Like any other drug, Propecia (Finasteride) also has its set of side effects and complications.
When it comes to hair loss, one of the common drugs that are prescribed by doctors is Propecia (Finasteride). It is primarily formulated to treat an enlarged prostate gland; however clinical trials have shown that it was also able to promote hair growth. That is why Merck, the pharmaceutical company behind it, courted the possibility of making it as a drug which is also used to treat male pattern baldness or androgenetic alopecia.
It was in 1997 when the US FDA approved Finasteride or Propecia for the treatment of male pattern baldness. The pill was prepared as a 1 mg dose, and true enough it was able to treat male pattern baldness in men who have tried it. Some go for hair transplant surgery, while others do well with Propecia alone.
The success of Propecia was astounding, but just like any other drug it also has its set of side effects and complications. But it was only recently that issues such as the loss of libido and curbing the thirst for alcohol was brought into the spotlight.
Propecia and sexual side effects
It was in April of 2012 when the Food and Drug Administration updated their warning regarding Propecia. Yes, it was already long been noted that the use of this drug would have side effects such as impotence, loss of interest in sex, abnormal ejaculation and trouble having an orgasm. But this was updated because studies found out that these side effects could last even after the patients stopped taking the drug.
According to the study that was published in The Journal of Sexual Medicine, these side effects not only continue when the medication is stopped, but it can even last for months or years.
Dr. Michael Irwig and his colleagues reached this conclusion after studying 54 men under the age of 40 who reported of persistent side effects even after stopping the drug for three months or even more. The participants reported of a number of sexual problems such as shrinking genitals, pain in the area, low libido, trouble reaching orgasm, and erectile dysfunction. Others also reported of neurological problems such as anxiety, depression and cognitive haziness.
The authors claimed that their findings suggest a potentially serious risk for men who are using Propecia. Based on their study sample, 96% of the men reported that their sexual problems lasted more than year after not using the drug.
In An interview with ABC News, Irwig shared, “Our findings make me suspicious that this drug may have done permanent damage to these men.”
But updated label warning that was brought by the FDA for Propecia was based on post-marketing reports of sexual dysfunction. From 1998 to 2011, the agency had a total of 421 reports of adverse sexual side effects through their Adverse Events Reporting System. Results showed that 59 of these lasted more than three months after stopping the medication.
Today Finasteride will include in its warning label that it poses libido disorders, orgasm disorders, and ejaculation disorders that persists even after discontinuing the drug. It will also include in its description that there are reports of male infertility and poor semen quality that improved after stopping therapy.
But despite these new findings both Merck and the FDA claimed that Propecia is still safe and effective.
Propecia and Alcohol
From a rather concerning side effect, there’s is also a positive one. According to a more recent study which was also done by Dr. Irwig, those men who experienced the sexual side effects may also want to drink less. The report was published just this June in the journal Alcoholism: Clinical & Experimental Research.
“In men experiencing persistent sexual side effects despite stopping finasteride, two-thirds have noticed drinking less alcohol than before taking finasteride.”
It seems that the drug is able to interfere with the brain’s ability to produce the hormone neurosteroid which is linked to alcohol consumption.
Irwig interviewed 83 men with persistent sexual side effects three months after they stopped the medication. From the 63 who reported that they had at least one drink a week before using Finasteride, 41 or 65% of these reported that their alcohol consumption reduced after they discontinued the drug.
There were 20 men or 32% who reported that there was no change in their alcohol consumptions, while two men said that their drinking increased.
However, there are also some who contested these results. Dr. James Garbutt, who is a professor of psychiatry at the University of North Carolina argued, “The biggest challenge with this finding is that it is naturalistic rather than a controlled study so cause-and-effect is hard to establish.”
According to him the consumption levels that were reported in the paper would suggest that the study population were social drinkers and not those who suffer from alcoholism. That is why it is not clear if these individuals will start drinking again if they stopped taking Propecia after a long period of time.
But he also recognizes a silver lining to the result of the study. He said that the study supports the idea that more attention can be given on the neuroactive steroid system in developing new medications for excessive alcohol drinking.
These results goes to show that even after years of being in the market, there are certain side effects that only surface years after. Some may be apprehensive about these that is why they opt for other treatments such as Hormone Replacement Therapy (HRT), Laser therapy or Hair transplant surgery.
But even with the promising result of hair transplant surgery as evidenced by celebrity sporting excellent hairlines and coverage, they are still advised by the doctor to continue taking these hair loss medications. This is to prevent further hair loss in other areas of the head.
Before anything else, always ask the advice of your doctor.
Link to the Headlines
For Some Men, Propecia’s Sexual Side Effects May Be Long-lasting. ABC News Medical Unit. July 18, 2012
Links to the science
Irwig MS. Decreased Alcohol Consumption Among Former Male Users of Finasteride with Persistent Sexual Side Effects: A Preliminary Report. Alcoholism: Clinical and Experimental Research. Published online June 13 2013
Irwig MS. Persistent Sexual Side Effects of Finasteride for Male Pattern Hair Loss. The Journal of Sexual Medicine. Published online March 18, 2011