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Propecia is basically a cure for baldness as long as you start taking it before you lose too much hair. It’s very widely used—walk into any gay bar in San Franc

Propecia is basically a cure for baldness as long as you start taking it before you lose too much hair. It’s very widely used—walk into any gay bar in San Francisco and you will notice there is hardly anyone under 40 who is bald. There is a strange phenomenon online where in every discussion of propecia, someone will show up and claim they had terrible sexual side effects. But in the original clinical trials, the rate of such side effects was nearly the same as placebo. And I personally know about 10 men who take it and none have experienced side effects. I think people make these claims to get attention in forums, or it’s simply a placebo effect.

Double_a_92 7y ago
How does this relate to gay bars? Is it something that gay men take for other reasons?
- vinceguidry 7y ago
  Many gay subcultures are thoroughly obsessed with appearance. I'm not a bad looking guy, but I wandered into a gay house party one day and was amazed at how every single guy there was much better looking than I was. They all, and I mean every last one of them, and there were hundreds crammed into that penthouse suite, simply cared about their appearance way more.
  - speedplane 7y ago
    > Many gay subcultures are thoroughly obsessed with appearance. ... I wandered into a gay house party one day was amazed at how every single guy there was much better looking than I was. Sorry, but your one accidental foray into a single gay party is not exactly convincing evidence for your theory. More importantly, even if gay men care about their appearance more than straight men, I'm not convinced that the behavior is purely linked to them being gay, as much as social norms that have developed around what "being gay" is "supposed to be". Sure gay people often run in different social circles as straight people, and it makes sense that they would have different norms. But similarly, people in Paris are generally far more attractive and fashionable than folks in St. Louis. There is little genetically different from these people, it's just the norms that they develop in.
    - vinceguidry 7y ago
      I didn't claim to have a proper explanation for my observation. Your guess is as good as mine.
      - thaumasiotes 7y ago
        Explanation: gay men are trying to attract men, and men care a lot about (the other person's) appearance.
        speedplane 7y ago
        > gay men are trying to attract men, and men care a lot about (the other person's) appearance Even if this is true today, I'm not sure it's anything more than a modern day social trend. Why should men care more about appearance than women? On a "selfish gene" level, in choosing a mate, both sexes should mostly care about passing on their genetic material. Appearance certainly can be a factor in that decision, but it's only one of many (e.g., responsibility, trustworthiness, work ethic, etc.). If in today's society, men do care more about appearances than women, I strongly suspect that is a function of the structure of our society itself than anything genetic or innate. One could easily imagine a society where gay men care less about appearances than straight men.
        thaumasiotes 7y ago
        > Even if this is true today, I'm not sure it's anything more than a modern day social trend. You're in luck! Records of the last several thousand years exhaustively document that ornamenting your appearance is characteristically a female behavior. For example, check out this text from the Iliad: > [The Carians] were commanded by Nastes and Amphimachus, the brave sons of Nomion. He came into the fight with gold about him, like a girl; fool that he was, his gold was of no avail to save him, for he fell in the river by the hand of the fleet descendant of Aeacus, and Achilles bore away his gold.
        emiliobumachar 7y ago
  - Raphmedia 7y ago
