10/2011 Study: <1.0% Japanese Men Show Side Effects on Finasteride

[HairTalk]

Some recent studies have established even a link to cancer (male breast cancer).

Could you cite the studies?

[ulanude]

Could you cite the studies?

Hi HairTalk,
here you go - this is a report published by the MHRA:

http://www.mhra.gov.uk/home/groups/p.../con065504.pdf

some excerpts of this report: "In total there have been five UK case reports to the MHRA of male breast cancer associated with finasteride 5 mg (all indicated for BPH)"....."There were 50 worldwide case reports of male breast cancer in patients aged between 54–88 years (mean age 71 years) treated with 5 mg finasteride (Proscar), which were received between April 1992–November 2009 These included 44 medically confirmed reports."

[HairTalk]

Hi HairTalk,
here you go - this is a report published by the MHRA:

http://www.mhra.gov.uk/home/groups/p.../con065504.pdf

some excerpts of this report: "In total there have been five UK case reports to the MHRA of male breast cancer associated with finasteride 5 mg (all indicated for BPH)"....."There were 50 worldwide case reports of male breast cancer in patients aged between 54–88 years (mean age 71 years) treated with 5 mg finasteride (Proscar), which were received between April 1992–November 2009 These included 44 medically confirmed reports."

This study — a review of existing literature — concerns finasteride dosed at 5mg/day; dosing of the drug for the treatment of hairloss is 20% of that. Regarding the 1mg/day dose, the article states there have been three cases reported, world-wide, of development of breast cancer in men on the drug.

I hardly believe any of this suggests the risk of formation of breast cancer in men may be increased by use of 1mg/day finasteride (even 5mg/day seems to have a very small likelihood of doing so, according to this study).

[ulanude]

This study — a review of existing literature — concerns finasteride dosed at 5mg/day; dosing of the drug for the treatment of hairloss is 20% of that. Regarding the 1mg/day dose, the article states there have been three cases reported, world-wide, of development of breast cancer in men on the drug.

I hardly believe any of this suggests the risk of formation of breast cancer in men may be increased by use of 1mg/day finasteride (even 5mg/day seems to have a very small likelihood of doing so, according to this study).

yeah but 50 reported cases (44 of them medically confirmed) for the 5mg dose. If 5mg can increase the risk of cancer why not the 1mg dose (possibly to a lower degree) one could argue? Better don't take a risk my gut feeling says...

[the_charger]

Is this really surprising? Ive been on Propecia for around 6 months or something like that, I havent had a single side effect. I literally feel no different. But im finally seeing my hair is thicker now, even my girlfriend commented on it!

Every other study shows the same thing, even in the north american ones. I dont even know why they still spend money studying this drug, because i've seen dozens if not hundreds of studies on it that all keep showing the exact same: It grows hair really well, and side effects are very rare. Maybe it isnt a miracle drug, because some people cant tolerate, but its pretty close to being that.

Its interesting that none of these guys had permanent problems either. It seems like certain people online want everyone to believe that permanent side effects happen to everyone, but in this study zero out of 3000 of had these horrible life ending symptoms that people describe. Maybe you need to increase the sample size to 10,000 to see this happening to even one person?

People can go on and on and argue about it. But when you get solid data like this, you cant really dismiss it. If you're on the fence about taking Propecia, you should just do it. How many studies do you really need to see to realize this stuff is safe?

[ulanude]

Side-effects are the one thing (and they do happen with finasteride!). Long-term irreversible damage is the other thing. Certainly no existing study has long-term data (e.g. 10 years and more) on this drug! Feel free to show me one...
Most studies have only been carried out for multiple month - and even then available study results are contradictory. I'm just saying that there are long-term risks (which have been started to be addressed by some studies - see above) and one should be realistic about this

[Thinning@30]

Who paid for these studies which purport to show such a low incidence of side effects?

I am highly skeptical of the studies showing a low incidence of side effects for the following reasons:

-Most men experiencing hair loss are at least middle age or approaching middle age. If they have a loss of libido while on propecia, they may mistakenly attribute it to normal ageing rather than to the drug.

-Any kind of sexual dysfunction is going to be embarrassing and awkard to discuss. For this reason, many men will be reluctant to admit to having sexual problems to their doctors and even to themselves.

-Most of the studies that I am aware of use subjective self-assessments of whether or not side effects were experienced. Men are notorious for overestimating their sexual prowess. I would have more confidence in the studies if I knew they used objective measurements (for example, the number, firmness, and duration of erections over the course of the study period), but this would be much harder to do.

-Propecia has not been around long enough for long-term safety studies. No one caN say with certainty that there are no long-term side effects to propecia use.

If propecia would actually restore my hair to its former density and thickness then I might consider it worthwhile. But to risk serious and possibly permanent side effects simply to slow down hair loss (if that) to me is not worth it.

[the_charger]

It looks like the university who did the study funded it.

Your first and second arguments dont really make sense. If this were the case, wouldn't all of the propecia studies then be useless? I think on the contrary, guys will be LOOKING for side effects so that they can report them to their doctors. I believe also when they are reporting sexual function, they take a questionnaire and report anonymously to avoid embarrassment.

Propecia has only been around for like 10 years, but the active drug finasteride has been used for over 20 years. That's not as long as some drugs, but it's a pretty damn long time. I remember reading about this one study of somewhere around 20,000 guys using it for prostate problems, and they were studied for over 5 years….. That's pretty significant!

I don't know, some people seem to just become afraid of something, and decide forever that they won't go near it. It reminds me a lot of this whole aspartame debacle. It's the most widely studied food additive in history, and no one has found it causes any side effects at any level (except for a trigger of migraines in a few, but anything can trigger migraines). There is so much scientific data that says it’s perfectly safe, but there are still millions of people that swear it causes cancer and a ton of horrible problems. It's almost like some people subconsciously want to be afraid. It really reminds me of this whole propecia debate.

[Thinning@30]

Your first and second arguments dont really make sense. If this were the case, wouldn't all of the propecia studies then be useless?

I think most of the propecia studies are pretty useless. I think they overstate benefits and understate risks.

I think on the contrary, guys will be LOOKING for side effects so that they can report them to their doctors. I believe also when they are reporting sexual function, they take a questionnaire and report anonymously to avoid embarrassment

Denial is powerful, and I bet most people experiencing sexual problems can't admit to themselves let alone to others, even anonymously. Furthermore any kind of questionnaire or self-reporting is always going to be subjective. It would be more meaningful if objective physiological measures were used.

I don't know, some people seem to just become afraid of something, and decide forever that they won't go near it.

As I said, if propecia actually restored my hair to an acceptable level of density, then I might consider the risks worthwhile, but for many, if not most men, that is not what it does. It merely slows down the rate of hair loss, if that. To risk gynecomastia, breast cancer, and possibly permanent sexual side effects to maybe slow down the rate of hair loss to me is not worth it.

Look, I'm no fan of conspiracy theories. I don't think that there is some vast conspiracy on the part of big pharma to suppress a hair loss cure, but at the same time, I'm not naive enought to think that the big pharmaceutical companies and their investors will always do what is in the public's best interest and are above pushing subpar and risky treatments when profit is involved.

[CurlyBird]

I would tend to place quite a lot of weight on who funded the research. Medical studies today are notoriously suspect in general because the money so often comes from business institutions with a financial stake in a product's success. Or the doctors doing the study are in big pharma's pockets. If this study was done independent of corrupting sources of money, I would say it is probably quite valid. Especially with a 3000+ sample size. That is more than enough to make the study relevant, in addition to the fact that the men took the drug for several years.