I am in my early twenties and am in Type II of my hair loss. I started losing here about 2-3 years ago and in the past year it is becoming quite noticeable, i am losing hair at a faster rate then ever and am concerned that I will end up like my father (type 6). I have been staying away from Propecia and Rogaine due to their irreversible side effects concerning sexual dysfunction. Is there no viable alternative other than hair transplant for me?
Nope.
Side effects are not proven irreversible from Rogaine and Propecia, but if you don’t want to try either of the two FDA approved hair loss medications, that is your choice. Unfortunately, hair transplantation is the only permanent solution at this point if you do not want to manage your balding problem with medication.
Paid advertisements (not an endorsement):
Dr. Rassman, you operate in the field of science which is why I am surprised you overlook the amount of evidence present for the irreversibility of some of Propecia’s side effects. One may logically argue there is no guarantee the sun will rise again tomorrow, so personal bias a large capacity to influence personal opinion.
Jeremy, all of the evidence is anecodotal and most of it comes from anonymous internet personas. A good scientist will look at anecdotes and consider whether the matter may be worth pursuing, but no good scientist will draw conclusions based on “I heard it from anonymous people on the internet!” The only pseudo-scientific study was based on post-hoc self-reporting, which is only a slight step up from “I heard it on the internets” in terms of quality (and it doesn’t help that the study has ties to propeciahelp). One of the core tenets of being a scientist is to have a healthy dose of skepticism. One result of this is that you shouldn’t draw premature conclusions based on scant empirical evidence. When you look at all the different internet personalities complaining of side effects, it’s deeply saddening to see just how quickly they’re jumping to conclusions. I’ve seen people complain of side effects, such as gyno, only to realize they don’t even have that side effect — but of course they were damning Propecia for the side effect until they realized they weren’t suffering from it. Others blame propecia for never-heard-of side effects within hours after taking their first pill or after many years of taking it, and it never occurs to them that anything other than propecia could be responsible. (Hint: if you take any prescription, eat any food, or watch any favorite TV show daily for long enough, you’re bound to have a health issue at some point. That doesn’t mean the health issue is related to that particular daily activity.) Hair loss can be emotionally devastating, as I know firsthand, and it tends to bring out obsessive tendencies in a many people while not giving them a good education on the basics of science. In short, Dr. Rassman is being a respectable scientist while you and your propeciahelp fearmongers are happily preying on people who are emotionally vulnerable with your unfounded conclusions while preparing for your lawsuit paydays.
Sorry for the lack of paragraphs in that post. I’m not sure how to do those on here. (I tried the BR tag, but it didn’t work.)
Agree, Bob. Science can often be anecdotal but in the field of drugs and side effects, one would like to have more information than people upset on blogs. When case histories appear in peer-reviewed journals (I have yet to see one) or the FDA acquires enough post-marketing complaints that a reasonable statistical analysis can be conducted (those of similar age and risk factors who don’t take these drugs vs those who do), it would be more compelling.
Biotech MD – A case SERIES was published in the Journal of Sexual medicine with 71 patients after eliminating over 30 patients. The elimination process was to make sure that 0 of the 71 patients had a questionable case history prior to taking Propecia.
Another article was also published.
Merck updated their warning labels in the United States.
A simple information request from the FDA shows there are many hundreds of patients who reported side effects to Medwatch or Merck through their doctors. The FDA is currently figuring out what to do about it, expect a black box warning to appear on the label at the very least in the following few months. These reports are not anonymous anecdotes.
A lawsuit payday will not even begin to compensate the damage in quality of life that Propecia has inflicted on its patients. Believe me, money will not change very much when you can’t maintain relationships or enjoy life’s most fundamental pleasure.
On the Journal of Sexual Medicine, the first article that popped up on google includes “That the effects might not be reversible is a concern, he said. ‘But they haven’t convinced me yet, based on this data, because they don’t have any long-term data,’ Kava said. [Dr. Bruce R. Kava, an associate professor of urology at the University of Miami Miller School of Medicine]” Your “another article” is extremely convincing evidence; Merck updating their label is just to protect themselves from bloodsuckers like you. I noticed at least you’re honest enough not to dismiss that you and propeciahelp are mostly interested in making money from this. By the way: if you think sex is life’s most fundamental pleasure, or you can’t maintain a relationship because of sexual dysfunction, you have other problems than sexual dysfunction.
You are cherry picking a single response from an article. In truth, the most irrefutable evidence is the hundreds and hundreds of submissions to the FDA for a condition that is virtually non-existent in men in their 20’s. Anybody with a dash of logic can figure out there is a strong causal relationship.
Anyway, the quote you use above implies that Dr. Kava very much agrees the persistent side effects are caused by Propecia usage. The data goes out as far as 5 years for patients (long term) to show that the effects will not naturally reverse without intervention. At this point in medicine, no known effective intervention exists rendering the side effects to be the equivalent of permanent. Maybe when the whole generation of Propecia victims has passed away without recovery and Propecia has been taken off the market, these resistant doctors will finally admit they made a mistake and there is sufficient long-term data to draw these conclusions. Or… maybe not because one could always cling to the fact that maybe they would have still recovered had they not died due to a confounding issue…
You are quite a vile person if you assume the main purpose of PH is to recoup damages from Merck. I stated this was not true, and in fact if you had been properly informed, you would know that the primary objective is to conduct research for a treatment or cure. There are several of these underway and MUCH more effort has been put into research than legal processes. If you don’t think the victims of Propecia are entitled to compensation for being misled into taking a product that severely impaired their lives, you likely have a sociopathic sense of justice.
Merck is now in the process of seriously cannibalizing sales of its drug since it has publicly admitted the connection between taking Propecia and permanent erectile dysfunction (while ignoring the other severe symptoms). It makes little business sense to do this purely for the sake of protecting against lawsuits (which it does not even effectively do) since the overall effect will severely diminish Merck’s bottom line.
