The long list of symptoms can include brain fog, sleep disturbance, anxiety and muscle loss, as well as shrinkage of the penis and testes, anhedonia, weakened erections, an inability to ejaculate and testicular aching.
The problem, explains Professor Pierre-Marc Bouloux, director of the Centre for Neuroendocrinology at University College London, is not only that finasteride is easily and cheaply available via the internet, but the range of symptoms is so broad that it is not easy to ascertain which ones are linked to the drug as opposed to an underlying conditions.
He says he has treated many men reporting associated symptoms. ‘There is clear evidence that the symptoms of some patients who have been exposed to finasteride are unexplained,’ he says, ‘and the pharmaceutical industry has been extremely reticent to explore this.’
He points out, however, that it is difficult to know what proportion of the patients had premorbid tendencies to, for example, depression. ‘Add in relational difficulties plus premature hair loss and you could have a perfect storm to make some people more vulnerable.’
Merck has previously denied allegations in court filings that accused the company of not adequately warning patients of the drug’s possible side effects and their duration. It has also said it ‘stands behind the safety and efficacy of Propecia’, and that it ‘works continuously with regulators to ensure that potential safety signals are carefully analysed and, if appropriate, included in the label’.
Hims, the website through which James was prescribed hair-loss treatments, told The Telegraph, ‘Quality and safety is integral to our mission and only licensed medical professionals who have successfully completed a rigorous vetting process are able to provide care through our platform… All customers have access to follow-up appointments and continued care.’
Rowan*, an operations manager from Tyneside, was prescribed Propecia privately by his GP in 2000. He was 32 at the time and had noticed a tiny bald spot on his crown.
Weeks after first taking the drug, he was in the garden of his home, about to go on a night out, when he experienced what he describes as ‘a bolt of lightning panic like I’d never experienced in my life’. He cancelled his night out, told his manager he wouldn’t be at work the next day and went to bed, hoping the feeling would pass. It didn’t.
In the weeks, months and years that followed, Rowan’s life changed completely. He went back to work, but felt his interactions with others had changed: he was nervous, conversations felt forced. He says he struggled with certain cognitive tasks, like spelling. He’d always been a keen gym-goer but now, when he went, he noticed he’d lost strength. His sex drive dropped off a cliff, and over time he developed what seemed like breasts, despite losing weight. His skin dried out, his teeth fell out and his eyes got sore. But neither he nor medics made any connection to finasteride, so he continued to take it.
Then, in 2017, he read an article about PFS. It struck a chord. ‘I was elated at first – I’d found the cause of all these health issues,’ he says. ‘Then I started to research it. I read obituaries, about suicides, on online forums I found places of desperation for guys trying to get relief.’ He stopped taking finasteride immediately.
He went to his GP, who said PFS wasn’t a real thing. ‘I was met with cynicism at every turn,’ he recalls.
Meanwhile, his health continued to deteriorate. He is 57 now. He lists other symptoms he lives with: a receded jaw and gums; lost tissue and subcutaneous fat; allergies developed to myriad foods; and poor sleep. He’s had suicidal thoughts too. His marriage is, he adds, ‘in ruins’.
In 2018 he reported his symptoms to the UK’s Medicines & Healthcare products Regulatory Agency (MHRA), which approved finasteride for use in male hair loss in 1999. He says he has since sent ‘numerous emails’. ‘I got replies… Anything outside of what they are prepared to recognise was and is played down, stating it is not proven.’ It was, he says, like ‘banging my head against the wall’.
Sarah Carter is a health and wellness expert residing in the UK. With a background in healthcare, she offers evidence-based advice on fitness, nutrition, and mental well-being, promoting healthier living for readers.
