Month: October 2011

HI, I have taken propecia for about 3 1/2 years. I recently stopped taking it which has been about 2 months because of fears of developing breast cancer. I had a form of gynecomastia which developed when I was around 12 years old. I had surgery to correct it 7 years ago. Also the only person in my family to get cancer has been my mother who had breast cancer 5 years ago. Now I was told by my doctor that propecia does not cause male breast cancer but I have read online that it might increase the risk.

The best medical advice is obtained from your medical doctor, not the Internet. This site isn’t a place for medical advice either. In general, Propecia can cause gynecomastia as a rare side effect… but it does not CAUSE breast cancer.

There have been reports of breast cancer in men who took Propecia, but the causality cannot be established and it is very, very rare by the reports I’ve read in the literature. So the lesson here is talk with your doctor and find the treatment option best for you.

I started propecia just under 2 months ago, and within the last 2 weeks recently began experiencing sexual side effects in that i cant maintain an erection with my girlfriend

i have decided to stop propecia, as im nervous about the risks now – will my ability to maintain an erection return? how long does it take for the side effects to go away?

i’ve seen very disturbing blog postings on how these may be permanent sexual side effects – is that possible for me given i only took it for 2 months?

thanks!

Decreased erection is one of the side effects of Propecia which occur in 1 to 2 percent of the men who take it. It correlates with what I see in my clinical practice (as well as my colleagues around the country). These side effects are reversible within one to two weeks once you stop the medication, which also correlates with what I see in my clinical practice (as well as my colleagues around the country). I do realize there are some men on the Internet who claim they lost their ability to achieve an erection permanently, but I cannot validate the claims.

There was an article published that claimed persistent sexual side effect associated with Propecia, but it was not a scientific study. The published paper was an interview of 71 men with clear limitations. The study itself mentions this: “Study limitations include a post hoc approach, selection bias, recall bias for before finasteride data, and no serum hormone levels.” In my opinion, the publication of the study did more harm than good, as many are now citing this article blindly as proof.

If you are having trouble with your erection, follow up with the doctor who prescribed the medication or your primary care doctor. The Internet is a great source of information and misinformation, but it is not a substitute proper professional diagnosis or treatment.

Hey guys, love the blog. Big fan for years. So, I’ve been using proscar for over ten years and lately (due to lack of effectiveness) I’ve upped my dose from 4 equal parts to 3. I don’t know if it’s just coincidence because I’m having stress and anxiety but I’ve been having problems with shortness of breath. So, I put myself back down to 1/4 pills months ago, but the symptoms persist. I’m wondering if I should just go off the drug all together for a few wks and reset my gauges. Have you heard of this before?

Thanks

All drugs have side effects, but I do not believe shortness of breath is in the list of effects possibly caused by Propecia, although it might be indicative of an allergy. I don’t know if you recently switched brands of finasteride, but if there’s no allergy, shortness of breath can be an early indicator of heart or lung disease. Please follow up with your doctor.

Snippet from the study:

Before now, there has been no study of finasteride use exceeding 1 year in Japanese men with androgenetic alopecia (AGA) except the study subsequently conducted from the development phase. Since the launch of finasteride, no study in a larger population had been reported. Ethnic variation of the onset age, progressive nature and degree of hair loss of androgenetic alopecia are known. The therapeutic effect of oral finasteride (Propecia) was examined on androgenetic alopecia of Japanese men. The efficacy and safety of finasteride (1 mg tablet) was evaluated in Japanese men with AGA in the long term.

Read the full abstract — Evaluation of efficacy and safety of finasteride 1mg in 3177 Japanese men with androgenetic alopecia.

A new study has been published on the use of finasteride 1mg in the Japanese Journal of Dermatology, addressing the safety and effectiveness of finasteride in 3177 balding men, and the impact on 2561 men in this group was observed. Safety data was obtained by interviews and laboratory tests. Of the 2561 men who followed through the study, the published report says that “the overall effect of hair growth was seen in 2230 of 2561 men (87.1%), in whom hair greatly (11.1%), moderately (36.5%) and slightly (39.5%) increased”.

Adverse reactions were reported in 23 of 3177 (0.7%). It is interesting that the higher degree of sexual side effects in some other studies were not matched in this study at a single Japanese institution. If one subtracted the placebo group’s side effects in the US studies, the number seems to come closer to this recent Japanese report. The article also showed increasing benefits over time in those individuals who had the best results from the drug.

Hi Dr. Rassman,

First of all, kudos for the very informative and educational blog – I have used it extensively to become knowledgeable about the options available for MPB. My question concerns propecia and the impact of lowering DHT in the follicle…By taking propecia – one reduces the amount of DHT being generated by the body but what of the levels in the follicle? The conversion of testosterone to DHT occcurs in the prostate gland, liver and skin but how does propecia reduce the existing DHT molecules in the follicle? By halting the conversion – would the DHT levels in the follicles reduce on their own (over time) and result in either reduced hair loss, hair re-growth or increased fiber size?

I am not aware of any studies of what or how DHT is doing at the follicular level, so I really cannot get into the exact biochemical process behind hair loss and hair growth related to DHT.

However, in general DHT does impact hair follicles for those men who are specifically predisposed to androgenic alopecia (also known as male pattern baldness). So the concept behind Propecia (finasteride) is to lower the DHT level in your body and thus diminish the impact of androgenic alopecia. For a specific biochemical approach to your question, I will defer to the biochemists.