A drug for promoting hair growth, finasteride (Propecia), is among the medications that President Donald Trump has been reported to take. That is what his longtime doctor told the New York Times. The good doctor admitted that he too takes this drug:
“He has all his hair. I have all my hair.”
The Back Story on Finasteride:
The story of finasteride reads a bit like a medical mystery. In a small village in the Dominican Republic, some children were born without obvious male sexual characteristics. They would be raised as girls until they reached puberty and developed into men.
This was common enough that the villagers had a term for it. They called these kids “guevedoces,” which roughly means penis and testicles grow at twelve. Another term, “machihembras,” translates first female, then male.
This happened because their bodies did not convert testosterone into dihydrotestosterone, DHT. These men were relatively immune to prostate enlargement and male pattern baldness as they aged.
A Drug Company Gets Into the Act:
Scientists from the drug company Merck were able to figure out how to make a drug that blocked the conversion of testosterone to DHT. Finasteride is that medication.
This pill was first approved as Proscar to shrink enlarged prostate glands. The dose is 5 mg daily.
A lower dose, 1 mg a day, was approved to combat male pattern baldness. It was first marketed as Propecia in 1997 to stimulate hair growth. It is now available generically.
Finasteride Side Effects:
Side effects are less common with Propecia than with Proscar because the dose is lower. That said, some men do report decreased libido, erectile dysfunction and reduced ejaculate volume. For most men, side effects disappear when the drug is discontinued.
The official FDA prescribing information notes:
“sexual dysfunction that continued after discontinuation of treatment, including erectile dysfunction, libido disorders, ejaculation disorders, and orgasm disorders; male infertility and/or poor seminal quality (normalization or improvement of seminal quality has been reported after discontinuation of finasteride).”
Some of our readers have reported their own experiences with this medication. Some, like this man, are quite happy:
“I have been taking Propecia for 20 years. I have noticed a decrease in semen but no effects on libido, erection or any other negative effects on sexual functions. I also still have a full head of hair at 64, while my three brothers all have obvious hair loss.”
Not everyone is so pleased with the effects. Here is one reader who is unhappy:
“Propecia has shrunk my genitals. I regret ever taking it, of course, especially when there doesn’t seem to be much hope of recovering.”
Brian has a similar story:
“I do not have any of the (enlarged prostate) drugs left but I know the ones I took including Proscar and Finasteride. I do have a smaller penis with very little sensation of an erection.
“I had a prostatectomy in Dec, 2012 due to cancer. I had to stop taking testosterone which helped me maintain that fireball feeling in doing my husbandly duties. I miss having erections but the surgeon did leave my orgasm nerves intact. Orgasm is possible even with a small scrotum and smaller penis. I think it was this big when I was ten years old..lol”
Tom shared this:
“Finesteride (Proscar) has not been kind to me. I have an enlarged prostate and must get up two to four times a night.
“In 2003 my doctor prescribed Proscar (5mg daily). It didn’t change my nocturnal visits, but the good doctor assured me it was keeping things from getting worse.
“By 2010 I was experiencing minimal libido, ED and what I later learned was called Peyronie’s Disease (bent penis). As I was in my seventies, I assumed it was the cost of old age.
“This February I discovered some web sites describing the effects of finesteride and I stopped cold turkey. Well, my nocturnal visits haven’t changed, I am rediscovering my libido, but I guess I will be blessed with Peyronie’s for the rest of my days.”
N.C. offered a different concern:
“My husband has been on finasteride for more than 5 years. He is now 86. His sex drive started to dwindle when he was in his late 50s. Yes, it gave him thicker hair. But I think finasteride might have a side effect and perhaps someone will know about it.
“He has what he says are night sweats from his neck up. Has anyone heard of this happening?”
This is not unheard of. Other men have also reported hot flashes with finasteride.
Finasteride and the Sniffles:
There are a few side effects that don’t seem to have gotten as much attention, perhaps because they don’t have anything to do with sex. Here’s one report:
“I have been taking finasteride primarily to minimize hair loss, but there is evidence that it also helps prevent prostate problems. I have a constantly runny nose, but always carry a tissue or a handkerchief.”
The revelation by Dr. Harold Bornstein about President Trump’s medications has focused the spotlight on finasteride, a drug that hasn’t been in the news much lately. Perhaps it will now get renewed attention from men who seek to reverse male pattern baldness.