Propecia Concerns

[Bill - Seemiller]

My one concern about Propecia. My wife and I haven't been trying to conceive so I haven't been worrying about it...but when the time comes:

 

1. Do I have to stop taking Propecia when trying to conceive?

 

2. Can there be complications/problems trying to concieve or after conception using Propecia?

 

Please advise. Thanks.

 

Bill

[hairbank]

Bill,

 

I don't believe so my friend but, If I were you, I'd call H&W or a derm for advice on this.

[Bill - Seemiller]

thanks for the reply Hairbank,

 

I have also sent an email to H&W for their medical advice on it.

 

Any other thoughts would be helpful too. Thanks

 

Bill

[irish homer]

http://en.wikipedia.org/wiki/Propecia

 

check out the side effects here regarding birth defects.

[Guest Cousin_It]

Bill...

 

First of all Merck issues no warning to those trying to conceive, that being said from everything I have read and heard the best recommendations would be to:

 

1-Stop the medication for one week prior to any attempts at conceiving

 

2-When not trying to conceive or after conception always wear a condom (if you are on Propecia)

 

Naturally the other warnings associated with Propecia, ie not having your wife handle any of the pills goes without saying.

 

So far no birth defects have been attributable to the use of Propecia if proper precautions are taken as indicated.

[nobuzz4me]

Bill,

 

That is great you are trying to have a child, it will change your life for the better! Good luck and have fun trying!

 

I am no doctor but had many of the pre-med courses in college and this was my strength in school. I think all is good with Propecia, there are no warnings that I know of that it drops your sperm count, possibly only your semen amount.

 

You might argue that a drop in the semen level may impact the ability for the sperm to survive during its journey to the egg but that may be speculation. Sperm counts and semen levels do not necessarily coincide.

 

If this were a problem, the lawyers would have been all over Merck about it you could bet your boner on that.

 

Do your child and the human race a favor and try not to pass on that shitty bald gene!!!! LOL.

 

Good luck my friend!

[laughter's medicine]

Here is a copy of one of my previous posts;

 

Posted February 19, 2006 04:40 PM

 

I've read a lot on the net and was told by the doctor that unless women/children take or touch a broken pill there shouldn't be a problem with safety. As far as getting your wife pregnant I've been on Propecia for just over three years and in that time had a beautiful healthy baby girl, she is just over one year old, and I mean absolutely beautiful! Oh course I might be a touch bias.

 

Hope this helps.

[Bill - Seemiller]

Thank you all for the replies.

 

Nobuzz...well you know what they say right? The best part about babies is making them .

 

So ok....

 

Irish homer,

 

Copied from Wikipedia:

 

"Finasteride is not indicated for use by women. Finasteride is in the FDA pregnancy category X. This means that it is known to cause birth defects in an unborn baby. Women who are or who may become pregnant must not handle crushed or broken finasteride tablets, for the medication could be absorbed through the skin. Finasteride is known to cause birth defects in a developing male baby. Exposure to whole tablets should be avoided whenever possible, however exposure to whole tablets is not expected to be harmful as long as the tablets are not swallowed. It is not known whether finasteride passes into breast milk, and thus should not be taken by breastfeeding women. It appears that finasteride can pass into the semen of men, thus, at certain dosages, caution should be used to avoid ingestion of semen during oral sex if a woman is pregnant or may become pregnant.

 

Finasteride can also be used to mask steroid abuse, and many professional sports have banned finasteride use for this reason."

 

Anyway...

 

This doesn't really mention anything about having regular sexual intercourse being a problem from what I can tell...obviously women shouldn't injest or handle the pills at all, or obviously semen which can apparently obtain some finasteride when pregnant. That interests me though that semen can hold some finasteride but this is not considered a problem when trying to conceive. Hmm...interesting. Any thoughts on this article?

 

From what I have read here and also from what Dr. Hasson said, there seems to be no problem continuing the medication.

 

Bill

[hairbank]

I read the article linked by IH and came to the same conclusions. It appears the main concern to be actual contact in any way shape or form with a woman if pregnant.

 

If Dr. Hasson gave you the green light I think you should be fine.

 

Kids are a blessing............best wishes to you and your wife!

[tkerr22]

Bill,

 

I had all of the same concerns as you as my wife and I were going to try and have a baby last spring, I did a lot of research as did my wife and the only thing we came to is that she shouldn't handle or touch my propecia. There was one article that did say it was totally fine to conceive while on propecia. And I was concerned because I did read on the internet that guys were complaining of reduced sperm count, but there was no credible evidence that it was related to the drug.

 

Well, low and behold probably a week or two after trying my wife became pregnant and we are expecting our first child, a girl, in mid March.

 

The only thing I am wondering is that we are having a girl and Laughter's Medicne had a girl as well....hmmm, maybe the drug increases the chance of having a girl?