Lastly, the primary biological imperative is reproduction and the creation of offspring (I will not go into evolutionary theory 101 with you). But sex is undeniably life (not even just humans) most rudimentary behavior. If you think it is easy to maintain a relationship without the ability to have sex, you are either completely inexperienced and/or entirely clueless about what it means to have a human relationship.
Kudos to this guy who has the brains and guts to say no to Propecia (nothing against Rogaine but it’s pretty much worthless anyway-harmless but worthless). The way I see it he loses a little hair, which he corrects with a hair transplant, and preserves his sex life or at least doesn’t run the risk of jeopardizing it with pill. A pretty prudent course of action in my opinion.
Bob wrote: “By the way: if you think sex is life’s most fundamental pleasure, or you can’t maintain a relationship because of sexual dysfunction, you have other problems than sexual dysfunction.”
From a strictly evolutionary and biologic perspective, the whole purpose in life is to have sex. Period. That’s it. It’s just that simple. It’s not to worship some made up sky god, or write poetry or contemplate the stars. Just my two cents worth.
“nothing against Rogaine but it’s pretty much worthless anyway–harmless but worthless”
Is that why it’s FDA-approved to treat hair loss?
“the most irrefutable evidence is the hundreds and hundreds of submissions to the FDA for a condition that is virtually non-existent in men in their 20’s. Anybody with a dash of logic can figure out there is a strong causal relationship.”
What does that prove? Thousands of men take Propecia. Side effects occur in 2% of men, so hundreds of complaints to MedWatch are to be expected.
@Johnny – I have answered these questions before and suspect you are entirely an internet troll, but I’ll respond just in case any curious readers want to understand the situation better.
Merck reports that about 2% of men experienced sexual side effects from taking Propecia but every single one in their clinical trials recovered within a median time of two weeks after stopping the drug.
The hundreds of FDA reports are for side effects that continued for months after stopping Propecia and did not naturally reverse themselves in the time offered by Merck. According to the literature distributed by Merck, one would not expect any Medwatch reports for side effects after discontinuation of the drug, with the possible exception of the very few patients that developed these symptoms from other causes. Since ED is almost non-existent for men in their early 20s, you would expect this number to be a very small handful and nowhere in the hundreds.
Additionally, upon closer review of Merck’s clinical review trial data (which Rassman apparently has not investigated), it is clear that Merck conducted fraud in playing with the data by categorizing some patients as fully recovered when they really had not (etc) in order to pass their initial warning information through the FDA. Boy, have they dropped the ball. But the good news is they are currently working (albeit at the speed of a glacier) to decide how to appropriately respond.
@Jeremy: You’re accusing me of being a troll? This coming from the guy who accused Dr. Rassman of being on Merck’s payroll!
Dr. Rassman was involved with a committee at Merck, one of the world’s largest for-profit corporations. It was reasonable to expect he would have been paid for providing services to them. If he never received money from them, that I clearly admit a mistake, but still is indicative of a relationship that poses a conflict of interest and a source of bias.
After Merck pays out 5-10 million dollars in claims on Propecia they will probably stop manufacturing it (it will fail their cost/benefit analysis). I’d predict the FDA will take if off the market in 5 years or less. Then the docs who prescribed it will be saying, “We were only relying on the best information available to us at the time….we know better now, of course.”
It’s an old story.
Here was my “informed consent” consult on Propecia with my hair loss doc: “Here’s the prescription [pre-signed and pre-printed form– fill in the name by hand]. ..Oh, don’t believe everything you hear on the internet about this. Just take it.” Fortunately I checked the internet and never took this stuff and tossed the RX in the garbage. Still the doc says (after I told her I’m NOT taking Propecia EVER…..”you really need to take it, especially if I’m doing the crown.”). Had to tell her TWICE- NO!
Don’t think hair loss docs don’t push this stuff.
Johnny: Yeah, Rogaine is a waste of money. FDA “approval” means what? That it grows some peach-fuzz that falls out as soon as you stop taking it? Is that what you call “effective”? Sure, for FDA purposes, but that’s not what most people expect.
@Jeremy: Your accusation that Dr. Rassman is receiving some type of financial compensation from Merck to promote Propecia usage via BaldingBlog is not only slanderous, but defies logic as well.
First off, why would Dr. Rassman promote a drug that hurts his business? Since Propecia dramatically slows down the balding process, it means fewer and fewer hair transplants. And it doesn’t take a genius to know performing a hair transplant is much more lucrative for Dr. Rassman than selling Propecia .
Furthermore, Dr. Rassman has recommended several times that Propecia users get off-label prescriptions for generic Proscar and cut the pills into fourths as a way of saving money. Hmmm…why would a Merck ‘shill’ promote the competition?
In other hair loss forums I have seen posters get banned for behavior like yours. The recurring theme is these disgruntled men accuse the forum administrator of being in Merck’s pocket because they treat “PFS” with a degree of skepticism. It’s to the site administrator’s credit that you’re still allowed to contribute here. I suggest you not abuse the privilege.
Steven, even if Finasteride was found to actually cause these long term problems in a small subset of men, you honestly think it would be taken off the market?
There are thousands of medications on the market that commonly cause problems way more serious than what some claim Propecia does. There are drugs that cause cancers, seizures, and even death in a subset of people that take them. Even if propecia caused these problems in 0.1% of men, it would still be a hundred times safer than many drugs out there.
In fact probably over 90% of prescription medications very commonly cause much, MUCH worse side effects than finasteride does. People pop SSRI’s without thinking twice, and don’t worry about the fact that they can cause horrible side effects, including having been PROVEN to cause persistent sexual problems in both men and women.
