Propecia And The Fear Of Sexual Side Effects
When it comes to treating hair loss, many men feel trapped between two terrible choices:
Choice #1: Start taking a drug forever that will help fight hair loss – but at the risk of developing sexual side effects (that are sometimes reported as permanent).
Choice #2: Don’t take that drug… and instead, accept that you will continue to lose your hair.
This is exactly how I felt when, at 17-years old, my doctor diagnosed me with pattern hair loss and then prescribed to me Propecia.
Propecia – an FDA-approved drug – helps slow, stop, and even partially reverse hair loss by reducing the amount of DHT in our bodies (a hormone that may indirectly trigger pattern hair loss).
Unfortunately, the hormone DHT (dihydrotestosterone) isn’t just implicated in hair loss… It’s also critical for male sexual development. In fact, men who have never been able to produce normal amounts DHT tend to suffer from low libido and poor genital development. So it’s no surprise that the drug Propecia (Finasteride) – a DHT reducer – is associated with similar side effects: lower sex drive, poorer quality erections, and in rare cases, impotence. For an unlucky few, these sexual side effects persist even after they stop taking the drug.
As a high schooler with thinning hair, I didn’t want to risk impotence – no matter how small the chance. So I decided against taking Propecia.
But here’s something I never understood…
Many People Are Afraid To Take Finasteride To Reduce DHT, So They Instead Take “Natural” Supplements To Reduce DHT… But What Difference Does It Make?
Many hair loss sufferers who fear Propecia’s sexual side effects instead take what they call “natural” DHT reducers… supplements like saw palmetto or pumpkin seed oil.
Their rationale? They say that “natural” DHT blockers reduce DHT… but without the same sexual side effects as Propecia.
At first glance, that makes no sense. Propecia, saw palmetto, and pumpkin seed oil do the same thing: they decrease DHT. But DHT is required for proper sexual function. So how come Propecia has a history of sexual side effects… while, according to some supplement advocates, “natural” DHT blockers don’t?
Or maybe these supplement takers are wrong about their “natural” DHT reducers. Maybe these supplements do cause sexual side effects, but no one ever looked deep enough in the literature.
This article uncovers the answers. By the end, you will learn:
- Why the word “natural” is subjective, confusing, and misleading
- Do natural DHT blockers cause sexual side effects? The answer may surprise you
- How natural DHT blockers reduce DHT differently than Propecia – and how this relates to your sex drive
- If we stop taking DHT blockers – natural or synthetic – are we worse off than if we never started?
- Should we use natural DHT blockers to fight pattern hair loss? And if so, how?
Warning: this article gets technical. But if you’re considering taking any kind of DHT blocker – even if it’s naturally derived – then understanding this content is critical.
Let’s start by reviewing how DHT is connected to hair loss, how reducing DHT might help fight thinning hair, and where Finasteride comes into play.
The DHT-Pattern Hair Loss Connection
When I was first diagnosed with pattern hair loss, I asked my doctor why my hair was falling out. His answer:
DHT (a hormone made from testosterone) is higher in the scalps of balding men. For reasons not entirely understood, our hair follicles start to become more sensitive to DHT, and then begin to shrink over a series of hair cycles. The end result: pattern hair loss (and eventually baldness).
Beyond this relationship, the DHT-hair loss connection is cemented by two major findings:
- Boys who are castrated before puberty produce 95% less DHT for the rest of their lives. Interestingly, castrated prepubertal boys never go bald later in life.
- Some men have a rare genetic mutation that prevents DHT from binding to their scalp tissues. These men also never lose their hair to pattern baldness later in life.
While researchers still can’t explain why DHT causes hair loss, the evidence is clear: 1) men who can’t produce DHT don’t go bald; and 2) balding men have elevated DHT levels in their balding regions. So goes the DHT-hair loss connection…
These findings were the basis for pharmaceutical companies to develop drugs that could reduce DHT, and hopefully reverse pattern hair loss.
Enter Propecia… A Drug That Reduces DHT
Finasteride (branded as Propecia) reduces DHT. How? By inhibiting an enzyme known as type II 5-alpha reductase.