 

I wonder if they have done a study on the sex of the baby while the man was on propecia??

 

Anyways, it's all good Bill!!

[Bill - Seemiller]

Ok late reply here....but...

 

Tkerr22....congrats on conceiving a baby girl! That's wonderful.

 

Thanks for all the insight above guys! That helps!

 

Bill

[Proactive]

http://en.wikipedia.org/wiki/Propecia

 

 

In this article it claims side effects were recorded in 6-19% of users, that's quite a difference from the 2% stated by Merck!

 

It also states that DHT plays an important role within the body, interesting reading.

 

Proactive

[Bill - Seemiller]

Proactive,

 

Thanks for the link. I will say, that I have no authoritative proof, however, I've heard that Wikipedia is not always known for being 100% accurate as a source of information. But yes, any hormone that is in the body has a role and a function, so I would agree that DHT does as well. Thanks for the insight.

 

Bill

[Brando]

Hey guys...it's been a while since I've been on this site. My wife and I are wanting to start trying to have a baby very soon.

Bill...should I stop Propecia? Any updates?

[HairHope]

IMO, I would stop taking for a month - by then there should be no impact on sperm. Then work on getting her pregnant, once succesful...start over again.

 

The health of your child will be much more important than any hair you lose, personally - I wouldn't risk it - despite the lack of evidence either way.

 

Best to you and your wife.

[Brando]

Thanks alot. That's kinda what I had in mind. My doctor told me to take Propecia 3 times a week. He said it would work that way because it stays in your system about 72 hours. Hopefully a month would be long enough to be off it completely.

[Bill - Seemiller]

Brando,

 

I've talked to a number of physicians on this subject since I asked about it, and the majority have claimed that there's no problem staying on Propecia while trying to conceive.

 

You may want to read the article I published about a year or so ago from Coalition member Dr. William Reed, "Trying to Conceive while on Propecia".

 

All the Best and good luck to you and your wife :-)

 

Bill

[Brando]

Bill,

Thanks for the input. Dr Cooley emailed me and told me that there's no reason to quit Propecia, just like you said. However...just to be safe.. I believe I'm gonna quit until, if the good Lord blesses us, we're successful. I don't wanna take any chances.

[VeniVidiVici]

Bill, I'm about to start using Propecia and I want to ask you something. I know that you are using Propecia for many years and I want you to tell me (if it's not a problem for you) about sperm counts after using Propecia for a long period. Have you been to doctor to determine your sperm count?

[Peter88]

Bill

 

I take finasteride for 10 years. Now I have 2 childrens (One girl with 3 years and a boy with 2 months). 4 years ago I had the same concern about Propecia. I sent an email to Dr. Lee and he answered me the next. I discontinued to use of Propecia 1 month before conceiveing. This could be "important" if you have a small volume reduction on sperm ejaculated like I used to have (not now). I returned to finasteride after conceiveing and fortunately with no problems for the kids. Good luck!

 

FINASTERIDE AND BIRTH DEFECTS

 

There are very few more anxiety provoking times in anyone's life than possibly causing a birth defect in one's own unborn child. So, it's quite understandable that the mention of a possible birth defect with the use of finasteride (Propecia 1mg and Proscar 5mg, Merck) would cause considerable anxiety and concern. The package insert for Proscar states under the section on Contraindications: 'Because of the ability of Type II 5alpha reductase inhibitors to inhibit the conversion of testosterone to DHT, finasteride may cause abnormalities of the external genitalia of a male fetus of a pregnant woman who receives finasteride'. So, is the risk real? Theoretically, yes. Practically, no.

 

The specific birth defect that can be caused by the absence or inhibition of the Type II 5-alpha reductase enzyme in the male embryo is hypospadias. Hypospadias is a birth defect in which the urinary tract opening is on the ventral surface (under side) of the penis rather than at the tip of the penis. There have never been congenital abnormalities observed in female fetuses at any dosage of finasteride.

 

During the research and development phase of finasteride, studies were done on experimental animals. Rats, rabbits, and rhesus monkeys were given finasteride to determine its relationship to birth defects, i.e. hypospadias.

 

Hypospadias did occur in the male offspring, when pregnant rats were administered finasteride equivalent to 5-5000 times the amount of recommended for men in treating MPB (1mg/daily). The critical period during which these effects can be induced in male rats was determined to be during the 16th ??“17th days of gestation.

 

In rabbit fetuses exposed to finasteride in utero from days 6-18 of gestation at doses equivalent to 5000 times the recommended human dosage, no evidence of malformations was observed. This result would be expected, since there was no exposure during the critical period of genital system development in rabbits.

 

When pregnant rhesus monkeys were given intravenous finasteride at a level equivalent to at least 750 times the highest estimated exposure of pregnant women to finasteride from semen of men taking 1mg/day, there were no genital abnormalities observed.