Bob’s first response was on the money. A very, very small of extremely vocal men have what they believe to be permanent problems resulting from Finasteride. There is a possibility there is a relationship between the two, but I personally don’t believe it in the slightest. These guys work away at insecure, anxious men, convincing them through fear mongering that they also have these problems. Power in numbers!
I constantly see the gentlemen with these issues saying that there is already proof. Take their comments at face value and you might believe them. Look a bit deeper, read the articles they cherry-pick in their entirety, and you start seeing a very different picture.
There is absolutely no scientifically verified PROOF that these persistent symptoms exist. There is a truck load of anecdotal evidence and some good theories, but that’s still very far from proof.
What really gets me is these guys try to force all this anecdotal data on us, trying to convince us all that it’s proof enough. Then anybody that is rational enough to question them gets attacked!
“First off, why would Dr. Rassman promote a drug that hurts his business?”
Propecia and hair plants are both not perfect substitutes nor are they mutually exclusive. I have addressed this before in more detail, but the vast majority of men would not bother to undergo a full-fledged surgery to recover hair as opposed to simply taking a pill. They simply do not care about hair loss enough to have surgery. I am included in this majority of men.
“Hmmm…why would a Merck ‘shill’ promote the competition?”
Proscar is not competition. It is the 5mg brand name pill made by Merck. The reason the cost is significantly cheaper is that Dr. Rassman is prescribing the drug under the pretense that the drug is not for hair loss so insurance will cover it. Buying in bulk (5mg vs 1mg) also reduces costs for the consumer.
” It’s to the site administrator’s credit that you’re still allowed to contribute here. I suggest you not abuse the privilege.”
Given there are no registered names on this blog, there is nothing to ban. If my IP were to be restricted, it is not difficult to get access to another computer/internet source/whatever. It is not practical for the administrators to do something like this. If it is true what you say and users were banned on other forums for asking questions about conflicts of interest, that behavior is very suspect and raises significant red flags. Dr. Rassman acknowledged that he was not paid for Merck and the question was dropped. The conflict of interest is there still and public for all to see, but it was very reasonable for him to state he has never received a penny from Merck.
“Steven, even if Finasteride was found to actually cause these long term problems in a small subset of men, you honestly think it would be taken off the market?”
Contrary to what you think, Propecia is rather dangerous compared to most prescription drugs and serves no actual medical solution. Propecia is a purely cosmetic drug. If it saved lives or extended life expectancy, it is more acceptable to accept a certain amount of risk. The FDA is currently deliberating upon what they want to do. I’m not unreasonable, I think informed consent with a very apparent black box warning would be sufficient if people are really that insecure about hair loss.
“People pop SSRI’s without thinking twice, and don’t worry about the fact that they can cause horrible side effects, including having been PROVEN to cause persistent sexual problems in both men and women.”
You are incorrect. The evidence is actually much stronger for Post Finasteride Syndrome given there are only a few case histories written for persistent SSRI disorder. However, since you imply there is sufficient evidence for post-SSRI syndrome you have some hypocritical reasoning to explain away when there is more abundant evidence for PFS. The reason why people don’t doubt persistent SSRI effects is the benefits can truly justify the risks and many factors more people are taking SSRIs than Propecia. It has been hypothesized that the mechanism is actually the same for both persistent conditions since the introduction of foreign pharmaceuticals are thought to be able to effect epigenetic mutations.
“A very, very small of extremely vocal men have what they believe to be permanent problems resulting from Finasteride.” “Power in numbers!”
Nice, you contradicted yourself two sentences later. Please express your ideas more cogently.
“What really gets me is these guys try to force all this anecdotal data on us.”
Articles published in highly respected peer-reviewed medical journals and non-anonymous submissions to the FDA are simply not anecdotal data. Sure, the stories from PropeciaHelp are anecdotal, as is the case when I offer my personal experiences, but they simply provide context for the dangers of the drug.
Tex: You have to keep in mind Propecia is prescribed not for a medical problem but a cosmetic one. That being the case it should be 100% safe, but it is not (besides, I can’t think of a worse side effect-other than death I suppose- of irreversible ED). So yeah, I think that if you consider why it is prescribed the entire analysis changes and it could end up being taken off the market. Sort of like food additives. You don’t really need them for much of anything but once they are shown to harbor any potential for health problems they get pulled off the market, even if the evidence is scant. And that’s the way it ought to be. Not like a life-saving drug that’s high risk. Totally different standard is applied.
Propecia will be pulled someday- just a matter of time. And all the anti-Propecia crowd will be saying “told you so.” And the docs will be saying, “Don’t blame us, we didn’t know.”
I just think it is grossly irresponsible to recommend Propecia to some 22 year old in the prime of his sex life when the drug could cost him his sex life for a decade- or maybe forever. What, to save a few stands of hair on his head nobody would ever notice missing anyway? Please!
And one other thought about Propecia coming off the market someday and people reflecting on the harm it causes: “History is a cruel teacher and she speaks with a barbarous tongue.”
I think Jeremy’s remarks have always been respectful, intelligent, cogent and well-thought out. There’s no reason for him to be banned.
I don’t think any hair loss docs are shills for Merck, but the reality is they really do push Propecia. I’ve experienced it myself. And why? Well, probably because they don’t think it’s harmful and will help with hair loss, but mostly because they are doctors. It’s like that post above about “pushy patients.” The reality is there are a hell of a lot more pushy doctors than there are pushy patients. Most patients are like sheep being led to slaughter and do anything their docs tell them to do. And the docs expect this. Informed consent to medical care? That’s more a legal fiction than a reality. Most docs I know totally ignore their role as a consultant who makes treatment recommendations and take on the role of a daddy telling his little kids what to do and how they will order their lives. If some doc says, “here go have this test done” how many patients even bother to ask why, let alone say no. The idea that it would be questioned never even comes up. If I go to a doc I treat anything I am told to do as a recommendation-there is no such thing as “doctor’s orders”. I’m not stupid. I can make my own decisions about what healthcare I want and what I do not want. If I want to go along with the recommendation, fine. If not, I tell the doc to shove it. My body, my rights.