5-Alpha Reductase, DHT & Hair Loss: What You Need To Know
Remember how DHT is made from testosterone? Well, this conversion doesn’t just happen on its own. In order for testosterone to convert into DHT, it needs the help of an enzyme called 5-alpha reductase.
5-alpha reductase is an enzyme required for our bodies to convert free (unbound) testosterone into DHT. Without 5-alpha reductase, this conversion doesn’t happen.
The 5-alpha reductase enzyme comes in a few types, but the one that is of highest interest to hair loss researchers is type II 5-alpha reductase. Why? Because type II 5-alpha reductase is the exact enzyme needed to convert testosterone into DHT in our prostate tissues and scalp skin.
Do you recall that rare genetic mutation which prevents some men from going bald? That mutation is actually a type II 5-alpha reductase deficiency. The reason why men with that mutation don’t go bald is because they don’t have any scalp DHT, and the reason why they don’t have any scalp DHT is because their bodies can’t produce the type II 5 alpha reductase enzyme.
Finasteride’s goal: to do the same thing.
Finasteride Reduces Hair Loss By Inhibiting Type II 5-Alpha Reductase
The logic behind Finasteride is as follows: if we can stop type II 5-alpha reductase from forming, then we can stop DHT from binding to our scalps.
Finasteride (Propecia) does exactly this. It inhibits type II 5-alpha reductase, and in doing so, reduces DHT levels in our prostates and scalps.
Does Finasteride Help Fight Hair Loss?
Yes. While studies show that Finasteride (Propecia) isn’t great at regrowing a lot of hair, it can significantly slow, stop, and even partially reverse pattern hair loss.
Unfortunately, this is sometimes at the cost of our sex lives.
The Evidence: Sexual Side Effects of Finasteride and Dutasteride (Type II 5-Alpha Reductase Inhibitors)
Depending on the dose, Propecia can reduce DHT levels by ~70%. And while this may help our hair, a DHT reduction this severe sometimes coincides with the following side effects:
- Lacking sexual appetite
- Difficulty orgasming
- Low volumes of ejaculation
- Gynecomastia (or the more familiar term: man boobs)
Propecia’s manufacturers say these effects are rare and impact up to just 2% of drug users. But some studies suggests that incidence is much higher.
In one study, men taking 5mg daily of Finasteride saw a 15% incidence in sexual side effects within one year. And while this isn’t a perfect apples-to-oranges comparison (most Finasteride users take up to 2mg daily instead of 5mg), it’s an indicting example of how 5-alpha reductase inhibiting drugs can curb our sexual performance.
And it gets worse.
There are forums dedicated to helping men who once took Finasteride for hair loss, then stopped due to sexual side effects, but after stopping, never saw their sexual side effects resolve.
This is called Post-Finasteride Syndrome, and there’s even a foundation dedicated toward advancing research into why these sexual side effects persist for certain men but not others (expect an article on this soon).
These sexual side effect fears are what scare many hair loss sufferers away from Finasteride and Dutasteride, and toward other protocols for hair loss management.
The Good News: Finasteride (Propecia) And Dutasteride Aren’t The Only Things That Can Reduce DHT
There are many foods (and food derivatives) that also reduce 5-alpha reductase activity, and thereby DHT levels.
For example, studies show that the extract from saw palmetto fruit is a 5-alpha reductase inhibitor. And some studies suggest the fatty acids in pumpkin seed oil also reduce DHT levels.
There’s also evidence that a seaweed extract called ecklonia cava may have DHT-reducing capabilities. And even the volatile oils inside rosemary and peppermint extracts show some ability to reduce 5-alpha reductase activity.
Many hair loss sufferers refer to these extracts and concentrations as “natural” DHT reducers. And as a result, most people also consider these safer.
But are these food derivatives actually safer than Finasteride? The research is more complicated than you’d expect…
…But even more complicated? People’s definitions of the term, “natural”… And why, for some reason, these DHT blockers are considered “natural” while Finasteride isn’t.
