July 13, 2012 — New research adds to the growing body of evidence that Propecia (finasteride) can have sexual side effects that persist months, years, or potentially indefinitely after the drug is discontinued. A new study has been published in the Journal of Sexual Medicine by George Washington University’s Dr. Michael Irwig: “Persistent sexual side effects of finasteride: Could they be permanent?” The men involved in the study reported severe, persistent sexual and neurological disorders — such as erectile dysfunction, genital pain, shrinking genitals, loss of sexual desire, ejaculation disorders, depression, anxiety, or mental fogginess.
Dr. Irwig recruited 54 males from PropeciaHelp, an online group for men who have persistent sexual dysfunction after taking Propecia. All of the men had suffered at least three months of sexual dysfunction after discontinuing Propecia. They were all under 40 years old, had no prior history of sexual problems, medical conditions, or use of other oral prescriptions for hair-loss. They used Propecia for as little as a few weeks, or up to a few years before discontinuing the drug.
Dr. Irwig found that 96% of the men in the study reported sexual dysfunction that lasted for at least 12 months after stopping Propecia. He also found that nearly one out of five men reported sexual dysfunction for at least 6 years after they stopped taking Propecia. This data suggests that their sexual dysfunction may be irreversible.
The design of the study introduced some sample bias, according to Dr. Irwig. Because the men were specifically selected because they were already suffering from persistent sexual dysfunction, the study likely omitted men with less serious Propecia sexual dysfunction. In clinical trials of Propecia, 36 out of 945 men reported sexual dysfunction, or about 3%. The actual number of men suffering from persistent sexual dysfunction is likely relatively small.
Even so, Dr. Irwig’s study suggests that for some men, the persistent sexual side effects could be permanent. “Our findings make me suspicious that this drug may have done permanent damage to these men,” said Dr. Irwig. “The chances that they will improve? I think it’s lower and lower the long they have these side effects.”
Propecia (finasteride) is an anti-balding medication that was developed by the drug company Merck in the 1990s. Finasteride was originally used to shrink enlarged male prostate, but doctors noticed it also treated hair-loss. Propecia works by inhibiting the body’s normal conversion of testosterone to the more-potent dihydrotestosterone (DHT). For men with a genetic predisposition to lose their hair, over time, exposure to DHT causes hair follicles to shut down. Propecia stops hair-loss by preventing the body from making most DHT.
Unfortunately, this drug therapy is known to have sexual side effects. When Propecia was first sold, Merck assured men that if they stopped taking Propecia, the sexual problems would go away. Instead, many men suffered persistent sexual problems. In 2011, the FDA updated the label on Propecia to warn about the risk of persistent erectile dysfunction. The FDA updated the label again in April 2012 to warn about the risk of persistent dysfunction of male libido, orgasm, and ejaculation.
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