Finasteride (sometimes known as Propecia) is a commonly prescribed drug for male pattern baldness. On October 26th, 2022, I made the worst mistake of my life: I applied topical finasteride to my scalp.
I know what you’re thinking: The notion of the application of a spray being the “worst mistake of my life” sounds nonsensical and asinine. I wish that weren’t the case, but it is unfortunately true.
In order to depict the true nature of this drug and what it has done to me, I think some context on my life prior to finasteride is needed. Before taking finasteride, I was a 21-year-old college student. Admittedly, I did have some struggles with my mental health prior to taking this drug. I suffer from ADHD, NVLD (Nonverbal learning disorder), and OCD. Despite this, I was very high achieving. I had a 3.8 GPA and was in the top of my class within my college major. I was pretty introverted, but I was passionate about so many different things. I loved music so very deeply. I was essentially constantly listening to music. There was nothing like that sense of euphoria I got from a song that I loved. Travis Scott’s 90210 was constantly on repeat. I loved movies, as well. One of my favorite life memories is watching Spider-Man: No Way Home with a group of high school friends and absolutely losing my mind in the theater. I loved to read, too. I got so obsessed with George R.R. Martin’s A Song of Ice and Fire (Game of Thrones) that I read the first four books (approximately 5000 long pages) in a matter of about 3 months. In addition to all these passions, a core tenet of my life was fitness. I exercised 6 days a week and included both weightlifting and intense cardio in my regimen. Overall, I led a very clean, healthy lifestyle. I stayed away from hard drugs and drank very minimally, only during social events. Additionally, one of my biggest life goals was to build a happy, healthy relationship. This a surface-level dive into who I was, but for the purposes of this article, it should suffice. At the end of the day, despite my struggles in life, there was a lot I loved. I was a complex, driven, vibrant person.
In the Fall semester of 2022, I felt I was finally getting the hang of socializing in a college environment. As I said, I was quite introverted, so being at a typical state school big on party culture was certainly a new challenge. However, being that I had just turned 21, I had many more opportunities for socializing, and I made many new friends & memories. Romantically, my life was going pretty great, as well. I was going on dates, and I enjoyed getting to know new people in this regard. All in all, things were going quite well, even amidst some challenges.
Hair loss was something that was always in the back of my mind. All of the males in my extended and immediate family are bald (or balding), and that worried me a bit. My hair, as is the case for many other men, was a part of my identity (as vain as that may sound), so I wanted to do what I could to keep it. It appeared that in my transition from my teens to the start of young adulthood, my hair had thinned out a bit in my crown. I did some research online and came across the drug finasteride. The general consensus I was presented with was that, if one starts finasteride at the first sign of hair loss, they will likely maintain (and/or regrow) most of their hair. Additionally, all of the research I came across stated that the drug was well-tolerated and safe.
Thus, in order to ensure I could maintain my hair and my confidence, I decided to try the drug. I used a very popular telehealth company known as “Hims.” I filled out a brief health questionnaire, and they prescribed me topical finasteride, as that formulation has less risk of side effects when compared to the oral method. In addition, Hims’ topical finasteride was voted one of the best hair products of 2021 by the popular website AskMen. I honestly felt like I had nothing to lose, and I was told that side effects were very rare, and if they did occur, they would stop upon cessation of the drug.
Within about a week, the drug arrived at the office of my apartment complex. I picked it up and was excited to start the treatment and finally quell any fears of hair loss. The next morning, I applied the drug to my hair. For the most part, things seemed to be going okay; I went about my day as I normally would and didn’t notice any issues. I went on to use the drug for 3 more days (for a grand total of 4 applications), and over this period, I started to notice a burning in my genital area. It progressively got worse, so I decided to message my Hims provider as I was very concerned. She told me that this was not normal and that I should seek in person evaluation. Eventually, I decided to go to urgent care. I told them my symptoms, and they told me that I should stop the drug and that these symptoms should go away in about a week. I left the urgent care office thinking that I had dodged a bullet. It was Halloween weekend, so I went out with my friends, and I had a lot of fun. Little did I know this would be the last time I would get to experience life as a normal college student.
