The developing truth about finasteride

[Shadow of the EMpire State]

I didn't intend to make another post on this subject, but I recently got a private message from a poster who reminded me that this forum has been rather uncritical of finasteride and its various trade names. It's true: by and large, people here seem to repeat the company line, to wit, that the incidence of sexual dysfunction is very low and that any dysfunction will always abate quickly upon discontinuing the drug. In short, they believe the drug companies.

 

But an ever-increasing amount of evidence suggests that the sexual side effects of this drug are likely greater than admitted and that the resulting dysfunction is often chronic or even permanent. I know that speculation about the safety of finasteride has been around for a while, but there have been two noteworthy changes in recent months. First, the number of reports is growing apace. Second, the stories are now being published by first-rate media outlets including Time Magazine, the Los Angeles Times, CBS, msnbc, etc.

 

Go to google news, type in "propecia" or "finasteride." See what you get. It's not a pretty picture. Of course, I reserve the possibility that this could all be much ado about little, but given the increasing number and quality of these reports, I tend to think not. In fact, I think that we could very well be on the precipice of learning some very disturbing truths about the drug. But in any event, I think people should be aware of these reports when deciding whether to take it. The idea that this is a low-risk medication might not be exactly true.

 

Propecia for Treating Hair Loss: Is it Worth the Risk?

Edited March 23, 2011 by Shadow of the EMpire State

[Tsakalos]

Today i had exactly the same convertation with 3 other HT greek patients . They told me that they are willing to quit for side effects.all of them. I do not have side effects like them but lately there is tendency for the announced 5% sexual side effects from propecia to be revealed to be a big inaccuracy.

 

according to this http://www.propeciasideeffects.com/ the side effects are NOT reversable which is a completely opposite from what we knew untill know.

Edited March 22, 2011 by Tsakalos

[Tsakalos]

BREAKING NEWS: New Prescription Information for Propecia released in Europe - Permanent Erectile Dysfunction now official.

 

BREAKING NEWS: New Prescription Information for Propecia released in Europe, persistent erectile dysfunction now OFFICIAL • PROPECIAHELP: Unresolved Finasteride Propecia Proscar side effects info & discussion forum

[Blake Bloxham]

Hmm, I'm a bit confused here and maybe someone can help clarify:

 

1. Tsakalos, the first link you posted is to another hair restoration forum where the original article about PROPECIA causing permanent side effects is hosted. However, when I clicked on the article (which took me to a Swedish page), it gave me a 404 error and I couldn't find the information.

 

2. The only conclusive piece of information in that thread was a PDF that explained Dr. Reddy's 1 mg finasteride tablets would now have a 'permanent' warning on them in the UK, but I didn't see any mention of Propecia. Granted, I know that the active ingredient is identical and in a comparable concentration, but I'm wondering why one and not the other?

 

3. Dr. Rassman posted the following regarding this new information on his blog today:

 

This is new to me. We always try to follow publications, but remember that just because an article is published does not mean it is FACT and everyone needs to understand how the results were compiled. This was a paper based only on interviews of 71 men with sexual side effects only. I’m unsure about what lengths they went to find any underlying health issues or even conducting physical exams.

 

If this is true, then those men who develop sexual side effects will have a difficult decision. This has not been my experience in using and prescribing this drug for over 14 years. We have to make our decisions not just based on what we read, but also the methods of how the conclusions were based

 

He also included a link to the actual study (which references the new Swedish and UK regulations): Persistent Sexual Side Effects of Finasteride for Male Pattern Hair Loss - Irwig - 2011 - The Journal of Sexual Medicine - Wiley Online Library

 

So, from this point I have a few questions:

 

1. Is the product still approved by the FDA under the original assessment that side effects include reversible sexual dysfunction in other areas like the U.S.?

 

2. Why does this study base it's conclusions upon talking to 71 individuals (a very small "n") who have already admitted that they are suffering sexual side effects? I don't understand why they wouldn't survey a much larger population of individuals taking the medication and determine, from there, how many were suffering sexual side effects, and how many had persisted 3 months after stopping the medication?

 

I hope this doesn't label me as someone "uncritical" of finasteride, because obviously I think these types of discussions and studies are important and that patient safety should always be the number 1 priority with regard to any medical treatment. However, I simply don't want to condemn something that's helped a lot of individuals based off anecdotal opinions or a biased study (if this is the case). Any clarification is welcomed.

Edited March 23, 2011 by Future_HT_Doc

[Shadow of the EMpire State]

I hope everyone understands that my concern does not arise solely out of the George Washington study discussed above. That's the latest piece of news, yes, but I began reading google news articles about the pervasiveness and permanency of sexual side effects long before the GW study became news.

