July 18, 2012 — Dr. Michael Irwig of George Washington University has published a study in the Journal of Sexual Medicine linking Propecia (finasteride) to long-term sexual side effects that continue even after the drug is stopped. Patients may endure these “persistent” side effects for months, years, or possibly indefinitely. In the paper, Dr. Irwig writes that “20% of subjects with male pattern hair loss reported persistent sexual dysfunction for ≥6 years, suggesting the possibility that the dysfunction may be permanent.”
The study asks “Persistent sexual side effects of finasteride: Could they be permanent?” The study involved 54 adult males who were recruited from PropeciaHelp, an online forum for former Propecia users who have serious side effects. The men were chosen for the study because they reported at least three months of sexual side effect. A “persistent” side effect must last for at least three months.
The FDA recently updated the label on Propecia to warn of the risk of several “persistent” sexual side effects — including persistent impotence, ejaculation disorders, orgasm disorders, decreased libido, and more.
When Dr. Irwig began his study, he wanted to know how long a “persistent” sexual side effect really lasted. He tracked the men for an average of 14 months to find out whether their persistent side effects remained or disappeared. An overwhelming 96% of the men reported continued sexual dysfunction at the end of the study, and the vast majority (86%) met the technical definition of sexually dysfunctional according to the Arizona Sexual Experience Scale (ASEX).
The findings of this study suggest that the “persistent” sexual side effects of Propecia may last for years.
The biggest drawback of the study is that it has a sample bias. All of the men involved in the study had already suffered so severely from Propecia that they sought help online, which skews the sample in favor of men who have long-lasting persistent sexual dysfunction. Other, well-controlled studies have estimated that 2-3% of Propecia users have sexual side effects. The frequency of long-lasting sexual dysfunction is unknown, which is one reason why researchers are calling for more studies.
Propecia users have reported many sexual side effects, including:
- Erectile dysfunction
- Ejaculation disorders (decreased ejaculate volume)
- Orgasm disorders (inability or difficulty orgasming)
- Decreased libido, lack of interest in sex
- Genital shrinkage
- Penile fibrosis
- Endocrine system (hormonal) changes
- Psychological damage
- Body disfigurement
- Gynecomastia (enlargement of male breast tissue)
- Post-Finasteride Syndrome
- And more
In 2011, Dr. Irwig published another study in the Journal of Sexual Medicine with a design similar to this recent study. In the 2011 study, Dr. Irwig recruited men from an online forum and interviewed them to determine the most common persistent sexual side effect. The majority of his subjects had erectile dysfunction, low libido, and orgasm disorders.
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