Over the next 7 days, the burning subsided. However, I started to notice sexual dysfunction that was not there before. I should add that prior to this point, I had absolutely no issues in this domain. Once again, I was very concerned. I talked to some people I trusted, and they told me it was likely nothing to worry about.
In the ensuing weeks, my mental state started to decline, rapidly. I had to leave the semester early and move back home for support. I was in the deepest, darkest depression of my life. I would sob for hours at a time. I had never genuinely considered suicide, but during this period I was constantly entertaining the idea. I couldn’t sleep at night. I could barely carry out my daily tasks. While yes, I did mention that I struggled with three disorders: OCD, NVLD, and ADHD, severe, suicidal depression was not something I struggled with. This was out of character for me.
Eventually, I learned that these symptoms are part of a condition known as Post-finasteride syndrome (PFS). PFS entails a constellation of sexual, neurological, and physical symptoms that occur after usage of the drug finasteride. I eventually decided to seek out further medical care, hopeful that this could be resolved. I saw my family doctor, and she explained to me that she had never heard of such a thing happening and that it is likely psychosomatic. Nonetheless, she referred me to a urologist to receive further testing. Fast forward a few weeks, I explained to the urologist my symptoms, hopeful there was something he could do. He quickly told me that PFS is real, but that there is nothing he can do for me.
Fast forward to today. While I have stabilized somewhat, I suffer from an extensive number of symptoms, including genital shrinkage, genital pain, ED, lack of libido, complete impotence, anhedonia (lack of pleasure/severe depression), anxiety, and impaired memory/focus. My life has completely changed. I no longer get any sense of euphoria from music, so I don’t listen anymore. I rarely watch movies or read. Schoolwork is incredibly difficult due to the anhedonia and the inability to focus. Obviously, with the aforementioned sexual symptoms, it is essentially impossible to pursue a relationship. I’ve withdrawn from many of my friends because of this condition; when I socialize, I largely have to pretend to be the person I once was, and that is very mentally draining. I feel like a shell of my former self. This is an immensely torturous experience. Life is incredibly grey. I constantly have suicidal thoughts. With all this in mind, it’s important to reiterate that there is no treatment, whatsoever. Antidepressants do not help, and they often make PFS patients worse. Testosterone replacement therapy (TRT) is completely useless; my testosterone levels are in the normal range. For those who suffer from PFS, something has gone horribly wrong in the body.
Independent of the symptoms themselves, the sheer trauma of this experience is immensely difficult to deal with. I will often hear a song I used to love and crumble on the inside. I see my friends on social media, living life as they are supposed to, and it almost physically hurts. This is not how life is meant to be lived. I had so much going for me and a lot to look forward to. So much has been taken from me that this is, in all honestly, almost impossible to cope with. I wake up every single morning and I just dread having to live like this for another day.
With all this said, I am not alone. There are thousands of other young men suffering in the same way that I am. With the advent of telemedicine companies like Hims and Keeps, finasteride is increasingly accessible. I have talked to numerous men in their 20s who have had their lives derailed by this horrible drug. The youngest PFS patient I have come across is just 17 years old. Finasteride is certainly safe for the majority of people who take it, but having thousands of men become collateral damage is not an acceptable trade-off. Unfortunately, hundreds of PFS patients have committed suicide. Those innocent men did not deserve that cruel, cruel fate.
If you’ve made it this far into my story, I request you to please have a look at the PFS Network (PFSNetwork.org). Collaborating with scientists from The Institute for Human Genetics at the University Medical Center Schleswig-Holstein, they have funded a study to explore the epigenetic changes that have occurred in PFS patients. Additionally, they are currently raising funds for a second study looking into possible genetic predispositions for developing the condition. The work being done by PFS Network is our only real chance of treating this condition. If you have the means, any donations will mean the world, as these studies are currently largely funded by the PFS community.
Please help us eradicate this horrible condition and get our lives back.
Thank you for reading.
