side effects can help men and their loved ones take action early. For psychiatric symptoms, watch for changes in mood, behavior, or thought patterns. For sexual side effects, keep track of changes in libido, erectile function, and ejaculation patterns.

3. Mental Health Support

If psychiatric symptoms such as depression or anxiety emerge, seeking support from a mental health professional can be beneficial. Therapy and counseling may help address these symptoms and reduce the risk of more severe outcomes.

4. Consider Alternative Treatments

For men experiencing significant side effects, alternative treatments for hair loss or BPH might be worth exploring. Discussing these options with a healthcare provider can help determine the best course of action based on individual needs and risk factors.

5. Weighing Risks and Benefits

Ultimately, the decision to use finasteride should involve a careful consideration of the potential benefits and risks. Men should weigh the positive effects of the medication against the potential side effects and determine if the medication aligns with their health and quality of life goals.


Finasteride has proven effective in treating conditions like male pattern baldness and BPH, offering benefits to many men. However, it’s essential to be aware of the potential psychiatric and sexual side effects associated with its use. By staying vigilant, maintaining open communication with healthcare providers, and seeking support when needed, men can make informed decisions about their health and well-being.


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