Much like protein powder, creatine and Garmins, finasteride has slipped into men’s lives with barely a ripple – talked about in barbershops, dissected in group chats and ordered discreetly through subscription apps.
What began in the 1990s as a prostate medication has since become the gold-standard treatment for male pattern baldness. Fast-forward to 2026 and it has become the backbone of a booming online subscription market. Telehealth brands such as Hair + Me, Manual and Hims now offer fast, near-frictionless access after a short online questionnaire, packaging finasteride as a simple confidence-boosting fix. But critics say the convenience comes at a cost. Beneath the slick marketing and influencer endorsements, a growing number of men are reporting enduring side effects including sexual dysfunction, depression and anxiety – collectively known as post-finasteride syndrome (PFS).
As social media testimonials, Reddit forums, and patient advocacy groups amplify these concerns, regulators have acted. In 2024, the UK’s Medicines and Healthcare products Regulatory Agency (MHRA) strengthened its safety warnings and introduced a new patient alert card after reviewing reports of sexual and psychiatric complications, some persisting even after discontinuing the drug. And in April 2025, the British Association of Hair Restoration Surgery (BAHRS) expressed that men should not be prescribed finasteride ‘on the basis of a completed online form’, noting that ‘a presumptive diagnosis can often be made from photographs or appearance on video’. But as the appetite for digital hair-loss treatments continues to grow, questions remain: are men truly being informed, or simply sold a convenient fix?
A Whole New Bald Game
The story of finasteride begins, like many scientific breakthroughs, almost by accident.In 1974, an endocrinologist at Cornell University published observations about a group of genetically male children who lacked the enzyme 5-alpha reductase. But it wasn’t until the 1980s that researchers developing treatments for enlarged prostates noticed new hair growth on their scalps.
The mechanism sounded esoteric at the time, a matter of blocking the conversion of testosterone into DHT, a hormone harmless in most contexts but catastrophic for hair follicles genetically primed to miniaturise. That discovery led to clinical trials and finally, in 1999, the MHRA approved it for hair loss, kick-starting a slow cultural shift that has accelerated a generation of men treating hair loss not as fate, but as a solvable problem.
Data on how many men are currently taking finasteride is hard to come by as 1mg, the amount needed to treat hair loss, can only be prescribed privately. However, Superdrug Online Doctor said the number of new patients requesting finasteride was up 122% in the first three months of 2025 compared with the same period in 2024.
Steve*, 53, from Doncaster, began taking finasteride at 36 in 2007, after noticing thinning at the temples and crown. Initially, the results were remarkable; ‘I’ve still got a full head now, years later,’ he tells MH. But soon after taking it, he began to feel depressed, anxious and increasingly isolated.
Steve decided to come off the medication in 2010, but three weeks later, his situation took a drastic turn. My endocrine system and brain chemistry spiralled, I was having suicidal thoughts, I couldn’t even cook myself a basic meal.’ In April 2011, Steve made a suicide attempt and was taken up by the mental health crisis team. Aged 40, I moved in with my parents as I just couldn’t look after myself.’ Eventually Steve was admitted to a psychiatric ward, where he stayed for three months.
Although it wasn’t a recognised condition at the time, Steve was suffering from PFS, which has no known cure and few, if any, effective treatments; and it was a recent as as 2021 when the first diagnostic criteria was published. Currently ,the Post-Finasteride Syndrome Foundation, a US based non-profit, has recorded nearly 27,000 adverse reactions to the drug worldwide and 126 known suicides.
Steve recalls the medical gaslighting he experienced. ‘They thought that it was all in my head. My dad even offered to take the drug to prove it; I stopped him, of course.’ Aside from the mental health effects, Steve also had to deal with penis shrinkage, another side effect. ‘I had a girlfriend but that ended because I’ve got no libido, no sexual function – there was no closeness in the relationship,’ he says. Despite getting back on his feet, Steve says he lost everything – ‘my business, my house, my relationship. I’ll be on anti-psychotic medication for the rest of my life.’
Steve’s experience isn’t one that exists in a vacuum. As far back as 2011 experts began to raise the alarm when two endocrinologists co-authored the first peer-reviewed study, which suggested a potential link between finasteride and long-lasting sexual side effects.
Some critics argued the study’s participant selection might have been biased and the authors did acknowledge that the study did not prove causation. Still, they believed the findings were a strong indication and serious enough to warrant further investigation, which prompted more research into persistent side effects, including depression and suicidal thoughts.
While it is true that as of now, there is no ‘definitive’ study that proves finasteride causes the aforementioned symptoms, a 2021 Reuters investigation reported that Merck & Co., the original maker of Propecia (the original brand name for finasteride) knew some users had reported these symptoms. Reuters also found that Merck was aware of reports of suicidal behaviour among Propecia users but chose not to include such warnings when the drug’s label was updated in 2011. Merck told Reuters that there was no scientific evidence showing Propecia caused suicidal thoughts, so the terms should not appear on the label. But by 2018, Merck faced several hundred active lawsuits over claims of long-lasting sexual side effects from Propecia, and that year the company agreed to a settlement of £3.2m to resolve hundreds of those cases.
