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  1. #1
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    Default Why is only Propecia implicated in PFS?

    Just to start off, I have been on propecia for a half a year or so and haven’t had any side effects. However, I am still pretty interested in the topic of PFS and serious symptoms that one could end up with by taking finasteride. After all, I want to be as sure as I can be that I won’t end up with serious problems. My doctor has told me he has looked into this because I was concerned, and says I have nothing to worry about.. But still I want to be as sure as I can be!

    I have been spending a bit of time looking at propeciahelp. The one big question I have that no one seems to ask is why do only men taking propecia (1mg) end up with PFS, but not men taking proscar, the 5mg version? Don’t get confused with the men that get prescribed proscar and cut them up into 1mg pieces. I am talking about older men who are 40+ years old taking proscar for prostate troubles.

    The big reason I find this very weird is I saw this press release about finasteride from the ISHRS and this is a quote taken from it:

    Since receiving FDA approval in December of 1997, 20.5 million and 6.7 million patient-years of exposure using Proscar and Propecia respectively are recorded with a low adverse event profile. The ISHRS believes that these are the most current and reliable data available until further studies are conducted.
    Even though patient years of exposure don’t tell us exactly how many men have been on each drug, it does show that men have been exposed to proscar 3-4x as much as men taking propecia. This would tell me that there should be 3-4x as many men who took proscar that should be complaining of persistent symptoms. But this didn’t happen.. Nobody even really heard about these serious symptoms until recently, in the last couple years, even though men have been taking proscar for the last 20 years.

    I looked through a lot of the member stories on propeciahelp over the last couple days and problems are almost exclusively linked to 1mg propecia, taken for hair loss. To me, this makes no sense, and makes me really think something else could be going on other than just “finasteride is causing all these problems”.

    I am anything but an expert in medicine or statistics, but what do you guys think? Does anybody have a good explanation for why this would happen? I hope this leads to some good discussion and not a war…

  2. #2
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    I had posted this question sometime ago, and I think the argument posted by others was mainly

    1)Older people are less likely to complain over the internet and more likely to complain to their doctors.

    2)Symptons of enlarged prostate are similar to those suffering from PFS


    I don't entirely agree with either. If older people are less likely to complain over the internet, then doctors that prescribe Proscar should be bombared with complains of PFS

    Even if symptons of enlarged prostate are similar, this should mean enlarged prostate should be considered a problem which leads to the same problems as PFS. In the medical litreature we don't see as much complain of sexual side effects from enlarged prostate as we see from PFS.
    Alot of men have enlarged prostate, but we don't hear of crippling sides effects from enlarged prostate?

    I also think its very naive to think men in their late forties and older, don't care if they become 100% impotent, or have crippling depression as a result of taking this medication at 5x the strenght.

    So yea I kind of want to know if someone else can come up with a better explanation.

  3. #3
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    The answer is fairly simple and can be explained due to a handful of factors:

    PFS does not actually occur any more frequently in younger men taking 1mg of finasteride versus 5mg of finasteride. A large part of this perception is driven by the response bias. Young men are much more likely to report this for a variety of reasons: they are more technologically savvy, they are more likely to be angered by the outcome since they are young and in their sexual primes, and they are more likely to know that the drug caused their problems since sexual dysfunction is virtually non-existent in men in the early twenties.

    Older men are less likely to report this (on the internet) and to a lesser extent, the FDA. Older men did not grow up using the internet and used finasteride to treat legitimate health issues, not a cosmetic problem like finasteride. For this reason they are less likely to feel they are the victims of fraud since they simply failed with a legitimate medical intervention. Younger men are more likely to feel that their insecurities were exploited and their livelihood was stolen as a result. Older men are also much more likely to have pre-existing sexual health problems from BPH so if they experienced a deterioration in their condition they would be less likely to acknowledge this as a result of finasteride. Additionally, they are no longer in their sexual prime, hence less likely for it to directly impact their lives.

    So while it occurs the same across age groups, if you read through anecdotal reports you will see these dynamics play out. For example, an older man reported being in a trial of Proscar and developed permanent sex problems as a result but was not very computer literature and a lot of his posts demonstrate technological incompetence.

  4. #4
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    Quote Originally Posted by khan View Post

    I also think its very naive to think men in their late forties and older, don't care if they become 100% impotent.
    This older demographic would obviously still care - but less than your average libidinous twenty-something male. Doctors would also likely attribute the problem to age or other irrelevant factors. As doctors gain awareness of the problem, you will find that a large population of older men will draw the connection. This trend has already started.

  5. #5
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    ^ What about other symptons of PFS?

    gynecomastia, penis shinkage, crippling depression and loss of cognitive ability. A simple scroll on p-help.com will show that loss of libido problems with errection is just part of the story.

    Even if older men don't care that they get 100% impotent, are older men likely to ignore "all" these sides!!

  6. #6
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    You can clearly see in the Propeciahelp.com the slogan :
    PROPECIAHELP: Persistent Finasteride Propecia PROSCAR side effects info & forum
    Info and forum for men with PERSISTENT sexual, mental and physical side effects which CONTINUE DESPITE QUITTING hair loss & prostate drug Finasteride Propecia, PROSCAR

  7. #7
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    Quote Originally Posted by khan View Post
    ^ What about other symptons of PFS?

    gynecomastia, penis shinkage, crippling depression and loss of cognitive ability. A simple scroll on p-help.com will show that loss of libido problems with errection is just part of the story.

    Even if older men don't care that they get 100% impotent, are older men likely to ignore "all" these sides!!
    They aren't ignored - they're just not reporting them online. These reports have likely been submitted to the FDA which is part of the reason they have recently launched their investigation.

    If you simply look at this forum, you would incorrectly conclude that only men 40 years of age and younger are going bald since you rarely see anybody older on here talking about taking finasteride or hair transplants. You just simply aren't look at a representative sample of bald men/ finasteride users.

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