That’s why Propecia get’s shoved down every hair loss patient’s throat. it’s just a power game doctors play over patients. That’s all.
“Proscar is not competition. It is the 5mg brand name pill made by Merck.”
I didn’t say “Proscar” I said “generic Proscar”. And generic versions of Proscar (i.e., 5 mg finasteride) are available at most major pharmacies. For example you can get 30 pills at Wal-Mart for ~$10. These generic brands compete directly with brand-name Proscar. If Dr. Rassman had any vested interest in Merck, he would not be promoting the usage of competing products.
“If it is true what you say and users were banned on other forums for asking questions about conflicts of interest, that behavior is very suspect and raises significant red flags.”
I think it’s perfectly reasonable to ban anonymous posters who make libelous statements.
“The conflict of interest is there still and public for all to see, but it was very reasonable for him to state he has never received a penny from Merck.”
How is there a conflict of interest? He presented at a Merck committee 11 years ago!
Johnny: What would be so terrible about Propecia being taken off the market? What did guys do before there was Propecia? Nothing, and everyone was fine. The world wouldn’t come to an end if this drug were simply removed from the market as it should be. Don’t forget, Finasteride was developed as a prostate shrinking drug for use in BPH, not to stop hair loss. As a prostate shrinking drug it is going to wreck havoc on the prostate, the proper functioning of which is essential to male sexual performance. So if a drug screws up the normal functioning of the prostate it’s going to wreck havoc on the male’s sexual functioning. That’s all Propecia is about. Seems simple enough.
Steven, from my experience perusing hair loss forums for the last year or so, you seem to be a very good example of a typical Fin basher. You have never taken the drug and are afraid to based on what you’ve seen online. Because of this fact, you are justifying your decision not to take it by taking up a case against it; taking time out of your day to badmouth it, and convincing others not to take it also. If you can’t benefit from it, why should others be allowed to? If you have to go bald, why shouldn’t everyone else go bald?
There are a surprising amount of guys like you out there, and it doesn’t make sense to me. Even though chances are you will respond great to it and not experience a single adverse reaction, you are scared sh*tless of taking it and vent your frustration by badmouthing it. I also see just as many guys who take the stuff for less than a week, get freaked out and quit. Then it’s ‘dodging a bullet’ when they don’t get permanent side effects, then they commit the rest of their days to badmouthing propecia. It’s really quite an interesting phenomenon, and I believe to be a big reason these beliefs continue to propagate across the internet.
Jeremy – a guy who believes he has been seriously wronged by the medication – I can see why he’s taking his time to discourage others from taking it.
I honestly think you should give Propecia a try, Steven. I’ve been on it for over 2 years, and I honestly have not had a single problem, except I experienced a testicular ache for a few days about a month in but that was it. In terms of benefits, I’ve gown down one ‘NW’ level (from NW3 to NW2), and completely filled in a golf-ball sized bald spot on the top of my head. My hairline is thicker than it was 5 years ago, and I no longer have any signs of balding whatsoever. My growth peaked at a year, and it’s been steady ever since. Thickness has increased all over, and I’ve gone from considering dropping $10k on a hair transplant to hair loss being the last thing on my mind.
You continue to believe ‘peach fuzz’ is the best you will get; if you’re committed to that belief, it’s your loss. Even if I knew there was an actual chance for serious problems down the line, I would do it again in a heartbeat, because the results I’ve had are well worth the risk to do it all over again.
Tex: Well, I’m glad you are happy. Of course, I don’t know anything about you in terms of your age or personal life. Maybe you have little or no sex life anyway, or no interest in sex, so it may be of little interest to you whether you develop ED from Propecia and you are hence willing to run that risk. That’s just not how I think. That’s not how my mind works.
You seem disinclined to drop $10K on hair transplant and that’s your choice too of course. But it’s all a matter of what we value in life. Some people think nothing of putting $10K down on a monster truck to drive around, but frankly I’d rather give the hair transplant doc the $10K and drive a broken down VW Bug and have a nice head of hair. Cost is usually not the impediment to having hair transplants. It’s laziness, fear of surgery- that sort of thing. I find it baffling that anyone, any rational thinking person, would willingly put his sex life in jeopardy by taking a drug that alters one’s normal biochemistry simply to restore hair when a simply hair transplant can do the same safely and effectively and provide a lifelong result. Whatever small gains you might have had from Propecia are only temporary. You know that. You gotta take that drug the rest of your life-with all the hazards- or lose any hair it saved you. I just don’t understand the logic of that pal.
Steven: My personal situation is of no consequence, but I’m in my late 20’s and have been in a steady relationship for several years. My sex drive isn’t what it was when I was 18, and I have noticed a decline since I reached my 20’s. I attribute this to my age. However, I enjoy sex and partake in this activity with my girlfriend on a regular basis. I started Propecia about a year before I met my current girlfriend, and like at the beginning of any new relationship, it was frequent and satisfying. It isn’t quite as frequent anymore, but just as satisfying if not more so.
Of course my sexual function is extremely important to me, and it would be devastating if I lost it. The difference as I see it between you and I is that when I take propecia, I take it knowing that it can’t cause permanent sexual problems. I’ve yet to see evidence that supports this in the slightest. You believe that the ‘evidence’ out there is real, and that there is a significant risk for this. I don’t have the slightest fear in my mind that this will happen to me. It’s not my way of justifying taking the stuff, or burying my head in the sand, but there is just no evidence. Perhaps evidence will present itself in due time. When that time comes, I may reconsider my choice.