To muddy the waters even further, regulatory bodies and medical authorities differ in how strongly they warn about risks associated with finasteride for hair loss. The European Medicines Agency says the drug can cause suicidal thoughts but maintains that, with proper warnings, its benefits outweigh its risks. France, Belgium and Israel disagree: they argue the risks are too great for a cosmetic treatment and have issued stronger warnings or urged doctors to stop treatment at the first sign of mood changes. Currently, the UK takes a middle path, saying the drug can be used, but only if patients are fully informed, monitored and told to stop if psychiatric or sexual side effects appear.
Baldness Begets Boom
As the hair-loss industry grows, so do cultural pressures pushing men towards finasteride and hair transplants, a market that was valued at around £16.43bn in 2024. Research shows Hollywood often typecasts bald or balding actors such as Bruce Willis, Jack Nicholson, Anthony Hopkins, Dwayne ‘the Rock’ Johnson as villains, stoic heroes or morally complex characters, with romance and vulnerability rarely portrayed. Over half of 15 high-profile bald actors studied were cast in secondary roles, and nearly half played characters with negative traits. ‘Hair loss becomes associated with deficiency or deviation, which can affect how men see themselves,’ says Kiran Jones, clinical pharmacist at Oxford Online Pharmacy.
These portrayals shape cultural perceptions, conditioning men to see baldness as a flaw and fuelling the demand for treatments like finasteride. While balding figures appear in many religions, from Buddha to Christian saints and Japanese gods, historically, baldness has carried stigma. In the Bible, two bears mauled 42 boys who mocked the prophet Elisha by calling him ‘Baldy’; Julius Caesar was known to be very sensitive about his premature balding; the Vikings believed beautiful hair was associated with a warrior’s virility and honour; and during the 1700s, bald men often wore elaborate wigs to signal wealth and status in elite circles. By the mid to late 20th century, its formal medicalisation as a condition treatable with proven, effective methods had begun and widespread marketing of anti-baldness products further cemented baldness as undesirable, tied to youth, attractiveness and masculinity.
For Tariq Kazemi, founder of Bld Bro – a UK-based skincare brand celebrating baldness that won Midlands StartUp of the Year in 2025 – that stigma is personal.
‘I remember the first time I noticed my hair thinning,’ says Kazemi. ‘I was at university standing in a bar and there was a light shining on my head, I could see it thinning in the mirror and I felt my happiness leave my body in that moment. ‘Society tells you bald is bad; the advertisements reinforce it. So, my first thought was, “What can I do to fix this?”’ Kazemi started taking finasteride in his early twenties, which stopped the hair falling out, but also increased his anxiety. ‘The intensity of it felt unnatural, so I stopped taking it and over time the anxiety faded.’
Kazemi says the experience shaped his mission: ‘to challenge the narrative that being bald is a problem’. A 2021 study by researchers at Leeds Beckett University and York St John University.supports this. Analysing men’s posts on hair-loss forums, they found that baldness often feels like a threat to masculinity, self-esteem and social acceptance, intensified by societal messages around attractiveness ads.
Is a healthier head of hair really going to bring you happiness?
Between Confidence and Caution
If reading this makes new users nervous, clinicians offer reassurance – with caveats. They say the polarisation around finasteride is partly rooted in an evidence gap. ‘Many reported cases come from online forums or support groups, which naturally attract individuals who have experienced difficulties, so the picture may be skewed,’ says Dr Suzanne Wylie, GP for IQ Doctor.
‘There may be other factors contributing to reported symptoms including underlying health problems, stress, body-image concerns or unrelated sexual dysfunction.’ Still, she cautions against dismissing patient testimony. ‘That we lack definitive proof does not mean the problem should be ignored. As clinicians, we must remain open to patient experience, while also being guided by robust evidence.’
Even the drug’s strongest advocates acknowledge its limits. ‘It is one of the most effective treatments for male pattern baldness,’ says hair-restoration surgeon Dr Bessam Farjo. ‘Hundreds of thousands of men take it with excellent results, and side effects are uncommon.’ But he warns that proper medical evaluation is essential. ‘Subscription services may make the drug more accessible, but they do not always capture nuanced risk factors. Without specialist oversight, patients may be exposed to unnecessary risks.’ Early but unpublished findings funded by the PFS Network, a charity that helps further understanding of PFS, suggest age may play a role in susceptibility to adverse effects, a concerning possibility in the era of Gen Z looksmaxxing and algorithmically targeted ads.
For men like Kazemi, the question is not how to keep your hair, but why you feel you must. ‘Every bald man will tell you: once you accept it, being bald is pretty sweet,’ he says. ‘No bad hairdays, no worrying, no spending money on pills. If someone had told me in my twenties I’d actually like being bald, I would have saved myself thousands of pounds and years of anxiety.’ As he sees it, anti-bald-bloke prejudice may not be the world’s most urgent injustice, but it still shapes the choices men make about their bodies.
Steve sees things differently. He watches younger men discussing finasteride on TikTok and Reddit, praising its results. ‘And it’s true, the efficacy is amazing. But when you try to tell them about the side effects, they laugh or say you’re a one-off.’ His experience tells another story. ‘I’ve had friends who took it for a short time, had no side effects and kept their hair. But I’ve also had two friends who took their own lives as a result of finasteride. It’s a lottery.’ Ultimately, until the science catches up with the lived reality, men are left to navigate that tension largely on their own, weighing the value of hair against the cost of keeping it.
*Name has been changed.
If you are taking finasteride and experiencing any one of these symptoms, consult a doctor.
Source link
