Finasteride doesn’t cause sexual side effects, UK hair-transplant surgeon assures undercover journalist
Feb. 5, 2026
Dear Friends:
In what may be a finasteride-awareness first, traditional and social media are working together to crack down on fast-and-loose access to the hair-loss pill that the European Medicines Agency (EMA) has deemed capable of causing patients to consider killing themselves.
Last month, BBC Radio’s File on 4 debuted an investigative documentary into whether UK finasteride hawkers are heeding a 2024 alert by their nation’s regulatory authority that the drug “has been associated with depression, suicidal thoughts and sexual dysfunction.”
That dispatch from the Medicines and Healthcare products Regulatory Agency (MHRA) also advised health pros to ask patients—prior to prescribing the drug—if they have a history of depression or suicidal ideation, and to direct any patients who develop such adverse reactions to ditch the drug immediately.
Titled Thin on Information? Hair Loss Drug Finasteride, the 38-minute documentary by host Johnny I’Anson and producer Rob Byrne enlisted experts to weigh in on the legality of influencers touting finasteride on social media, and the ethics of hair-transplant surgeons downplaying the drug’s risks.
It also examines the case of PFS patient Conall Gould, who, despite having no history of addiction, died of a drug overdose in 2017 after a team of psychiatrists in his hometown of Ballymena, Northern Ireland, diagnosed his symptoms as a delusional disorder.
They’re fired!
In all, File on 4 identified six influencers who frequently extoll the benefits of finasteride on TikTok. That, while offering discount codes redeemable on Manual, a popular UK telehealth site that specializes in “solving” hair loss, erectile dysfunction, and low testosterone.
Among them is Carlo Brancati, a contestant from Season 19 of The Apprentice UK who was booted three episodes in for disrupting his team and making meager contributions to its tasks. After undergoing two hair transplants, Brancati now bills himself as a leading advisor on the procedure.
“This right here is the number one thing in the world that you can do to save your hair,” he says in one post, File on 4 reports.
Johnny then asks Adela Williams, MD, who specializes in regulatory issues at the London law firm of Arnold & Porter, for her take.
Carlo “shows images of people who he says have been treated with finasteride and have shown improved or increased hair growth. He refers to ways in which people are able to obtain supplies of finasteride online and provides a code by which people who want to purchase finasteride can obtain a discount at checkout,” says Dr. Williams.
“I think there’s no doubt that it constitutes advertising. In circumstances where advertising of prescription-only medicines [POMs] is not permitted, then this statement is in breach of the legislation.”
In the UK (as in every nation worldwide, save the US and New Zealand), it is unlawful to advertise POMs to the general public on any venue. That includes traditional media, social media, and other consumer-facing channels.
Dr. Williams also flagged the TikTok posts of another finasteride-happy influencer, Tom Gilbanks, telling File on 4:
“He describes a podcast and then he goes on to refer to various celebrities who he suggests have probably used finasteride. It’s unclear, firstly, whether these statements are true and it’s unclear whether Tom Gilbanks has permission to use these images in the way that he does. Clearly, the reference to celebrities and the suggestion that if hair is important to them then they would use finasteride, then this is clearly advertising in breach of the legislation.”
Armed with Dr. Williams’ expert opinions, Johnny passed the seemingly illicit posts on to MHRA Chief Safety Office Alison Cave. Shortly thereafter, TikTok told File on 4:
“As per our community guidelines we do not allow content which markets or promotes the use of regulated goods including prescription-only products and have removed the flagged content which breaches our laws.”
What’s more, Carlo, Tom and one other self-proclaimed “men’s health influencer” were banned outright from TikTok.
First, tell no lies
To find out what hair-transplant surgeons are saying about finasteride, Rob posed as a potential patient at 10 clinics. During his initial visits, he reports:
“Ten out of 12 consultants recommended taking finasteride. Of those 10, all mentioned side effects. Four claimed they would definitively stop once you cease taking finasteride. Two clinicians even questioned the existence of sexual side effects. So we followed up with these two clinicians.”
First up was Paul Hill, director of UK Hair Transplant Clinics, whom Rob contacted via video call, which, unbeknownst to Hill, was recorded for inclusion in Thin on Information? When the BBC producer inquires about finasteride causing adverse reactions, Paul says:
“The most common minor side effect is sexual dysfunction… Slight dilution in your libido, slight erectile issues. But there are now studies, bigger studies, recent studies, that have proved…there is no such thing as sexual dysfunction.”
Next, Rob asks what happens after a patient quits finasteride, to which Paul replies:
“If you come off it, there’s no…long-term scientific evidence of persistent side effects for sexual dysfunction. We’ve not seen any in 15 years, which is consistent with the academia.”
This time, File on 4 asked Channa Jayasena, MD, who specializes in reproductive endocrinology and andrology at London’s St. Mary’s Hospital, for his take.
“I am very surprised that they haven’t seen a case in 15 years of persistent sexual problems. Now, that may reflect that they don’t follow up with these patients and [these patients are seeking medical advice] elsewhere,” says Dr. Jayasena. “But I would find it difficult to believe that none of their patients in 15 years had experienced a problem.”