Of course my gains are only temporary, but temporary could easily mean the next 10 years. Many, many men who have been on it for a long period of time have kept their gains for this amount of time. Especially the good responders – as I feel I am – have a good chance of keeping their hair for this long. For me, that would mean keeping it into my 40’s. I believe by that time, there will be even more effective treatments that don’t rely on a systemic approach like Propecia does. I don’t expect to have to take it for more than 5 years.
If you would like to understand my logic, I have systematically gone through a reasonable amount of medical literature relating to finasteride, spoken with several doctors, friends in medicine, and reached my own conclusion. Based on the fact that I feel pretty much exactly the same as I did when I started, the fact that I have dozens of friends on Propecia who haven’t had problems, and overwhelming statistical data that supports propecia as being a safe treatment, I have no problem continuing to take it as long as I need to.
One problem getting a hair transplant without propecia is that your hair will continue to fall out. The transplanted hair will remain, and the rest of your hair will continue to thin. You will need to continue getting transplants every couple years to maintain a natural look. This gets extremely expensive to say the least! Unless your hair has stabilized (ie, no longer thinning, this usually happens in your 40’s or 50’s) a hair transplant is not a permanent solution.
Tex: Interesting comments. But what took me back were your remarks about having experienced a decline in your sex drive since 18, and you are only in your late 20’s. I want to be very careful how I put this, but I would be very concerned about this if I were you. You should have the same or better sex drive at say 28 as you did at 18. I’m not going to suggest that Propecia had anything to do with it, that’s for you to say, but you’ve been on the pill for what, 5 years? I’m 53 and have the same or better sex drive and performance I had at 28, maybe only a little less than at 18, hard to say. I can’t remember that far back anyway. But the frequency of sex is actually more now than it when I was 28. Now if you were 50 and were saying that sex wasn’t what it was when you were in your 20’s I wouldn’t be too surprised because this is what many men in their 50’s say (this isn’t true, however, of all 50 year guys, or necessarily even the majority). But to only be in your late 20s and saying this is unusual.
For me you may be right that my hair loss has stabilized (I had no hair loss until my early 40s btw), so even if I were inclined to take Propecia there would be less benefit in my particular case and a hair transplant is the only option.
Still, if I were you I’d try going off Propecia just to test the waters and see if any improvement in your sex life were noticed. None of my business, of course, and I don’t mean to say anything off base, but you could try that as a little experiment. You’ve got nothing to lose.
It’s pretty well known that sex drive starts on a downward slide in the early 20’s. I still have a very healthy sex drive, and have absolutely no concerns in that department. However, when I realistically thick back to when I was 18, it’s just not the same. Sex isn’t on my mind 24/7 like it was then. Back then I would get an uncontrollable erection just by kissing a girl; even thinking about sex would usually do the same. It’s just not like that anymore. It’s developing an adult sex drive. It works when I need it, and doesn’t cause problems when I don’t! However, sex is much; much more enjoyable than it was back when I was 18. Experience (on both parts) is key! In fact, the best sex I’ve ever had was with a woman 10 years my senior!
I’ve been on propecia for around 2.5 years. It’s extremely difficult to reflect back from before I started the drug to realistically compare libido, but I honestly can’t tell there being any difference. It’s a tricky thing too. It’s easy to think back and imagine your sex drive being so amazing, but it’s almost impossible to accurately remember your emotions from so far back. Pain is a good example. I broke my ankle a few years back; it was excruciating. But when I try to imagine exactly how the pain felt? I know it hurt, but memories can only relay so much information.
Anyway I noticed the change in libido gradually throughout my 20’s, and it’s actually not something I complain about. More important things weigh on my mind now, and even though sex is enjoyable, I’ve discovered things in life that give me as much pleasure and fulfillment.
At the age of 53 however, you are likely in a rare percentile if you feel your sex drive is as potent as when you were in your late 20’s. Kudos to you if indeed it is! I don’t expect myself, or the vast majority of men, to be in that situation. I assumed you to be somewhere in your 20’s (no offense at all intended) but for your age in your situation, a hair transplant alone may be a more viable option, since your loss may have more or less stabilized.
Steven: I do not think Propecia should be taken off the market (I doubt it ever will). For most men who take (myself included) it is a miracle drug that halts and reverses hairloss. I’ve been taking it (and Rogaine) for almost six years and my hair looks 10x better now than it did in 2005. I can’t imagine what I’d look like today without the Propecia and Rogaine.
For some men losing their hair is no big deal, more power to them. But for me it is. Without the aforementioned two drugs, I’d probably be a “NW 4″ by now and much less confident in my appearance.
I know you advocated hair transplants in lieu of medication, but a hair transplant is a luxury product, so for many of us getting one just isn’t feasible at the moment.
“It’s pretty well known that sex drive starts on a downward slide in the early 20’s.”
I have to disagree. A decline in the early 20s? Why? That’s not the way it is suppose to be and, in fact, to whatever extent there may be a decline with age, I would expect it to be minimal and in the usual case imperceptible. Not saying a 70 year old or 80 year old should be functioning like a teen, but assuming good health there’s no reason a guy in his 50’s shouldn’t be having as much sex as a guy in his 20s. The reason guys in their 50’s suffer so much is because most neglect themselves physically and have done so for years.
“At the age of 53 however, you are likely in a rare percentile if you feel your sex drive is as potent as when you were in your late 20’s. Kudos to you if indeed it is! I don’t expect myself, or the vast majority of men, to be in that situation.”
Not as unusual as you think. Take care of yourself and you’ll see what I mean.