DHT Reducers: Why “Natural” Is A Ridiculous Term
When we define things as natural or unnatural, what do we mean?
Some people say that “natural” is anything that can’t kill you. According to these people, substances like cyanide or arsenic are unnatural.
Unfortunately, both cyanide and arsenic are naturally-occurring substances found all over the world. And they can kill us fairly easily.
Other people loosen their definition of “natural” to anything that isn’t harmful to our health – like water. But if we think about this critically, too much of anything can harm us. In fact, too much water can kill us.
Then we’ve got a group of “natural” thinkers who are sort of scientifically literate. They say that anything made in nature = natural. Anything made in a lab = unnatural.
I decided to poll ten people who agreed with this definition. When I asked if they considered steroids unnatural, 100% said yes.
Then I explained that synthetic estrogens (a lab-made steroid) are made from concentrations of the “natural” food source wild yams. And so came another tightening of their natural definition…
My point is this: people have wildly different takes on what is natural, and what isn’t. So before you go throwing out the term, make sure you know where your definition of “natural” starts and stops.
For purposes of this article, we’re going to draw a hard line too.
“Natural” DHT Reducers: Our Definition
I think a fair definition of a “natural DHT inhibitor” is one that is…
- Chemically unaltered
For example: pumpkin seed oil and saw palmetto extract fit my definition of natural DHT inhibitors. Why?
For one, both are derived from foods. Pumpkin seed oil is made by cold pressing the seeds of pumpkins. Saw palmetto extract is made by extracting the polyphenols and fatty acids from the saw palmetto fruit.
And aside from being highly concentrated, these extracts aren’t chemically altered. In other words, they’re not molecularly modified to look and act like a hormone in our bodies.
Now contrast this with Finasteride (Propecia).
Finasteride is synthetic. It’s made in a laboratory by modifying the chemical bonds of progesterone – an endogenous sex steroid released by the ovaries and the placenta during pregnancy.
And based on our research, Finasteride is not made from food. It’s a chemically altered derivative of progesterone that binds to a cofactor required for type II 5-alpha reductase expression, and as a result, stops that expression from ever happening.
As a result, I consider saw palmetto and pumpkin seed oil natural, and Finasteride more as unnatural (at least if I had to put definitions on them).
- Natural = food-derived, chemically unaltered.
- Unnatural = not from food, chemically synthesized.
Now that we know just how pure and “natural” saw palmetto and pumpkin seed oil are, surely they must be devoid of sexual side effects… I mean, they shouldn’t boast any sexual problems like the “unnatural” drug Finasteride… Right?
Wrong. (Sort of).
The Evidence: Sexual Side Effects of “Natural” DHT Inhibitors For Hair Loss
While the evidence is mixed, there are some reports that saw palmetto is sometimes associated with sexual dysfunction such as decreased libido.
The good news? These side effects are significantly less common with saw palmetto when compared to Finasteride. And on top of that, Finasteride may also result in more varieties of sexual dysfunction – like impotence, difficulty achieving an erection, and abnormal ejaculation.
Better yet: the adverse effects of saw palmetto (if any) appear to be mild and infrequent, and don’t persist after discontinuing the supplement. And a recent large, multi-center study found no evidence of significant adverse effects (including sexual dysfunction) after 18 months of treatment with saw palmetto… at three times the typical dose.
We can’t say the same about mega-dosing with Finasteride, as that earlier study showed that 5mg daily dose resulted in a 15% incidence of male sexual side effects in just one year.
The bottom line: there’s some evidence that saw palmetto can cause some sexual side effects. But this appears to be much milder versus Finasteride, and even better, reports show a reversal of side effects after stopping its use.
But what about other “natural” DHT reducers – like pumpkin seed oil?
Pumpkin Seed Oil And Other “Natural” DHT Reducers: Any Sexual Side Effects?
There are reports that pumpkin seed oil may cause ejaculation problems. However, several recent studies on patients receiving pumpkin seed oil over 6-12 months have shown no significant sexual side effects.
