Propecia and Side Effects: New Data

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  • Sara Wasserbauer, MD
    Junior Member
    • Dec 2008
    • 18

    Propecia and Side Effects: New Data

    I got an email from one of my patients today (who has never experienced a sexual side effect from taking Propecia) with concerns about the following article http://abcnews.go.com/Health/MensHea...3152993&page=3

    "What is your take on this, Doc?" he asked me in an email he titled, "Propecia Side Effects - not a myth."

    I replied to him that sexual side effect among those taking Propecia has never been a myth. It is an actual, scientifically documented, and quantified fact and these numbers sound about right. Less than one percent (71 out of the millions of men taking Propecia?) report a sexual side effect. I think the potential problem with this data (and we will have to evaluate that once it gets published) is the incidence of "permanent side effects." There are a lot of things which cause sexual dysfunction in men and in order to prove causality (i.e. that Propecia MADE it happen), each one of these cases should be controlled for other factors, like drug use, diabetes, smoking, and a host of other medical problems as long as your arm.

    This will always be the problem with trying to tease out what is truth from what is the psychology of sex drive - lots and lots of things in life affect a mans libido. Plus, sensationalist headlines like this do little to encourage rigorous scientific study since the issue gets so emotionally charged.

    So I guess I am saying that you have to weigh the odds for everything you do in life and what is published in this article looks about right for the odds of sexual dysfunction versus keeping your hair from taking Propecia. Further, I will have to read the article to be able to comment on the likelihood of permanent side effects, since that has not been well documented in the past.

    And no, I do not have stock in Merck!
  • Zao
    Senior Member
    • Dec 2008
    • 152

    #2
    I find it strange that most of the information I have read about permanent side effects after stopping Propecia are just anecdotal. Impotence is a complex issue that in my personal experience can be caused by anxiety, depression and a little too much beer. I’ve been on Propeciia since the late 1990s and have very normal sexual function. Most guys will deny it, but we have all had problems “performing” at one point or another in our lives. Sometimes it’s being nervous the first time you’re with a new girlfriend or something else. When it happens once it can be a source of anxiety for the next time and yes it can happen again. I believe that the very thought of this drug scares people so much that if they do become impotent when on it their anxiety of it happening again, makes it happen again. The mind is so powerful when it comes to sexual function.

    I would like to know how these researchers think they know for sure that these permanent side effects are caused by the drug and not the mind?
    Thank you for bringing this to our attention Dr. Wasserbauer.

    You can read my story here.
    Eleven years ago back in 1998 I was an 18 year old freshman in college and I was losing my hair. I had been losing it since about 16, I think but it was becoming very noticeable when I got to college. Styling my hair was nightmare and I was starting to get the comments from my friends. It came to a head one night when I was at

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    • Notbaldyet
      Member
      • Nov 2010
      • 31

      #3
      causality

      the problem with saying that there is an absence of 'causality' is that this is a medication which targets a major male hormone. DHT is known to cause absence of erections in animals in animal studies, and is known to cause degeneration of the corpus cavernosum and changes in the tunica albuginea, the structures responsible for erections, in rats. there is a huge incidence of side effects (much, much more than 1%) in a majority of studies on humans (with the exception of the Merck study). its not like propecia is a drug which is related to some completely unrelated biological pathway -- its a drug that is intimately related to the regulation of male hormones. Merck tried to fool everybody by saying that DHT wasn't important -- it was just some sort of extra "throw-away" hormone which magically only was responsible for making hair fall out. Unfortunately, DHT is critical for male functioning, hence the name - dihydroTESTOSTERONE. to imagine that there is no causality is like imagining that turning off the sun will not cause darkness on earth.

      Comment

      • skipstah70
        Member
        • Dec 2008
        • 92

        #4
        Originally posted by Sara Wasserbauer, MD
        I got an email from one of my patients today (who has never experienced a sexual side effect from taking Propecia) with concerns about the following article http://abcnews.go.com/Health/MensHea...3152993&page=3

        "What is your take on this, Doc?" he asked me in an email he titled, "Propecia Side Effects - not a myth."

        I replied to him that sexual side effect among those taking Propecia has never been a myth. It is an actual, scientifically documented, and quantified fact and these numbers sound about right. Less than one percent (71 out of the millions of men taking Propecia?) report a sexual side effect. I think the potential problem with this data (and we will have to evaluate that once it gets published) is the incidence of "permanent side effects." There are a lot of things which cause sexual dysfunction in men and in order to prove causality (i.e. that Propecia MADE it happen), each one of these cases should be controlled for other factors, like drug use, diabetes, smoking, and a host of other medical problems as long as your arm.

        This will always be the problem with trying to tease out what is truth from what is the psychology of sex drive - lots and lots of things in life affect a mans libido. Plus, sensationalist headlines like this do little to encourage rigorous scientific study since the issue gets so emotionally charged.

        So I guess I am saying that you have to weigh the odds for everything you do in life and what is published in this article looks about right for the odds of sexual dysfunction versus keeping your hair from taking Propecia. Further, I will have to read the article to be able to comment on the likelihood of permanent side effects, since that has not been well documented in the past.

        And no, I do not have stock in Merck!
        I have a hard time believing that a licensed physician could be so gullible in saying what you are saying, As a doctor, I'm sure you must know how the pharmaceutical drug approval process works. When a company like Merck privately funds their own test trials on a drug, they are also looking for the lowest percentage numbers with regards to side effects of any sort. Tell me how you can't see a conflict of interest in this practice, and how any resulting test numbers might be heavily biased in favour of the company and getting the drug approved, because it's glaringly obvious. I've had two physicians who have given me Propecia prescriptions up here in Canada tell me that Merck's side effects numbers are,and I quote "WAY off".

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        • tbtadmin
          Inactive
          • Sep 2008
          • 524

          #5
          Originally posted by skipstah70
          I have a hard time believing that a licensed physician could be so gullible in saying what you are saying, As a doctor, I'm sure you must know how the pharmaceutical drug approval process works.
          While all opinions are welcome here, we ask that our users act in a respectful manner when addressing our physician contributors as well as all other posters on this forum.
          Thank you.

          Comment

          • jncogt14
            Junior Member
            • Jan 2011
            • 13

            #6
            Sexual desire is just as physiological as it is mental. Read articals bout these side affects and let it haunt you thennn the next time you and your partner want to share a little fun, your thoughts are owned by this and look, your a side affects statistic! "You are what you think about." I'm no doctor but I am a student of human physiology with a massive interest in mental health and its affects on human physiology...(excuse any typos and poor grammar, on a droid!)

            Comment

            • Winston
              Moderator
              • Mar 2009
              • 929

              #7
              Originally posted by jncogt14
              Sexual desire is just as physiological as it is mental. Read articals bout these side affects and let it haunt you thennn the next time you and your partner want to share a little fun, your thoughts are owned by this and look, your a side affects statistic! "You are what you think about." I'm no doctor but I am a student of human physiology with a massive interest in mental health and its affects on human physiology...(excuse any typos and poor grammar, on a droid!)
              There is no doubt that sex is practically 100% between the ears and not the legs, so to speak. I believe firmly that these so called permanent side effects are caused by mind over matter. There is no real proof that I have come across that can point to a definitive physical reason for men to have permanent side effects from Propecia. Once the anxiety is triggered your body takes over. Eventually it’s involuntary and it is possible that a man can be impotent for years if the anxiety snowballs.

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