Still, as I said, it would be an interesting experiment for you to go off the Propecia and see if there is a change for the better in any respects in your overall well being. Just my 2 cents worth.
Johnny, Propecia would never be taken off the market. Even if all this permanent-side-effect talk was actually proven real, an official warning would be added to the PI, a number of lawsuits would come and go, and things would continue on. Even if Merck decided to pull their Propecia/Proscar products from the market, the generics manufacturers would continue to do their thing and it would still be readily available.
Perhaps, at the very worst, the FDA would pull Propecia from the market, since it’s simply treating a cosmetic problem. However, Proscar is treating BPH, an actual medical condition. Not threatening, but bothersome nonetheless.
“The difference as I see it between you and I is that when I take propecia, I take it knowing that it can’t cause permanent sexual problems.”
You can ‘know’ all you want, you will always be wrong.
“I’ve been on it for over 2 years, and I honestly have not had a single problem, except I experienced a testicular ache for a few days about a month in but that was it.”
What about the time where you developed impotence, freaked out, and supposedly cured yourself by going to hypochondriac rehab? I don’t see how you overlooked this simple fact unless you were previously lying.
“What about the time where you developed impotence, freaked out, and supposedly cured yourself by going to hypochondriac rehab? I don’t see how you overlooked this simple fact unless you were previously lying.”
Interesting, Jeremy. I didn’t know Tex had previously reported that. I found his remarks about his declining sex drive since reaching the ripe old age of 20-something bizarre to say the least. Where did he get the idea that it is normal for a late 20-something to have experienced a decline in sex drive? And yet Propecia’s got nothing to do with any of it? Hum.
We can keep going back and forth calling each other wrong, but I believe what I believe, and so do you. I won’t budge until I’m proven wrong, and I don’t see anything on the horizon that will do that any time soon.
But yes, my story was entirely true. It wasn’t ‘hypochondriac rehab’; it was a therapist specializing in cognitive therapies, who tailored a treatment program for me based on a program used to treat hypochondriacs. I absolutely developed impotence, but it wasn’t a result of Finasteride use. It was a result of worry, anxiety and obsession over side effects, as I mentioned in my original post. My therapist showed me how to effectively manage this fear, rationally talk it down and in a short amount of time my symptoms abated.
In the end, it was putting a stop to telling myself that finasteride has caused these problems. Essentially, I brainwashed myself to believe nothing was wrong with me, and now that I believe it at a core level, I’m ‘cured’.
In fact, now that you bring this up, I am going to contact my therapist and ask her if I can scan the program and host a pdf of it online. A therapist is handy, but I believe people could do it at home if they chose to. However, I’m not expecting a lot of PFS volunteers to try it out, simply based on the refusal to consider that the problems could possibly be cognitive in nature.
I’m not suggesting you suffer from the same, but I absolutely did. I have been problem free ever since, and I believe 100% in my case that it was my mind causing the symptoms. As a rather average individual with an obvious inclination towards obsessive behavior (a quality most males with MPB will also exhibit), I can realistically reach the conclusion that others are currently going through the same as I did.
Thank you for coming clean and admitting you lied. I will do your online PDF 4x a day until I die and its not going to reverse my pudendal neuropathy. You are ridiculous.
Tex: There’s enough evidence to show Propecia causes ED in a substantial number of users and in some it cannot be reversed upon stopping the drug. The drug will be taken off the market sooner or later and you’ll have to go to Mexico to get it or some 3rd world country. It’s baffling to attempt to understand why anyone would take this drug when a simple hair transplant is all that is needed. Is everyone so broke or cheap that they cannot afford a hair transplant, or frightened by the idea of a minor scalp surgery that take one lousy day to complete? They’re not afraid to take a drug that will ruin their sex lives, but hey, that’s the mentality of the average US consumer I suppose.
The EU will probably be the first to ban Propecia and then the US. I’m afraid you are just on the wrong side of history.
Steven Says: “You have to keep in mind Propecia is prescribed not for a medical problem but a cosmetic one. That being the case it should be 100% safe, but it is not (besides, I can’t think of a worse side effect-other than death I suppose– of irreversible ED).”
Um, there are LOTS of medical treatments for cosmetic issues that are far from being 100% safe; in fact, there is likely no medical treatment that is 100% safe, ever. By this flawed logic, we should ban all cosmetic treatments — by this reason, we would ban skin reconstruction for burn victims, facial reconstruction for head trauma victims, cleft pallete surgery for kids born with those missing, breast reconstruction for breast cancer victims… I mean hey, it’s cosmetic, right?
Jeremy: care to explain what you believe I lied about? I don’t understand your statement, but i’m sure you will clear it up for me. You, like many other ‘PFS sufferers’ outright refuse to believe your problems have a mental component, and convince yourself it’s a physical problem. I disagree with that. But it’s like trying to talk to a wall, so i’m giving up trying to convince you.
So you were actually diagnosed with pudendal neuropathy, or was it a conclusion you reached purely based on your symptoms?
Steven:
“There’s enough evidence to show Propecia causes ED in a substantial number of users and in some it cannot be reversed upon stopping the drug”
You make a lot of these types of statements, but i’ve never seen you cite a source. Please provide a source to back this statement up. And not the Irwig study; that is chaff. Obviously we know it causes ED rarely. Proof that it doesn’t reverse after discontinuing? I’ll give you a hint: there is none.
“It’s baffling to attempt to understand why anyone would take this drug when a simple hair transplant is all that is needed. Is everyone so broke or cheap that they cannot afford a hair transplant, or frightened by the idea of a minor scalp surgery that take one lousy day to complete?”
Seriously? How many people do you honestly believe have $10,000-$20,000 sitting around in the bank? You’re asking why young guys opt to take a medication that costs less than $100 a YEAR over surgery that costs as much as a car? For the vast majority of men, medication that is tolerated perfectly fine and often provides results that are evern better than a hair transplant?