 

In the human embryo, the sensitive period of external genitalia development is during the 7th - 9th weeks of gestation. Although the chromosomal and genetic sex of an embryo is determined at fertilization by the kind of sperm, either Y-bearing or X-bearing, that fertilizes the ovum, male and female morphological characteristics do not begin to develop until the seventh week. Prior to this time, the genital systems of the two sexes are similar, and the initial period of genital development is referred to as the 'indifferent state of sexual development'. About six weeks after conception, if a Y chromosome is present in the embryo's cells (as it is in normal males), a gene on the chromosome directs the undifferentiated gonads to become testes. If the Y chromosome is not present (as in normal females), the undifferentiated gonads will become ovaries. If the gonads become testes, they begin to produce androgens, primarily testosterone, by about eight weeks after conception. These androgens stimulate development of the one set of the genital ducts into the epididymes, vas deferens, and ejaculatory duct. The presence of androgens also stimulates development of the penis and the scrotum. Hypospadias can result if there is inadequate production of androgens by the fetal testes.

 

Since the sensitive period of development of the external genitalia in the human embryo is the 7th to 9th weeks of gestation, there can be no danger to the child if the father is taking finasteride at the time of conception. Originally, Merck decided to err on the side of caution and warned against the possible problem of finasteride transfer in semen. This warning has since been removed from the package insert. Considering the medical/legal implications of a theoretically possible link of finasteride treatment to birth defects, it is reasonable to assume that Merck & Co. must be very confident in knowing that impregnating a woman while taking finasteride absolutely does not cause birth defects.

 

Nor is there any evidence of birth defects when the father taking finasteride has intercourse with the pregnant mother during the critical periods of sexual development. The in utero effects of finasteride exposure during the period of embryonic and fetal development (gestation days 20-100) were evaluated in the rhesus monkey, a species fairly predictive of human development. Intravenous administration of finasteride to pregnant monkeys at doses as high as 800ng/day (at least 60 to 120 times the highest estimated exposure of pregnant women to finasteride from semen of men taking 5mg/day) caused no abnormalities in male fetuses.

 

Still, Merck retains this admonition: 'Women should not handle crushed or broken Propecia tablets when they are pregnant or may be potentially pregnant because of the possibility of absorption of finasteride and the subsequent potential risk to a male fetus. Propecia tablets are coated and will prevent contact with the active ingredient during normal handling, provided that the tablets have not been broken or crushed.'

 

Considering that intravenous administration of finasteride to pregnant experimental animals during the critical periods of sexual development didn't cause birth defects, there is no reason to believe that transdermal absorption of finasteride from handling broken tablets could cause birth defects in the male child. But, since Propecia has not been approved by the FDA for use by women, Merck has nothing to lose by retaining this warning. In fact, it has good p.r. value.

 

So, can finasteride cause birth defects? Yes, there is a theoretical possibility that it can, but the probability is close to nil, when finasteride is taken in the recommended dosages. Since Propecia was approved by the FDA on 22 December 1997 and Proscar on 28 August 1996, millions of doses of finasteride have been taken and there has not been a single case report of a birth defect. Now that's reassuring information.

 

Richard Lee, M.D.

 

 

Andersson, S.; Berman, D. M.; Jenkins, E. P.; Russell, D. W.: Deletion of steroid 5-alpha-reductase 2 gene in male pseudohermaphroditism. Nature 354: 159-161, 1991

Greene, S. A.; Symes, E.; Brook, C. G. D.: 5-Alpha-reductase deficiency causing male pseudohermaphroditism. Arch. Dis. Child. 53: 751-753, 1978

Imperato-McGinley, J.; Gautier, T.: Inherited 5-alpha-reductase deficiency in man. Trends Genet. 2: 130-133, 1986

Moore, KL and Persaud, TVN: Before We Are Born-Essentials of Embryology and Birth Defects; 6th Edition, Saunders 2003

New England J of Med: 1994, Jan 13; 330 (2) 120-5

Physicians Desk Reference, 58th Edition, 2004, pp. 2172-2178

Thigpen, A. E.; Davis, D. L.; Milatovich, A.; Mendonca, B. B.; Imperato-McGinley, J.; Griffin, J. E.; Francke, U.; Wilson, J. D.; Russell, D. W.: The molecular genetics of steroid 5-alpha-reductase 2 deficiency. J. Clin. Invest. 90: 799-809, 1992

http://encarta.msn.com/encyclo...exuality.html#endads

http://science.howstuffworks.c...an-reproduction5.htm

Sex-organ development is determined by the third month of development.

http://www.people.virginia.edu/~rjh9u/sexdev.html

http://www.lindasy.com/cgi-loc...dec01.html?E+scstore

[Nick911]

All,

 

Recently had a healthy son, conceived while I was on Propecia. No issues.

 

N