We also haven’t observed any sexual side effects with topical rosemary oil use – another anti-androgenic extract. And ironically, the seaweed extract ecklonia cava may reduce DHT levels in men while simultaneously improving their sexual function.
The Takeaway: Natural 5-Alpha Reductase Inhibitors Reduce DHT, And With Far Fewer Sexual Side Effects Than Propecia
And this brings us back to our main question…
How can both natural 5-alpha reductase inhibitors and Finasteride reduce DHT… but only Finasteride is associated with higher rates of sexual dysfunction?
There are three possibilities. If you’re going to take any anti-androgens for hair loss, it’s in your best interest to understand each.
Theory #1: Natural DHT Blockers May Cause Sexual Side Effects, But We Don’t Yet Have The Studies To Prove It
There are an overwhelming number of studies on Finasteride and its sexual side effects. On the contrary, there are fewer studies on saw palmetto, pumpkin seed oil, and other natural DHT reducers. By the volume alone, the literature skews heavily against Finasteride. As a result, we might be making misleading conclusions about these “natural” DHT reducers.
But for a moment, let’s assume this isn’t true.
Instead, let’s take the current body of evidence at face value: despite the fact that Propecia and food-based extracts reduce DHT, Propecia causes significantly more sexual side effects than saw palmetto or pumpkin seed oil.
The question is… why?
Well, there are two remaining possibilities.
First, that natural DHT reducers aren’t as effective at reducing DHT as a drug like Propecia, and as a result, produce fewer sexual problems.
And secondly, that natural DHT blockers reduce DHT through a completely different set of mechanisms, and that only certain DHT-reducing mechanisms are to blame for Finasteride’s negative side effects
Let’s take these one-by-one.
Theory #2: Natural DHT Blockers are Worse at Reducing DHT than Finasteride, And Thus Cause Fewer Sexual Side Effects
This is an uncomfortable truth for most “natural” DHT reducer advocates: these natural compounds are probably less effective at reducing DHT versus Finasteride.
Finasteride And Dutasteride Drastically Reduce Serum, Prostate, And Scalp DHT
Studies have shown that Finasteride decreases serum DHT levels by 71% after 24 weeks of use. Similarly, Dutasteride has been shown to lower serum DHT by 95 % after 24 weeks.
Those are some serious reductions. So how do food-based 5-alpha reductase inhibitors compare?
Sadly, we don’t really know. But based on the evidence so far, these food-based DHT reducers are much less effective.
Natural DHT Reducers Only Reduce DHT By A Fraction Of Finasteride
In a randomized trial, saw palmetto reduced prostate tissue DHT levels by 32%.
Another study showed that saw palmetto inhibits the activity of type II 5-alpha reductase by 76%, and Finasteride by 82%. Unfortunately, there was no evaluation in actual DHT levels. And to make matters worse, when we compare half-lives and metabolism rates of saw palmetto versus Finasteride, the 5-alpha reductase reduction from saw palmetto appears much shorter-lived.
Even worse news: there are no studies evaluating “natural” DHT blockers and their reduction in DHT levels in the prostate or scalp. And when it comes to pattern hair loss, the scalp is where DHT reduction really counts.
Based on the limited evidence – if we control for dosage sizes, half-lives, and the studies above – our best guess is that natural DHT blockers reduce DHT levels by just 1/3rd of what a synthetic DHT blocker can achieve.
This would also explain why saw palmetto isn’t as effective as finasteride: it’s just not as powerful.
The take home note? With less of a reduction in DHT, fewer sexual side effects will arise. So it’s no wonder that food-based DHT reducers are associated with fewer sexual problems.
But this might not be the “big” reason why natural DHT reducers boast fewer sexual side effects. In fact, it might be due to the actual structure of these synthetically-made drugs.
Theory #3: Natural DHT Blockers Indirectly Reduce 5-Alpha Reductase, Whereas Finasteride Directly Reduces 5-Alpha Reductase… Which Explains Why Finasteride Has More Sexual Side Effects
5-Alpha Reductase Inhibitors: Steroidal Versus Non-Steroidal
Remember how we defined “natural” versus “unnatural”? Natural is food-based and chemically unaltered; unnatural is not from food and chemically synthesized.