You might be in a fantastic financial situation, but the majority of the population is not. Also, most men who choose to take propecia are in their 20’s, when their hair loss is just starting. As I mentioned, if you get a hair transplant at this stage, you are going to need to touch-up surgery at least every 5 years, especially if you don’t take propecia.
“seriously? How many people do you honestly believe have $10,000-$20,000 sitting around in the bank? You’re asking why young guys opt to take a medication that costs less than $100 a YEAR over surgery that costs as much as a car? For the vast majority of men, medication that is tolerated perfectly fine and often provides results that are evern better than a hair transplant?”
It’s like I said earlier, people have money for things they want. All you have to do is look around at people driving new cars and there’s your $10-20K being dropped not on something that will make them look better and improve their self-esteem but something that will depreciate $5K the moment it’s driven off the lot, and lose another 10K or more the first year.
“You might be in a fantastic financial situation, but the majority of the population is not. Also, most men who choose to take propecia are in their 20’s, when their hair loss is just starting. As I mentioned, if you get a hair transplant at this stage, you are going to need to touch-up surgery at least every 5 years, especially if you don’t take propecia.”
I’m talking about the safest and best way to go, which is with the surgery. It’s a no-brainer.
“So you were actually diagnosed with pudendal neuropathy, or was it a conclusion you reached purely based on your symptoms?”
Diagnosed. Are you that ignorant to think somebody could diagnose themselves with this?!? The diagnosis requires a specialized test where electrical conduction is sent through the body and the speed and intensity of the signals are measured. This is not something that just spontaneously emerges in men in the early 20’s. No harm, physical injuries, or diabetes present either that would cause the condition in the absence of Propecia.
I think you may have some unresolved issues regarding your experience with the drug. I cannot tell you whether your symptoms were imagined or caused by the drug since I don’t know your case history. But since you are convinced they were psychosomatic, it is selfish of you to project your own insecurities onto others by denying the existence of the problems the drug can cause. Sure, its possible a few men freak out from hearing about what Propecia can do and believe it has happened to them as well, but there are very tangible tests that can show there are physiological dysfunctions which you are ignoring. Including, but not limited to (ultrasounds, endocrine profiling, neurological testing)
Jeremy: Specifically how is one diagnosed with “PFS”? What tests need to be performed to determine if a man has Propecia-induced ED?
Like all medical syndromes, it is usually a diagnosis of exclusion and subject to imprecision. If one usually develops ED and it has been ruled out there is a separate cause, one realizes they have PFS. There isn’t an official process, but if one has several symptoms after taking Propecia it is fairly clear they came as a result of taking the drug since they don’t usually occur together. For example, ED may occur on its own, along with watery semen, but when a patient experiences both after taking Propecia it is highly probable there is a causal relationship stemming from the use of the drug. Hopefully, that helps even though the answer is somewhat ambiguous at this stage in time.
Even though I never took Propecia, I am concerned about the side effects others have reported. My boyfriend took Propecia several years ago and stopped and now has some sexual problems that I wonder about. He has problems with delayed ejaculation and I’ve been wondering if this can be a side effect. He’s only 39 so this should not be an issue but I wouldn’t be surprised if Propecia had something to do with it.
Steve: your boyfriend should have a full workup by a urologist if he hasn’t already. Propecia can cause delayed ejaculation as an in-use side effect, but it would be unlikely for the problem to persist afterwards. Especially if he didn’t experience this symptom while using propecia, I would say its very unlikely to be related if the problem popped up a couple years afterwards.
Steven, I’m sorry to hear about your bf and now understand a little bit about why you seem to be the only non-PFS patient to actually support our cause. Has he undergone any doctor’s visits or testing to get the problem checked out?
If his problem is only delayed ejaculation, he should be happy that at least the consequences could have been much worse. But I imagine, he probably has some lack of sensation, which can decrease overall satisfaction.
Thanks Tex and Jeremy: At first I was afraid that there might be a little homophobia on this board and that my remarks would be removed. Glad to see that hasn’t happened. Things are definitely getting better for us (GLBT people, and gay men in particular).
Yes, I am concerned about my boyfriend’s delayed ejaculation. It’s been a problem for him for a while and it’s always concerned me. When I was looking into hair transplants I happened to mention in passing something about Propecia and told him I had decided not to take it. He mentioned, “Oh I took that before.” It totally surprised me because he’s an Asian guy with a pretty good head of hair. I asked him if he ever had any side effects from it and he said he didn’t think so (all the while I’m thinking about the delayed ejaculation problem of his). He did take it for a while and then stopped apparently. Not sure if it’s related but it’s got me wondering. He’s kind of in denial about the problem and he shouldn’t have it because he’s a really healty, in shape guy.
Of all the kinds of sexual dysfuntion one can have I think delayed ejaculation is probably the least of them. At least you can still function in a sense, maybe in the most important way, but it’s a frustrating problem nonetheless. I only brought it up here because I was wondering if this was ever a reported side effect from Propecia. That’s another problem I see with Propecia: I wonder if there are many guys out there who took the drug and have sexual side effects from it not thinking there is any connection, attributing the problems to something else?
Thanks again for your comments guys.
I can only speak for myself, but homosexuality doesn’t bother me in the slightest.
From what I know about the ill-effects of Propecia and sexual dysfunction, I can’t really offer you any opinion. Delayed ejaculation, I believe, is somewhat common although perhaps not consistently across continuous encounters. Since the chronology of when he developed the delay and took the drug is unknown, it would be impossible to even begin to speculate. Propecia can cause loss of sensation which would obviously lead to delayed ejaculation, however.
