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Propecia May Lead to Increased Hair Growth, Reduced Drinking

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Propecia is prescribed for men with male pattern baldness.
Propecia is prescribed for men with male pattern baldness.
Propecia is a best-selling drug made by Merck as a treatment for male pattern hair loss. It is taken in pill form daily, and has been shown to slow or stop male-pattern balding, and in some cases even reverse it.

Generally, several months are required for the effects of Propecia to become evident, and if a user wants to continue to experience the hair re-growth benefits of Propecia, he has to take it indefinitely. When users stop taking Propecia, hair loss resumes.

How Propecia Works

Propecia is known as a 5-alpha reductase inhibitor, meaning it inhibits the action of 5-alpha reductase, a substance that causes conversion of ordinary testosterone into dihydrotestosterone (DHT). High levels of DHT are associated with male pattern baldness.

By inhibiting 5-alpha reductase, Propecia prevents some testosterone from being converted into DHT, and this can slow, halt, or reverse hair loss. Men tend to have better results from Propecia if they start taking it before hair loss is severe, but men who take it after having lost significant hair may slow the rate at which hair is lost, or preserve the density of the hair they have.

An Interesting Side Effect

One side effect of Propecia is reduced sex drive, but some men who have experienced decreased libido after taking Propecia noticed another side effect: they consumed less alcohol. Dr. Michael Irwig, assistant professor of medicine at George Washington University School of Medicine and Health Sciences in Washington, DC, authored a study of this phenomenon. “In men experiencing persistent sexual side effects despite stopping finasteride, two-thirds have noticed drinking less alcohol than before taking finasteride,” he told HealthDay.

Rodent Studies on 5-Alpha Reductase Inhibitors and Brain Function

Researchers know that stress on cells in the hippocampus, a specific brain region, can block the formation of memories, as can consumption of drugs, including alcohol. In a study of rats authored by Yukitoshi Izumi, research professor of psychiatry at Washington University in St. Louis, researchers found that if they were able to block manufacture of so-called neurosteroids (steroids that alter neuronal excitability), they could preserve long-term potentiation (LTP), a brain process that strengthens connections between neurons. LTP is critical to learning and constructing memories. Researchers preserved LTP with 5-alpha reductase inhibitors, the active ingredients in Propecia and Proscar. In other words, 5-alpha reductase inhibitors appear to preserve memory in rodent brains.

Human Study on 5-Alpha Reductase Inhibitors and Alcohol

Men who experienced loss of libido on Propecia also lost some of their taste for alcohol.
Men who experienced loss of libido on Propecia also lost some of their taste for alcohol.

Irwig’s study mentioned above was based on the question, “Do men who experience decreased sex drive after taking Propecia also loose their taste for alcohol?” In a survey of 63 former patients who experienced sexual side effects of Propecia, 65% noted that they drank less, even after they quit taking finasteride.

On average, these men were consuming about five alcoholic drinks per week before taking Propecia. This average dropped to two drinks per week after Propecia. “These men with persistent sexual side effects said alcohol did not have positive effects. They had a longer hangover or less tolerance to alcohol [after finasteride treatment],” said Dr Irwig to Medscape Medical News. Some stopped drinking altogether.

What’s Next?

Izumi and colleagues at Washington University School of Medicine plan to study 5-alpha reductase inhibitors to determine how easily they get into the brain and if there may be a role for such drugs in preservation of memory.

As for the human studies, while doctors should be aware of possible effects associated with alcohol use in patients taking Propecia, experts warn it isn’t a good idea for them to prescribe the drug for treating alcoholism, at least until more systematic studies on humans are done. As Dr. Irwig told MedicalDaily, “It is unknown whether finasteride could suppress drinking in otherwise healthy men,” he said. “I hope that this study will generate more research on the effects of finasteride in humans as it relates to alcohol.”

Men who take Propecia or who are considering taking it should be aware of all potential side effects, including loss of sex drive and lower tolerance for alcohol. And they should always take the drug exactly as prescribed by a physician.

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