    I would argue that it is not that gay culture that is obsessed with appearance, but that it is male heterosexual culture that is adverse to self-care. There are many men who do not even consider taking care of themselves for fear that their masculinity will decrease. Many gay men are free from these fears. From my perspective as someone who has had an insider's perspective of heterosexual male culture, gay male culture, and then female culture (I am a transgender woman), homosexual men do not make more effort in their appearance than most women when they go out. Going to a gay bar is a often big event of the week or month, some people travel far to go there. It's not the same as going to a dive bar to get drunk. It's a place where you can be at your best and meet people - it's a community hub. The people you meet there are the best on sunday's best. The same way you would wear a suit or at least clean up before a business meeting or recruitment day. Often, it is an outlet for being yourself, since some people are conscious when they are in public or at work and censor themselves. As someone else said, "Maybe the reason you're not seeing bald men in these bars is the swimmer effect. i.e. bald men aren't successful there so bald men don't show up." It would be erroneous to believe that the behaviours observed in such a place are representative of their daily lives.
    - vinceguidry 7y ago
      I agree with you in principle, but this house party really was something else. They didn't just primp themselves up to look good for this event. They all looked like male models, fit, tanned, healthy. You can't look like these guys did without a lot of work. Diet, exercise, I felt like I'd walked onto a Hollywood set. I wish I could have stuck around and mingled, gotten a sense for what in the holy heck I was witnessing, but large masses of people make me super uncomfortable. So I went back down to my apt.
      - Raphmedia 7y ago
        Enter any nightclub and you will find masses of slender, tanned women in great shape, wearing makeup and sexy clothes. But this house party sounds like survivor bias at play. One fit person invited their best looking friends, who then invited their friends, who then invited theirs. Anyone who does not fit the narrative (straight, gay or other) will feel the same unease you did and leave.
noitsnot 7y ago
I'm not sure how it's a strange phenomenon. There are 1,300+ lawsuits for permanent sexual dysfunction. More recent studies show increased problems the first year and the drug masking prostate cancer development. Drugs have risks, right? You can't blanket it as 100% safe because of a gay bar anecdote and ten acquaintances.
- heymijo 7y ago
  No, you can't, but the vast literature contradicts the claims of these lawsuits. Please see my comment and feel free to do a pubmed search. https://news.ycombinator.com/item?id=20534351 https://news.ycombinator.com/item?id=20534351
- smittywerben 7y ago
  > drug masking prostate cancer development This is only an issue if you're over 50 and have trouble peeing (isn't that a sign of prostate cancer anyways?). Remember the demographic these are derived from. Propecia wasn't brought to market as a hair loss drug. > a gay bar anecdote and ten acquaintances. Yes let me get on hn to talk about sex. It's not like I can't delete this or anything.
Kuinox 7y ago
Never heard of Propecia. So I googled it and I immediately found that it was not recommended in my country (France) due to the side effects.
Lio 7y ago
Why the cut off at the age of 40? Either it's a "cure" or it's not. I think that you'll find that actually it only slows down hair loss and only for a percentage of people. Maybe the reason you're not seeing bald men in these bars is the swimmer effect. i.e. bald men aren't successful there so bald men don't show up. The reason you don't see many bald men on TV shows or that you can count the number of world famous bald "leading man" actors on the fingers of one hand isn't because there's already a magic cure for baldness that actors use but other don't. It's simply because casting agents don't cast bald men.
- jquery 7y ago