Many men suffer damage to their ego when they can’t perform sexually, of course, so if you decide to mention it to him I would think he may be more open to talking about it if you highlighted the possible role of the drug. I expect it will be easier for him to talk about it if he recognizes it as a medical problem (like a cold or genetic defect) rather than a personal failure.
I can guarantee you many men do not realize that Propecia caused these problems. In part, due to physicians like Dr. Rassman who effectively deny or dispel the possible link between the drug and the problems. Also, like your bf, many men choose to ignore or deny these problems which would lead to severe underreporting. I imagine, due to ego reasons, this is probably the top issue that patients are embarrassed to speak about with their doctors.
I developed insensitivity and loss of arousal after a weak of taking Propecia and consulted my doctor who was misinformed and told me the problems would most likely go away. After another week of taking the drug, nothing changed, so I decided to stop on my own. The side effects never returned, but I convinced myself they were non-existent or unimportant since I didn’t want to deal with it. After giving Propecia another try and mentioning this to another doctor who felt the link was non-existent, the symptoms expanded in both scope and scale. It is very obvious, due to the timing, that Propecia played a very significant role in having me develop these problems. So in regard to your comment, there are many guys who are unknowingly suffering out there but we will never know how many. The lawsuits will raise awareness as they proceed which will allow some men to revisit the issue, but Merck was recently able to sneak the warning into their label without raising too many eyebrows. I am hoping the FDA requires Merck to put a black box warning label on the drug soon, which would be immensely helpful to raising awareness and allowing men to take informed risks.
I just read Tex’s above post and he really is very naive about the situation. His lack of ability to objectively assess the situation really irks me, but he is not the only one with this lack of perspective. Dr. Rassman constantly shows a lack of insight when discussing these types of problems with Propecia.
For example, nowhere did you mention the timing when your bf developed side effects and when he took the drug. Yet, he conveniently assumes the problems appeared a couple years after taking the drug, or at least implied that he felt that was likely the scenario. I also seriously doubt he has any idea what a ‘full workup’ (sic) entails. He lambasts PropeciaHelp members for dispensing medical advice, yet he does the same thing with no experience in such a field and even less of an understanding. Modern urology is unfortunately rife with a lack of medical knowledge, like many fields in modern medicine, and the main tools available for managing sexual dysfunction are pills, injections, and implants. None of these are useful if you are having problems with sensation, libido, or arousal.
Thanks Jeremy. Yes, I am afraid that Propecia’s side effects are underreported because of the common reluctance of men to complain about sexual dysfunction and possibly out of ignorance that there even could be link to use of the drug. So yes, some guy takes the drug, develops the sexual side effects and either does nothing about it or goes to a doc who assumes it can’t be related to Propecia. One more case that slips under the radar and the stats end up as 1-2% of side effects, which may be way off. What bothers me the most, however, is that docs normally give no warnings about Propecia. There’s no informed consent counseling. They hand the pills out like they are nothing and everyone assumes them to be 100% safe, 100% side effect free. That’s the scary part.
oh, and one more thing, Jeremy. Very glad to hear that homosexuality doesn’t bother you. The medical profession is made up of a fairly conservative group of people and it has a history of and still a strong undercurrent of homophobia within it. Things are changing, but change is slow. I have a couple of gay doc friends- one in a dermatology residency- and they are typically not out at work. Funny, straight docs don’t have to hide their orientation.
Hi guys, I’ve been reading your conversation and would like to add my experiences. I’m 36 and started taking Propecia four years ago, when I was 32. I was concerned about sexual side effects, obviously there has been a lot of controversy about this in general. I’m curious to see if anybody else has had an experience similar to mine. I didn’t notice an immediate effect over time, but I have noticed some changes gradually over time. Basically, I look at porn and masturbate on a somewhat regular basis, probably the same more or less than any other guy these days. It seems that it does take me longer to cum than before, which maybe isn’t such a bad thing; obviously women (or your partner or whatever) don’t want a man to shoot his load in two seconds, being able to hold your load for a while usually allows the other person to be stimulated more.
Reading so much about the controversy of side effects with Propecia has made me want to look at porn more and masturbate more to kinda “check things out” for myself. I find that masturbation is still very pleasurable and the sensation feels great. However, when I ejaculate, it seems when I climax and ejaculate, it just isn’t as good as it was many years ago. I’m only 36, I don’t think it’s because I’m too old. Sometimes my cum just dribbles out. Sometimes I can literally “shoot” my load and it goes far occasionally, up my chest etc if I am laying down masturbating. But often my dick gets soft quickly after ejaculation, and again, the actual climax of the orgasm just doesn’t seem as good as it used to be. Sometimes it even feels anti-climactic, almost too much like I’m going to faint or whatever, but it’s that killer feeling I remember feeling the first time I experienced it at age 12 or whatever later. The problem has seem more pronounced in the last six months, even though I started taking Propecia in late July 2007, so basically I am saying the problems seemed to get worse much later, after 3+ years of using the drug. I have memories of awesome orgasms even a year ago or so, but in the last 6 months those have seemed to vanish. It seems like most people who have what they think are sexual-related side effects from Propecia develop them much more quickly after using the drug (not after 3+ years of using the drug).
Has this happened to anybody else on Propecia? Specifically, I’m curious if anybody else has experienced either one of these two things I shared: 1. A less pleasurable orgasm and 2. This problem not developing until after being on Propecia for several years. Please share your experiences, don’t be shy, where else can us guys talk about this stuff?
Sorry, wanted to edit my last comment but I guess editing is not allowed here. One sentence needs correcting: “Sometimes it even feels anti-climactic, almost too much like I’m going to faint or whatever, but it’s that killer feeling I remember feeling the first time I experienced it at age 12 or whatever later” should have said “it’s NOT that killer feeling I remember feeling the first time I experience it at age 12 or whatver”