 

Moreover, the fact that they're apparently now relabeling the product to include permanent erectile dysfunction as a side effect is very, very damning. Why? Because they certainly didn't add the warning solely on the basis of the GW information. They had to have had--or obtained--their own data showing the same thing or worse. And it's all made that much worse because they had previously trumpeted the reversibility of side effects as an enormous selling point. The alleged reversibility of side effects was set up to act as the safety net that would allay fears. After all, they told people that if they somehow wound up in the supposed "two percent" who experience side effects, all they had to do was stop using the product, and they'd be fine. But now, several years later, they're saying, "Oh, by the way, remember the reversible side effects? Well, they're not always reversible."

 

The point is that the drug companies either didn't know the full extent of side effects or made efforts to obscure them. In either event, we need to acknowledge that the drug, although useful for some, carries with it a larger-than-advertised risk of serious and permanent health problems.

Edited March 23, 2011 by Shadow of the EMpire State

[wb280]

Exactly. Manhood over hair anytime. I not gonna take that risk. I will do all i can to restore my hair but to risk my libido, no. period.

[Spanker]

I am on it, I had a bit of an issue a month or 2 after I started taking but it could have been in my head. After 7 months on it, all is well. In fact, better. I last longer but it's still like it should be.

 

I attribute that to aging like a fine wine and not to the fin tho.

[Tsakalos]

 

1. Tsakalos, the first link you posted is to another hair restoration forum where the original article about PROPECIA causing permanent side effects is hosted. .

 

actually is not a hair restoration forum. it is a forum against propecia which is alarming to say at least. why whould people who stop propecia and still have side effects to create a forum just for that ??

 

 

THIS IS NOT A HAIRLOSS FORUM -- this forum is for men that QUIT Finasteride and are still experiencing side effects. If you have questions about taking Finasteride for hairloss, please visit hairloss websites.

 

I just saw that there are also sites that endorse massive lawsuits against Merck Propecia, Proscar, Finasteride class action lawsuits. Register for Canada, USA & International litigation

 

An unknown percentage of men worldwide who took Propecia or Proscar for MPHL have experienced numerous mental, physical, and sexual side effects while on the medication, discontinued Propecia, and then fully expected to return to normal in accordance with representations made in the official prescribing information.

 

 

 

Instead, after discontinuing the drug, many of these men’s endocrine systems crashed and their side effects increased in severity. Many of these men continue to have unresolved and persistent sexual, neurological and physical side effects from Finasteride use -- even many years later.

 

 

 

If you or a loved one are suffering negative sexual and other side effects from Propecia or Proscar that have NOT resolved even AFTER discontinuing the drug, you may qualify for damages that may be awarded in a possible U.S. class action or mass tort lawsuit.

 

Many people have build their hair transplant plan in conjuction with the safe use of propecia, Reading such info on a period that HM or other future treatments have been just science fiction theries and nothing more its scary

Edited March 23, 2011 by Tsakalos

[Bill - Seemiller]

Many men considering taking Propecia (finasteride) for hair loss are concerned about the potential of sexual side effects they may experience by taking the drug. The possibility of long term or even permanent side effects indeed sounds scary.

 

This community encourages the truth no matter what it is. Thus, if proof exists that finasteride causes long term or permanent side effects, this community would like to know about it. However, I would hardly consider interviews with 71 men taking Propecia who already have sexual side effects to be highly scientific. But while it's far from the proof that medical doctors and potential consumers would like, perhaps it will encourage researchers to conduct actual scientific methods on the drug in revealing whether or not Propecia (finasteride) comes with any long term sexual side effects.

 

The only thing that we know for sure about the above study is that all of the 71 men were taking Propecia and also had sexual problems. Unfortunatley, there's no scientific evidence suggesting the two are linked and the study is very limited in scope.

 

I do hope however, that researchers will conduct real scientific studies which will provide real proof one way or another whether or not Propecia (finasteride) causes long term or even permanent side effects.

 

Best wishes,

 

Bill

[haircut]

Bill,

 

Dr. Rassman commented on this yesterday as well on his blog. Personally, I have been on Propecia (Finesteride) since 1998 with no problems at all.

[Shadow of the EMpire State]

This community encourages the truth no matter what it is. Thus, if proof exists that finasteride causes long term or permanent side effects, this community would like to know about it. However, I would hardly consider interviews with 71 men taking Propecia who already have sexual side effects to be highly scientific.

Bill

 

I agree that the study is too small to be definitive. But here's the thing, Bill: according to reports, they're putting it on the label in Europe. And as I said above, I doubt that they're putting it on the label because of a GW study of 70 guys. I can only assume that they have their own evidence supporting the same conclusion. After all, even an idiot understands that the more health risks you put on the label, the less likely someone is to buy it. So no one is going to put that sort of thing on a bottle unless they're satisfied that it's true and that they could be sued for omitting it---which, by the way, they already are. As far as I'm concerned, you can throw the GW study out the window. I'm far more concerned with the fact that Merck is now listing this is a side effect in Europe. To me, that's more damning than any 70-man study.

Edited March 23, 2011 by Shadow of the EMpire State

[TeufelHunden]

I'm 41 and have been on finasteride for 5-6 months. I've noticed a decline in my sexual desire but it could be my age or in my head.

