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Comment by ProjectArcturis | Hacker News Reader

As a balding man, I've certainly been tempted to try finasteride. But the idea of keeping my hair by messing with my hormones sounded insane, so I never did it. I agree, this should not be an approved drug.

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Personal anecdote: I have been on finasteride for 17+ years with no negative symptoms. I started using it at the age of 17 when I started losing my hair and it immediately stopped / reversed my hair loss. I have a family history of baldness and my grandfather went bald at 20.

So far I've had no issue with sex drive while on the medication. However I did notice an increase in my sex drive when I first went off of the pills while my wife was trying to conceive. (However that seems to be temporary for first few days while my hormones adjusted.)

[Throwaway account since I consider my medical data personal]

There is a group of people for whom the side effects are completely fine, welcome even. It would be a reduction in ability of care if the drug became unapproved. Maybe I'm just oversimplifying, but couldn't people who are not ok with the side effects, not take the drug? I find it ok to say, here are the side effects, and here are their prevalence and leave it up to the patient to decide, but perhaps I'm misunderstanding the point.

I think this would be a fair argument if the possibility of persistent side effects were acknowledged and clearly communicated. Right now, if you go to get a prescription for finasteride and ask your doctor whether you might have side effects that last years after discontinuing the drug, they will almost certainly say, no, that's not possible.

> if you go to get a prescription for finasteride and ask your doctor whether you might have side effects that last years after discontinuing the drug, they will almost certainly say, no, that's not possible.

I can absolutely see that happening. I'm very interested in tracing this line of questioning back to a root cause because it likely has a systemic cause, and fixing it would have major implication in the way medicine is practiced and the treatments people receive.

Doctors are the highest paid profession in the United States because they have a legal monopoly on the practice of surgery and prescription of medicine. Because their income flows from this monopoly, they over value medical treatments that use prescription drugs and under value treatments that do not, such as diet and exercise. The latest example is the reluctance of the medical community to say the Vitamin D reduces the risk from contracting Covid-19, even though there is strong evidence to show this. Since this is so, your doctor is likely to not tell you the full story of the risks versus the benefits of the drugs you are prescribed and you would do well to research the question on your own, especially if it is a drug you will take for a chronic disease.

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