  It’s absolutely the swimming effect. To any fully-haired people who don’t believe it, shave your head as if you’re going bald, then go to a club alone and see how much fun you have. Prediction: probably not much
- skohan 7y ago
  It's also because there is a "cure" for baldness, but it's not magical. A ton of actors and media personalities in general use hairpieces or get hair transplants.
heymijo 7y ago
> There is a strange phenomenon online where in every discussion of propecia, someone will show up and claim they had terrible sexual side effects. But in the original clinical trials, the rate of such side effects was nearly the same as placebo. "Known sexual side effects may appear" is a chilling phrase for a man to read. So before considering using a 5-alpha reductase inhibitor (finasteride or dutasteride) I pored over the literature. What I read was almost comical and made me grateful that I've developed a bit of scientific literacy to dig into these studies for myself. In a finasteride trial of nearly 1500 men, here's what "known sexual side effects" looked like: > Only 11 men (1.4%) in the finasteride group and 8 (1.0%) in the placebo group dis-continued the study because of sexual adverse events, which resolved after discontinuation. These adverse events also resolved in many of the patients who reported them but who remained on the finasteride regimen and continued in the study. [0] The absolute numbers are ridiculously low. I felt relief b/c I just imagined myself in a venue with 1500 other guys. Guess what, there are probably 8 of them experiencing some kind of sexual dysfunction. It doesn't take long to realize that the general population has numbers of sexual dysfunction that align with the study participants. Hell, I found out riding a bike has a greater probability of causing sexual dysfunction than using one of these medications. Mind you, there are reams literature, with long-term studies, and meta-analysis all basically reporting the same data about side effects. Moral being, do your homework and make a decision for yourself. [0] http://sci-hub.tw/10.1016/s0190-9622(98)70007-6 http://sci-hub.tw/10.1016/s0190-9622(98)70007-6
- gregsadetsky 7y ago
  Could you please share what you found re: effects of riding a bike? Thanks!
  - heymijo 7y ago
    The gist is that putting too much pressure on your perineum is bad for sexual function in males. The Bad - Cycling, especially with certain seats and handlebar arrangements, can cause a lot of pressure in the perineum The Good - Certain seats and maintaining your handlebars at a lower level than your seat lessen the risk I don't have the sources I originally looked at (this was several years ago!) but a Google search pulls up some that jive with what I recall. https://www.health.harvard.edu/blog/biking-and-sex-avoid-the-vicious-cycle-201209145290 https://www.health.harvard.edu/blog/biking-and-sex-avoid-the... https://www.health.harvard.edu/staying-healthy/can-cycling-cause-erectile-dysfunction https://www.health.harvard.edu/staying-healthy/can-cycling-c... https://www.webmd.com/men/features/biking-and-erectile-dysfunction-a-real-risk#1 https://www.webmd.com/men/features/biking-and-erectile-dysfu...
Raphmedia 7y ago
I am a trans woman who was taking Propecia before switching to stronger anti-androgens. Propecia destroyed my libido and made erections difficult to achieve - yes, more than having a testosterone that is close to zero. I constantly felt weak, as if I was about to faint. These were also some of the darkest months of my life. I was constantly having sudden suicidal thoughts, the kind that jumps on you even when you're healthy. I'd go on with my day and my head would ask me "should we die?" to which I would have to answer "no". There was no voice of course, I'm describing feelings. All symptoms I've never had before and have never had since. Reducing testosterone has stopped all hair loss, so I no longer need to take Propecia anymore. I am not saying that those side effects are common, merely that they exist. Could it be that the people you met online were also telling the truth and that there is no conspiracy?