I've also noticed over the last few weeks that my hair is shedding.

I'm new here so any and all input is appreciated!

[Guest paulthomas]

I haven't taken any Propecia or Finasteride because I am hoping that my receding hair line will eventually stop and frankly I don't trust them enough to use them. I have been reading lots of articles on these drugs and I rather be bald than impotent or some other horrible side effect.

 

(promotional link removed)

[pkbuck]

hi guys

i have been on Fin for 13 months now with no sides other than my hair is still falling like crazy.

[StaggerLee123]

This community has been quite skeptical about Finasteride and very frank converstaions have been had on the subject. The suggestion that this open forum is somehow purposefully "uncritical" about the drug is off base from the posts that I have seen on the subject. I don't think anyone is glossing it over and since we are all adults the ultimate decision is made by the individual.

 

It is good to be skeptical about any drug.

[Blake Bloxham]

Stagger,

 

I agree. I think our forum is fairly balanced when it comes to the ongoing finasteride debate. Many individuals report that they've taken the drug for a long period of time without any adverse side effects; some individuals claim they started a Propecia regimen, experienced ill effects, and stopped; and others report upon some of the rarer, but still serious cases of ongoing sexual dysfunction.

 

While the official studies still estimate the rate of sexual dysfunction around 0.2-3%, recent class action lawsuits and changes to finasteride warnings have progressed in various countries. It will be interesting to observe the final consensus. However, as of now, I still do believe the drug is a tested, effective hair loss medication.

[Aldebaran]

The main page of PROPECIAHELP: Unresolved Finasteride Propecia Proscar side effects info & forum explains a lot about the cause of the side effects of Finasteride.

 

The following page clarifies the way Finasteride operates and recommends a low dosage Plasma DHT levels 7 days after various Finasteride dosages

 

It's interesting to note what kind of reasoning went behind the daily 1mg dose, since 1mg can keep DHT levels quite low for days. It may be advisable, as the thread recommends, to use much, much lower doses of the drug to control DHT rather than striking it down to minimum levels, considering DHT regulates many important processes.

 

I remember reading the dosage complaints were ignored based on the reasoning that doses up to 1mg didn't present any bigger significant risk over much lower doses, such as 0.2mg, and only increased effectiveness of the drug, but that seems to be before the recent permanent dysfunction scandal.

 

I have no credentials to give therapeutic advice, but i currently believe the safest method of Finasteride utilization may be the following:

 

- Take an extended hormonal tally test to evaluate DHT levels and testosterone levels.

Balding men tend to have low testosterone, i'm guessing because it is converted in excess into DHT, but that doesn't sound right.

The values to test can be found at point 6 of the FAQ at Unresolved Propecia & Finasteride Side Effects - FAQ

(Take note that every poster who wants to actually take the drug is automatically banned from the forums.)

 

- Start with the smallest dose possible and the lowest effective frequency according to the thread i inserted earlier.

 

- Increase the dosage slowly and progressively paying attention to all and any side effects, remembering frequency of usage is as important as dosage.

 

- Take new hormonal tally tests to ensure your hormonal balance is maintained periodically

In theory, a satisfactory level of DHT could be achieved before reaching the commonly prescribed dosage.

 

- If unsustainable side effects present themselves, quit by "tapering out" the medication, reducing its dosage and frequency instead of quitting instantly. This should limit the shock on your body.

 

- If side effects persist for months after stopping the drug, seek medical advice.

Albeit many endocrinologists may scoff at the mention of finasteride side effects, having proof your hormonal balance was permanently altered will convince them that your case requires treatment.

 

While this method doesn't assure you will be safe from side effects, it might ensure a lower impact and more sustainable recovery. The hormonal tests are important, because every person has fairly "personal" hormone levels and metabolic balance, thus taking tests before starting on finasteride will ensure you have a record of your natural hormonal balance, as a target for an eventual recovery therapy.

 

Finally, i recommend reading all the information on PROPECIAHELP: Unresolved Finasteride Propecia Proscar side effects info & forum and their forums.

Edited April 13, 2012 by Aldebaran

[Bill - Seemiller]

Not too long ago, I interviewed a few leading hair restoration physicians regarding their opinion of Propecia, their patients' experiences and risks of permanent sexual side effects.

 

See "Propecia for Treating Hair Loss: Is it Worth the Risk? What the Experts are Saying" for more information.

 

Best wishes,

 

Bill

[aramis69]

Here's what I came across regrading FDA's reassessment

 

UPDATE 1-Sexual side effects added to Merck drug labels | Reuters

[TommyLucchese]

2 years and a month and I have no sexual side effects, only great results with the hair loss.

[daster]

Ultimately it seems to depend on the person so one has to realize you have to gamble the risk before you take it. I bought generic finasteride without a prescription here http://www.trustedtablets-online.com/ never had any side effects but it worked good for me.

Edited August 19, 2013 by daster