Well, chemists also divide 5-alpha reductase inhibitors into two categories:
- Steroidal 5-AR Inhibitors: 5-alpha reductase inhibitors made from steroids
- Non-steroidal 5-AR Inhibitors: 5-alpha reductase inhibitors not made from steroids
Examples of steroidal 5-AR inhibitors: Finasteride and Dutasteride. Why? Because these drugs are chemically synthesized from the sex steroid progesterone.
Examples of non-steroidal 5-AR inhibitors: saw palmetto extract and pumpkin seed oil. Why? Because these compounds are simply food concentrations.
Why The Difference Between Steroidal And Non-Steroidal 5-AR Inhibitors Matters
Interestingly, steroidal 5-alpha reductase inhibitors may reduce DHT differently than non-steroidal 5-alpha reductase inhibitors.
Steroidal 5-AR Inhibitors Directly Reduce 5-Alpha Reductase
Remember our chart from earlier? Free testosterone is converted into DHT by the enzyme 5-alpha reductase…
But in reality, this process isn’t that straightforward.
Why? Because 5-alpha reductase doesn’t just pop up out of nowhere. It actually needs the help of a cofactor to form and mediate the DHT conversion process. And what is that cofactor? A coenzyme known as nicotinamide adenine dinucleotide phosphate… or to put it simply, NADPH.
Finasteride works on a molecular level by binding to and altering the structure of NADPH. It changes NADPH it into a different cofactor – one that doesn’t allow 5-alpha reductase to form.
The end-result: a direct decrease in 5-alpha reductase expression.
This is an example of direct 5-alpha reductase inhibition. And based on the evidence, this is exclusively how steroidal 5-AR inhibitors reduce DHT.
But non-steroidal 5-AR inhibitors behave differently in the body. And these differences might explain the lacking sexual side effects.
Non-Steroidal 5-Alpha Reductase Inhibitors – How Are They Different?
Before we go any further – let’s be clear: non-steroidal 5-AR inhibitors like saw palmetto, pumpkin seed oil, rosemary extract, and ecklonia cava still directly reduce 5-alpha reductase.
Non-Steroidal 5-AR Inhibitors: Direct Mechanisms
Pumpkin seed oil is high in polyunsaturated fatty acids (linoleic acid) and zinc. And interestingly, linoleic acid and zinc are non-steroidal elements which directly inhibit 5-alpha reductase. Here’s how:
Linoleic acid reduces 5-alpha reductase by altering the lipid bilayer in cell membranes. Conversely, zinc inhibits 5-alpha reductase by decreasing the expression of NADPH – the same cofactor needed for 5-alpha reductase to form.
These non-steroidal elements direct reduce 5-alpha reductase (5-AR). Why? Because they act on a molecular level to directly shut down 5-AR activity.
We see these same direct mechanisms are play with other natural DHT reducers – like saw palmetto and rosemary oil.
Saw palmetto extract inhibits 5-alpha reductase directly by competing with free testosterone to bind to androgen receptors. The more saw palmetto present, the less free testosterone can be converted to DHT. And just like saw palmetto, rosemary oil also appears inhibit 5-alpha reductase through direct actions on cell function.
But this isn’t the only way non-steroidal compounds reduce DHT levels. In fact, they also act on DHT indirectly… And evidence suggests that this type of DHT reduction – indirect – is probably much safer when it comes to sexual side effects.
Non-Steroidal 5-AR Inhibitors & Indirect DHT Reduction
Unlike Finasteride, non-steroidal 5-AR inhibitors like saw palmetto and pumpkin seed oil reduce DHT through both direct and indirect means.
As a refresher:
- Direct – inhibit 5-alpha reductase directly (suppress 5-AR expression at molecular level).