Double_a_92 7y ago

How does this relate to gay bars? Is it something that gay men take for other reasons?

vinceguidry 7y ago
Many gay subcultures are thoroughly obsessed with appearance. I'm not a bad looking guy, but I wandered into a gay house party one day and was amazed at how every single guy there was much better looking than I was. They all, and I mean every last one of them, and there were hundreds crammed into that penthouse suite, simply cared about their appearance way more.
- speedplane 7y ago
  > Many gay subcultures are thoroughly obsessed with appearance. ... I wandered into a gay house party one day was amazed at how every single guy there was much better looking than I was. Sorry, but your one accidental foray into a single gay party is not exactly convincing evidence for your theory. More importantly, even if gay men care about their appearance more than straight men, I'm not convinced that the behavior is purely linked to them being gay, as much as social norms that have developed around what "being gay" is "supposed to be". Sure gay people often run in different social circles as straight people, and it makes sense that they would have different norms. But similarly, people in Paris are generally far more attractive and fashionable than folks in St. Louis. There is little genetically different from these people, it's just the norms that they develop in.
  - vinceguidry 7y ago
    I didn't claim to have a proper explanation for my observation. Your guess is as good as mine.
    - thaumasiotes 7y ago
      Explanation: gay men are trying to attract men, and men care a lot about (the other person's) appearance.
      - speedplane 7y ago
        > gay men are trying to attract men, and men care a lot about (the other person's) appearance Even if this is true today, I'm not sure it's anything more than a modern day social trend. Why should men care more about appearance than women? On a "selfish gene" level, in choosing a mate, both sexes should mostly care about passing on their genetic material. Appearance certainly can be a factor in that decision, but it's only one of many (e.g., responsibility, trustworthiness, work ethic, etc.). If in today's society, men do care more about appearances than women, I strongly suspect that is a function of the structure of our society itself than anything genetic or innate. One could easily imagine a society where gay men care less about appearances than straight men.
        thaumasiotes 7y ago
        > Even if this is true today, I'm not sure it's anything more than a modern day social trend. You're in luck! Records of the last several thousand years exhaustively document that ornamenting your appearance is characteristically a female behavior. For example, check out this text from the Iliad: > [The Carians] were commanded by Nastes and Amphimachus, the brave sons of Nomion. He came into the fight with gold about him, like a girl; fool that he was, his gold was of no avail to save him, for he fell in the river by the hand of the fleet descendant of Aeacus, and Achilles bore away his gold.
        emiliobumachar 7y ago
- Raphmedia 7y ago
  I would argue that it is not that gay culture that is obsessed with appearance, but that it is male heterosexual culture that is adverse to self-care. There are many men who do not even consider taking care of themselves for fear that their masculinity will decrease. Many gay men are free from these fears. From my perspective as someone who has had an insider's perspective of heterosexual male culture, gay male culture, and then female culture (I am a transgender woman), homosexual men do not make more effort in their appearance than most women when they go out. Going to a gay bar is a often big event of the week or month, some people travel far to go there. It's not the same as going to a dive bar to get drunk. It's a place where you can be at your best and meet people - it's a community hub. The people you meet there are the best on sunday's best. The same way you would wear a suit or at least clean up before a business meeting or recruitment day. Often, it is an outlet for being yourself, since some people are conscious when they are in public or at work and censor themselves. As someone else said, "Maybe the reason you're not seeing bald men in these bars is the swimmer effect. i.e. bald men aren't successful there so bald men don't show up." It would be erroneous to believe that the behaviours observed in such a place are representative of their daily lives.
  - vinceguidry 7y ago
    I agree with you in principle, but this house party really was something else. They didn't just primp themselves up to look good for this event. They all looked like male models, fit, tanned, healthy. You can't look like these guys did without a lot of work. Diet, exercise, I felt like I'd walked onto a Hollywood set. I wish I could have stuck around and mingled, gotten a sense for what in the holy heck I was witnessing, but large masses of people make me super uncomfortable. So I went back down to my apt.
    - Raphmedia 7y ago
      Enter any nightclub and you will find masses of slender, tanned women in great shape, wearing makeup and sexy clothes. But this house party sounds like survivor bias at play. One fit person invited their best looking friends, who then invited their friends, who then invited theirs. Anyone who does not fit the narrative (straight, gay or other) will feel the same unease you did and leave.

noitsnot 7y ago

I'm not sure how it's a strange phenomenon. There are 1,300+ lawsuits for permanent sexual dysfunction. More recent studies show increased problems the first year and the drug masking prostate cancer development. Drugs have risks, right? You can't blanket it as 100% safe because of a gay bar anecdote and ten acquaintances.

heymijo 7y ago
No, you can't, but the vast literature contradicts the claims of these lawsuits. Please see my comment and feel free to do a pubmed search. https://news.ycombinator.com/item?id=20534351 https://news.ycombinator.com/item?id=20534351
smittywerben 7y ago
> drug masking prostate cancer development This is only an issue if you're over 50 and have trouble peeing (isn't that a sign of prostate cancer anyways?). Remember the demographic these are derived from. Propecia wasn't brought to market as a hair loss drug. > a gay bar anecdote and ten acquaintances. Yes let me get on hn to talk about sex. It's not like I can't delete this or anything.

Kuinox 7y ago

Never heard of Propecia. So I googled it and I immediately found that it was not recommended in my country (France) due to the side effects.