Rob’s second follow-up was with Harris Hasib, MD, founder of Harris Hair Transplants, whose video call was also recorded without the surgeon’s knowledge. When the conversation turns to possible side effects stemming from finasteride use, Dr. Hasib tells the producer:
“If you’re depressed, then yes, you have to be careful. It doesn’t cause depression, but if you’re already depressed and you’ve been taking medications, then yes, it can actually make it worse. But remember, it doesn’t cause it. It makes the existing depression worse.”
Dr. Hasib also tells Rob, vis-à-vis one published study on finasteride use and sexual dysfunction:
“There’s no sexual side effect, especially with the finasteride… This medicine is given for prostate. So if you had a big prostate, if you were the age of 60, for example, on the [UK’s National Health Service], they will give you finasteride. They were asking those people who are the age of 60 if you’re having a sexual side effect. It’s nothing to do with the medicine.”
Bewildered, Rob again asks Dr. Hasib, “So [finasteride] doesn’t ever cause sexual side effects?” to which he responds: “No, no, it doesn’t cause it.”
Dr. Jayasena take? “I don’t agree with that clinician. I do strongly recommend to clinicians that they aren’t so forthright in their reassurance, and are much more measured and balanced in helping patients make the right choice,” he tells File on 4.
One flung into the cuckoo’s nest
Another dissenting voice in the documentary is Mary Gould, a midwife from Northern Ireland. In 2017, one day before Valentine’s Day, her son Conall overdosed on MDMA, a substituted amphetamine better known by its street name: ecstasy. He was just 21 years old.
At age 18, “Conall took finasteride for a couple of months, but because of side effects, he stopped, started taking it again, and then stopped for a second time. But it wasn’t until three years later that Mary learned Conall had been on the drug,” File on 4 reports.
“He talked about loss of libido, sexual dysfunction—things that a young man should really not have to be dealing with. He dropped out of university in 2016. He had not been feeling very well. He was suffering with probably severe anxiety, severe depression,” Mary tells Rob, who traveled to her home in Ballymena for the interview.
“I asked him what was wrong, and he told me that he just was feeling really low, and then he said he’d discovered this condition called post-finasteride syndrome… He was even talking now about end of life…saying to me, ‘When my mind starts to go completely, take me to Dignitas [a Swiss organization that provides physician-assisted suicides].’”
“And I guess the problem is that post-finasteride syndrome is not a medically recognized condition?” asks Rob.
“This triggered for him even more distress, because he didn’t know where he was going to get help, and was anybody going to listen,” says Mary. She then recounts how her son was prescribed multiple drugs to try and cope with his declining mental health, and was hospitalized after making attempts on his own life.
“Making this program, we’ve encountered clinicians who do use the term post-finasteride syndrome. But Mary says Conall’s doctors were skeptical,” Johnny notes. “They diagnosed him with a delusional disorder.”
Bitter backstory
On Nov. 26, 2016, an extremely polite yet audibly distressed Conall phoned PFS Foundation President Philip Recchia to report a barrage of PFS symptoms, depression, anxiety, insomnia, and ED being the worst of them. He also said he’d quit the drug three years earlier, and asked if there were any clinical studies on the condition in which he could participate.
The next day, he emailed us a completed Patient Support form and, as we’ve done for hundreds of young men since, we quickly dashed off a note to fellow PFS patients in his geographic region, asking them to contact Conall for moral support and to share coping strategies.
Cut to February 23, 2017. One of those fellow patients from Ireland, whom we’ll call David, called to tell us that Conall had died by what he assumed was suicide. That, despite David having pleaded with him to try and tough it out.
At the time, we were in the midst of compiling PFS suicide cases for our FDA Citizen Petition seeking to remove Propecia from the market, or at least add a black-box warning to the product. So after confirming Conall’s death via his obituary, we sought out Gould family members, in hopes that they could supply us with pertinent medical records for the petition.
In June, again through fellow PFS patients, we received an email address for a close friend of Conall, who passed our request onto Mary, who swiftly replied:
“I’m not willing to sit back and allow the death of my son go unchallenged and forgotten. I am going to help in whatever way I can to get this poison banned. It’s like thalidomide all over again.”
A month later, Mary wrote us to say that she’d be sending us Conall’s medical records as soon as she received them, adding:
“I intend to contact the General Medical Council to report the doctor who supplied my son with Propecia. Conall had no hair loss, so that prescription was totally unethical. The coroner’s inquest is scheduled for late September. I’ve told them about PFS several times, but I really don’t think they’re listening.”
That October, as promised, Mary sent us Conall’s medical records, which included a Statement of Witness to the coroner from Ciaran McNally, MD, a consultant psychiatrist with Northern Health and Social Care Trust; as well as a log of her son’s visits to his GP, Mark Hall, MD.
According to the latter, Dr. Hall prescribed Propecia to Conall in June 2013. Eighteen months later, in December 2014, Conall visited Dr. Hall, whose notes read, in part:
Depressed mood… for the last 2 years patient has had a lower mood than previously… Patient felt that it started around the time that he began obsessing about his hair thinning. Patient would describe: Feeling down. Poor concentration. Sleeping poorly at night then sleeping in during the day. Low energy: previously was running 5 miles a day and played sports regularly but has little energy or motivation for this. Struggling academically…
Talked about triggers. No financial or family worries. Not in a relationship. No recreational drugs.