- Steroidal examples: Finasteride alters the chemical structure of NADPH so 5-alpha reductase cannot form
- Non-steroidal examples: linoleic acid alters lipid bilayers so 5-alpha reductase cannot form; zinc decreases NADPH so 5-AR cannot form
- Indirect – inhibit 5-alpha reductase indirectly (by reducing inflammation)
- Steroidal examples: none.
- Non-steroidal examples: compounds in saw palmetto, pumpkin seed oil, and rosemary oil help reduce chronic inflammation, and as a consequence, reduce the amount of DHT in inflamed tissues
The definition of Indirect DHT Reduction is important – so let’s reinforce it.
Indirect DHT Reduction = Reducing Inflammation
When it comes to the causes of pattern hair loss, the question that no one seems to ask is…
If DHT levels are higher in balding scalps, then what causes DHT to rise in the first place?
Doctors have a simple answer for this: genetics. But it’s not necessarily true. In fact, new research shows that DHT doesn’t just increase it out of nowhere… instead, DHT likely increases as a response to chronic inflammation.
It’s far more likely that elevated scalp DHT in isn’t just due to genetic sensitivity, but rather, that this DHT is a response to inflammation in men’s scalp skin.
The causes of scalp inflammation are still debated. But one thing is clear: where there’s chronic inflammation, there’s often also increased DHT.
The net: higher DHT levels are a response to chronic inflammation. And if we take away the inflammation, we can indirectly take away the DHT.
And that is how you indirectly reduce DHT levels. You take away the sources of inflammation.
Interestingly, non-steroidal 5-alpha reductase inhibitors appear to do just this…
Examples Of Indirect DHT Reduction: Non-Steroidal 5-Alpha Reductase Inhibitors
There are hundreds of studies showing how substances inside pumpkin seed oil, saw palmetto, rosemary, and ecklonia cava can reduce inflammation (and thereby DHT levels).
Covering all of them would turn this 5,000-word article in 100,000. So instead, we’ll just give a highlight reel.
Indirect DHT Reducing Mechanisms Of Non-Steroidal 5-AR Inhibitors
The following parts of pumpkin seed oil help reduce chronic inflammation:
- Pumpkin Seed Oil
- Antioxidants (tocopherols): decrease oxidation, decrease expression of transforming growth factor beta
- Linoleic acid: reduces COX-2 enzyme
- Rosemary Oil
- Polyphenols: reduce COX-2 enzyme
- Volatile oils: reduce COX-2 enzyme, pro-inflammatory interleukins, and tumor necrosis factor
This list could go on for pages. But you get the idea: natural DHT reducers don’t just reduce 5-alpha reductase… They also reduce the signaling proteins and enzymes that create chronic inflammation in our scalp tissues. As a result, they directly reduce inflammation, and thereby indirectly reduce DHT levels.
And that’s the difference between direct and indirect DHT reduction. It’s my belief that these natural-based compounds probably do more to reduce inflammation than they do to directly reduce DHT, and as a result, cause fewer sexual side effects.
And if even after knowing this, you’re still not worried about the effects of steroidal DHT reducers like Finasteride, then you should know one last thing.
The Hidden Cost Of Finasteride: Dependency And Potentially Irreversible Remodeling Of Androgen Receptors
When it comes to Finasteride, there’s one thing that worries me most:
Finasteride, when combined with Letrozole (another anti-androgen), appears to increase androgen receptor activity in the prostate of mice. That’s not necessarily a big deal… But it gets worse: this change in androgen receptor activity doesn’t go away, even after stopping Finasteride + Letrozole treatment.
Why is this a problem? Well, if you get off Finasteride (Propecia), your prostate may have remodeled to have an even higher amount of androgen receptors. DHT has a higher affinity for androgen receptors than many other testosterone derivatives. Because of this, there’s a chance that if you increase your androgen receptors, the more likely DHT will arrive to those sites.
In other words, if your prostate remodels and you get off Finasteride, your prostate is likely going to flood with more DHT than if you never took Finasteride to start.
Does Androgen Receptor Remodeling And DHT Flooding Carry Over Into Pattern Hair Loss?
We don’t yet know, but it’s possible.