Lio 7y ago

Why the cut off at the age of 40? Either it's a "cure" or it's not. I think that you'll find that actually it only slows down hair loss and only for a percentage of people. Maybe the reason you're not seeing bald men in these bars is the swimmer effect. i.e. bald men aren't successful there so bald men don't show up. The reason you don't see many bald men on TV shows or that you can count the number of world famous bald "leading man" actors on the fingers of one hand isn't because there's already a magic cure for baldness that actors use but other don't. It's simply because casting agents don't cast bald men.

jquery 7y ago
It’s absolutely the swimming effect. To any fully-haired people who don’t believe it, shave your head as if you’re going bald, then go to a club alone and see how much fun you have. Prediction: probably not much
skohan 7y ago
It's also because there is a "cure" for baldness, but it's not magical. A ton of actors and media personalities in general use hairpieces or get hair transplants.

heymijo 7y ago

> There is a strange phenomenon online where in every discussion of propecia, someone will show up and claim they had terrible sexual side effects. But in the original clinical trials, the rate of such side effects was nearly the same as placebo. "Known sexual side effects may appear" is a chilling phrase for a man to read. So before considering using a 5-alpha reductase inhibitor (finasteride or dutasteride) I pored over the literature. What I read was almost comical and made me grateful that I've developed a bit of scientific literacy to dig into these studies for myself. In a finasteride trial of nearly 1500 men, here's what "known sexual side effects" looked like: > Only 11 men (1.4%) in the finasteride group and 8 (1.0%) in the placebo group dis-continued the study because of sexual adverse events, which resolved after discontinuation. These adverse events also resolved in many of the patients who reported them but who remained on the finasteride regimen and continued in the study. [0] The absolute numbers are ridiculously low. I felt relief b/c I just imagined myself in a venue with 1500 other guys. Guess what, there are probably 8 of them experiencing some kind of sexual dysfunction. It doesn't take long to realize that the general population has numbers of sexual dysfunction that align with the study participants. Hell, I found out riding a bike has a greater probability of causing sexual dysfunction than using one of these medications. Mind you, there are reams literature, with long-term studies, and meta-analysis all basically reporting the same data about side effects. Moral being, do your homework and make a decision for yourself. [0] http://sci-hub.tw/10.1016/s0190-9622(98)70007-6 http://sci-hub.tw/10.1016/s0190-9622(98)70007-6

gregsadetsky 7y ago
Could you please share what you found re: effects of riding a bike? Thanks!
- heymijo 7y ago
  The gist is that putting too much pressure on your perineum is bad for sexual function in males. The Bad - Cycling, especially with certain seats and handlebar arrangements, can cause a lot of pressure in the perineum The Good - Certain seats and maintaining your handlebars at a lower level than your seat lessen the risk I don't have the sources I originally looked at (this was several years ago!) but a Google search pulls up some that jive with what I recall. https://www.health.harvard.edu/blog/biking-and-sex-avoid-the-vicious-cycle-201209145290 https://www.health.harvard.edu/blog/biking-and-sex-avoid-the... https://www.health.harvard.edu/staying-healthy/can-cycling-cause-erectile-dysfunction https://www.health.harvard.edu/staying-healthy/can-cycling-c... https://www.webmd.com/men/features/biking-and-erectile-dysfunction-a-real-risk#1 https://www.webmd.com/men/features/biking-and-erectile-dysfu...

Raphmedia 7y ago

I am a trans woman who was taking Propecia before switching to stronger anti-androgens. Propecia destroyed my libido and made erections difficult to achieve - yes, more than having a testosterone that is close to zero. I constantly felt weak, as if I was about to faint. These were also some of the darkest months of my life. I was constantly having sudden suicidal thoughts, the kind that jumps on you even when you're healthy. I'd go on with my day and my head would ask me "should we die?" to which I would have to answer "no". There was no voice of course, I'm describing feelings. All symptoms I've never had before and have never had since. Reducing testosterone has stopped all hair loss, so I no longer need to take Propecia anymore. I am not saying that those side effects are common, merely that they exist. Could it be that the people you met online were also telling the truth and that there is no conspiracy?