When I asked about his goals, he stated that he wanted a medication that would bring his concentration back and bring him back to the way he was before. He went on to say that he did not want an antidepressant as he had heard about problems with them.
During the September 2017 inquest into Conall’s death, Dr. Hall was questioned about prescribing Propecia to the adolescent. He responded by referencing the MHRA’s drug-safety update, issued in May 2017, noting that the agency had received reports of depression and suicidal thoughts in men taking finasteride 1 mg. Then he noted:
Regrettably, that information was not available at the time of the Propecia issue in 2013.
Daft diagnosis
In August 2017, Dr. McNally, in his Statement of Witness, wrote:
I…have been asked by the Coroner to provide a short supplementary statement explaining Mr Conall Patrick Gould’s belief that he was suffering from post-finasteride syndrome (PFS)…I am aware that a considerable amount of detailed material is available on the Internet about “post-finasteride syndrome” and that for this reason, belief in its existence might not be considered unconventional or culturally incongruent in itself.
However, I must stress that the condition is not recognised within mainstream medical practice… Doctors will typically consult the Summary of Product Characteristics (SPC) for a particular medication when side-effects are complained of, and the SPC in the case of finasteride lists reduced libido, but not the other symptoms Mr. Gould identified: emotional lability, brain fog, depression, anxiety, insomnia and panic attacks. Even if he had experienced side-effects from this medication, he reported having taken it for six months at age eighteen, and it would seem unlikely that effects would persist several years later…
Between November 2016 and January 2017 Mr. Gould was assessed by doctors from four separate psychiatric teams across two Health Trusts. The first team (an outpatient service) described his presentation as “anxiety verging on a delusional belief,” speculating that he might be in the prodromal stage of a psychotic illness. The next three teams, all acute care services including my own, diagnosed his beliefs as delusional in nature.
“He ended up trying to treat his own symptoms, I think, is what happened in the end, is what I believe. He was trying to treat the way he was feeling,” Mary tells File on 4 of her son’s death.
On January 26, the PFS Foundation emailed Dr. McNally a request for comment, which read, in part:
Given all the clinical and epidemiological data that has emerged since 2017, most all of which is chronicled in our Newsroom, and on our Medical Literature page—including the EMA’s 2025 ruling that finasteride can cause suicidal thoughts—would you render the same diagnosis today in Conall’s case?
Otherwise put: Do you still believe that Conall’s symptoms following cessation of finasteride were purely “delusional in nature”? If not, how would you diagnose such a case today?
At press time, Dr. McNally had not responded to our request.
Postscript
As part of its research into the incidence of suicide among finasteride patients in the UK, File on 4 turned to Mayer Brezis, MD, who four months ago published a 4,000-word paper in The Journal of Clinical Psychiatry, titled Failing Public Health Again? Analytical Review of Depression and Suicidality From Finasteride.
The Professor of Medicine (Emeritus) from the School of Public Health at the Hebrew University of Jerusalem analyzed epidemiological data published in peer-reviewed medical journals over the past seven years. He concludes that strong scientific evidence shows finasteride can cause neuropsychiatric reactions, such as anxiety, depression, and suicidality.
“Studies from multiple countries using various research designs indicate that finasteride increases the risk of depression by 50%. Due to its widespread use, this results in about 30,000 more people with depression and several dozen suicides each year in the UK,” Dr. Brezis tells us.
“Since each suicide impacts, on average, 60 family members and friends, about 10,000 additional individuals may experience significant psychological effects from losing a loved one annually, which could raise their own risk of depression, anxiety, PTSD, and suicidality. Depression also leads to high treatment costs and lost productivity, potentially causing nearly $700 million (US) in annual losses in the UK.”
If you’d like more information on Dr. Brezis’s epidemiological analysis, feel free to email him at: brezis@mail.huji.ac.il.
Finasteride was originally developed by Merck & Co., Inc., and first approved by the US Food and Drug Administration in 1993 as Proscar (5 mg, for enlarged prostate), and again in 1997, as Propecia (1 mg, for hair loss).
In June 2021, Merck spun off its Organon subsidiary as an independent public company (NYSE: OGN). Founded in the Netherlands in 1923, Organon bills itself as a “global health care company dedicated to making a world of difference for women, their families and the communities they care for.”
Among the Merck products Organon acquired in the deal were Proscar and Propecia. To report adverse events for either finasteride product, call the Organon Service Center at (844)674-3200, or email Service_Center@Organon.com.
Anyone living in the US who suffers from PFS should also report his or her symptoms to the US FDA. Anyone living outside the US who suffers from PFS should report his or her symptoms to the US FDA as well as to his or her local DRA, as directed on our Report Your Side Effects page.
If you or a loved one are suffering from PFS, and feeling depressed or unstable, please don’t hesitate to contact the PFS Foundation as soon as possible via our Patient Support hotline: social@pfsfoundation.org
Thank you.