9 Facts to Know Before Using Propecia

Finasteride, the active ingredient in Propecia, is the only oral medication prescribed for the treatment of male pattern baldness. For best results, it’s advisable to begin taking the drug as soon as possible after hair loss is detected.

Hair loss can deliver a staggering blow to a man’s self-confidence, but it’s a widespread problem that affects more than half of all American men over the age of 50. Male pattern hair loss, known scientifically as androgenetic alopecia, affects an estimated 50 million men in the United States, according to the U.S. National Library of Medicine.

Androgenetic alopecia affects women as well, but the pattern of hair loss in females is different from that in men, whose hair loss usually follows a well-defined pattern. It begins with the receding of the hairline above both temples. Over time, the male hairline further recedes to form a characteristic “M” shape. At the same time, many men may experience hair loss at the crown of the head, which can expand eventually to a state of partial or total baldness.

Male pattern hair loss has no cure, but men troubled by the problem have a variety of measures they can take to camouflage the problem or attempt to slow — or even halt — the progression of hair loss. Among the many options is an oral medication known as Propecia. The drug’s active ingredient is finasteride, which is also sold in higher doses under the brand name Proscar as a treatment for benign prostate hyperplasia, or BPH, a noncancerous enlargement of the prostate gland.

If you’re considering using Propecia in your fight against male pattern hair loss, here are some facts you should know about androgenetic alopecia and the medication that may help you to slow your hair loss and possibly regrow some of the hair you’ve already lost.

1. Role of Genetics

As its name suggests, your susceptibility to androgenetic alopecia is determined to a large degree by genetics. Although researchers believe that multiple genes play a role in androgenetic alopecia, scientific studies thus far have only been able to definitively identify one gene involved in male pattern hair loss. The AR gene manages your body’s synthesis of proteins called androgen receptors, which in turn govern your body’s response to androgens such as dihydrotestosterone, or DHT, a byproduct of testosterone. Although science has yet to determine precisely how DHT causes hair loss, it is known to play a central role in androgenetic alopecia.

2. Propecia Reduces DHT Levels

Propecia’s active ingredient, finasteride, slows your body’s conversion of testosterone into DHT, high levels of which are associated with hair loss. For reasons that are not fully understood, DHT that has attached to an androgen receptor of a hair follicle on the head tends to shrink that hair follicle until it can no longer support the growth of hair.

3. Propecia Must Be Taken Daily

Propecia must be taken daily to ensure that it keeps working.

If you decide to take Propecia and you find that it works for you, you must be willing to commit to taking the drug on a daily basis indefinitely. Once you stop taking the drug, your gains in the battle against hair loss are likely to be lost.

4. For Men Only

Propecia is not intended for use by women or children. Women who are pregnant or might become pregnant should not take the drug nor should they handle the drug, which has been known to cause genetic abnormalities in the male fetus.

5. Works With or Without Food

Unlike some medications that must be taken either with or without food, Propecia can be taken on an empty stomach or with a meal.

6. Side Effects of Propecia

Side effects that have been seen in those taking Propecia include breast tenderness and enlargement, testicular pain, depression, and allergic reactions that include hives, itching, rash, and swelling of the lips, tongue, throat, and face. In rare cases, Propecia has been linked to male breast cancer.

7. Sexual Side Effects

In addition to its more general side effects, Propecia has been linked to some cases of sexual dysfunction that have persisted even after discontinuation of the medication. Some men using the drug have experienced ejaculation problems, erectile dysfunction, and a decline in sexual desire. A study conducted by researchers at Northwestern University looked at the incidence of persistent erectile dysfunction (PED) among men who had been exposed to finasteride or dutasteride, both of which are 5-alpha-reductase inhibitors. Of the 11,909 men exposed to one of the two drugs, PED was diagnosed in 169 men, 1.4 percent of the total. Researchers found that erectile dysfunction lasted longer in men with longer exposure to either finasteride or dutasteride.

8. Alternatives to Propecia

Propecia is the only oral medication approved for the treatment of androgenetic alopecia. However, minoxidil, a topical vasodilating drug also sold under the brand name Rogaine, has been shown to slow the progression of hair loss in some patients.

9. Propecia Is Sold by Prescription Only

Propecia and its generic equivalent, sold as finasteride 1 milligram, are available only by prescription in the United States. If you have a prescription from your doctor, you can purchase the drug at your local pharmacy or order the drug online from a reliable supplier, such as If you choose the latter, you can fax your prescription or scan and email it to eDrugstore along with your order.

If you don’t yet have a prescription, eDrugstore can set up a complimentary online consultation with one of its team of licensed U.S. physicians. If the doctor determines you’re an appropriate candidate for Propecia, he or she will authorize a prescription. To learn more about hair loss and how Propecia might help to treat the problem, click here to reach eDrugstore’s Hair Loss page.