In fact, this would explain why men lose hair so rapidly after dropping Propecia. More DHT floods the scalp and the hair rapidly miniaturizes. And some researchers are even looking into whether this androgen receptor remodeling might be responsible for the persistent sexual side effects some men experience even after dropping Propecia.
The reality is: anything irreversible scares people. And for those who’ve already committed to taking Propecia, if you stop taking it today, you might be facing a higher risk of hair loss now than if you’d never started taking it.
Again, we don’t yet know if these findings in mice apply to humans with pattern hair loss, or if androgen remodeling with Finasteride + Letrozole is similar to that observed with Finasteride alone. But the results do warrant more investigation, and more cause for concern amongst people considering either drug.
Do “Natural” DHT Blockers Like Saw Palmetto Or Pumpkin Seed Oil Remodel Androgen Receptors?
The answer to this question is that we don’t know.
While saw palmetto has been shown to not influence androgen receptor activity, there are no other studies (to my knowledge) that have evaluated this issue. But what’s reassuring is that food-based DHT blockers…
- Are less potent than Finasteride
- Reduce DHT through direct and indirect means
- Aren’t associated with prolonged sexual side effects after stopping use
In addition, natural DHT reducers have other health benefits besides promoting hair growth – like reducing oxidation and chronic inflammation – processes not only detrimental to our hair, but to our entire body. And if you’ve been keeping up with these articles, you’ll know how just how closely these processes are associated with nearly all disease development.
Should You Include “Natural” DHT Reducers In Your Hair Loss Regimen?
Based on the evidence, “natural” DHT blockers – saw palmetto, pumpkin seed oil, rosemary oil, and ecklonia cava – seem to be somewhat effective at reducing DHT. And even better, they appear to reduce DHT both directly and indirectly – making them a more robust approach to treating the myriad causes of hair loss.
These supplements are also derived from food substances as opposed to chemically altered steroids – which probably make them safer. Why? The evidence suggests that steroidal 5-AR inhibitors like Finasteride act directly on 5-alpha reductase and irreversibly remodel our androgen expression – which might explain why Finasteride causes so many more sexual side effects.
Finally, drugs like Propecia appear to have no other benefits to cardiovascular health or longevity. Conversely, studies show that the substances inside “natural” DHT reducers have anti-inflammatory properties that may benefit the entire body.
Together, these points make a compelling case for choosing “natural” DHT reducers over Finasteride. But to reiterate: there’s not much evidence that these natural DHT reducers are as effective as Finasteride or other hair loss drugs at stopping or reversing thinning hair.
While we’ve seen one-off studies done demonstrating incredible hair growth from pumpkin seed oil, and while we’ve read studies that rosemary oil may be just as effective as minoxidil – the evidence of hair growth on these food supplements is still limited.
We need to do more studies. And while the chances appear low, we still need to ensure that these natural DHT reducers don’t cause the same cell remodeling effects as Finasteride. Until these questions are answered, the jury is still out natural DHT reducers.
You’ve got hundreds of “natural” DHT reducing supplements from which to choose. So which are the best? Unfortunately we don’t yet know. There are just too few studies to confirm. And if you read a website that says any of these natural DHT reducers are as effective as Finasteride – you should know that they’re probably lying.
You could try saw palmetto, pumpkin seed oil, rosemary extract, peppermint oil, castor oil, olive oil, and just about every essential oil out there. All of these appear to have some anti-androgenic effects.
But if you do decide to try a “natural” DHT reducer – commit to it for at least six months before determining if it’s helping your hair loss. And better yet, do it in conjunction with mechanical stimulation exercises. Chances are the two will create a synergistic hair regrowth effect (read the case study in our saw palmetto article).
Questions? Comments? Please reach out in the discussion section.
Rob English is a researcher, medical editor, and the founder of perfecthairhealth.com. He acts as a peer reviewer for scholarly journals and has published two peer-reviewed papers on androgenic alopecia. He writes regularly about the science behind hair loss (and hair growth). Feel free to browse his long-form articles and publications throughout this site.