The Economist on finasteride: risk a breakdown?
John Phipps followed men who fell ill after taking finasteride for hair loss. What his 1843 magazine feature found, and what has changed since.
This is coverage by another outlet. We link to it because it reports on PFS, PSSD or PAS — the reporting and any views in it are the publisher's, not ours.
In April 2024, The Economist’s 1843 magazine profiled men who say finasteride for hair loss made them ill. They describe lasting symptoms that went on after they stopped. Patients call it post-finasteride syndrome (PFS).
The writer, John Phipps, built the piece around Ben, a friend in his twenties. Ben used a finasteride gel for about two months in 2021. Days after he stopped, panic attacks began. Then came weight loss, no erections, brain fog and suicidal thoughts.
His story is hard to read. If something changed for you after finasteride, parts of it may sound familiar.
What did The Economist report?
The feature follows Ben through months of tests and conflicting advice. His testosterone came back low. One doctor offered testosterone gel, which might affect fertility. Others suggested different hormone treatments. With treatment and time, his sleep and libido came back and he could read for pleasure again, though he still needed hormone injections.
Phipps also spoke to 13 people with lasting symptoms. None would give their full name. One, a man in England, bought finasteride online and later lost pleasure in music and struggled to read.
The reporter tested online pharmacies too. Ticking boxes for suicidal thoughts and erection problems did not always stop an order going through.
What do doctors and companies say?
The piece gives the other side too. It says PFS is disputed among scientists and that a cause has not been proved. Several hair-loss doctors told Phipps they had never heard a complaint from their patients.
It also reports that in the trials behind the 1 mg tablet, about 4 in 100 men had sexual side effects, against about 2 in 100 on placebo. Merck has said these effects stop when the drug stops. Organon, which now owns Propecia, told the magazine the drug is safe and effective.
The specialists Phipps spoke to could not say how common lasting effects are, or why some men get them. One urology professor, Abdulmaged Traish, put it plainly: “If I knew that, I would be a millionaire.”
What has changed since 2024?
Regulators have moved. In late April 2024, the UK medicines regulator said a patient card would go in every finasteride pack. It warns of psychiatric side effects and sexual problems that may continue after stopping.
In May 2025, the EU medicines regulator confirmed suicidal thoughts as a side effect of finasteride. It also asked for a patient card in packs of the 1 mg tablets. Nobody has yet measured how often lasting effects happen.
What you can do
Finasteride helps many people keep their hair. If you take it, the UK leaflet says to stop and see a doctor if your mood changes. Any other change is a decision for you and your prescriber.
If you have thoughts of suicide, call Samaritans on 116 123, free, day or night.
Report it: it helps everyone
A doctor’s note helps you. A report to the medicines regulator helps everyone else: it is how patterns get noticed.
- No proof needed. A suspicion is enough, even years after stopping.
- Where: the Yellow Card scheme in the UK, MedWatch in the US.
- Use the right words. If symptoms continued after stopping, write Post 5-alpha-reductase inhibitor syndrome (MedDRA 10082430).
Our reporting guide walks you through it
Ben’s recovery came slowly, after months of fear. Read what post-finasteride syndrome is, and if this sounds like you, report it.
Sources
- Phipps J. Would you risk a breakdown to cure baldness? 1843 magazine, The Economist, 5 April 2024.
- MHRA. Finasteride: reminder of the risk of psychiatric side effects and of sexual side effects. Drug Safety Update, 29 April 2024.
- EMA. Finasteride and dutasteride containing medicinal products: referral. PRAC recommendation 8 May 2025; EC decision 22 August 2025.
- MHRA. Yellow Card reporting site.
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