General Incidence of Erectile Dysfunction vs. those on finasteride

[Orion]

Okay, since the main concern for most of us who are (or are considering) taking finasteride is impotence/ED, I thought I would search for the incidence of erectile dysfunction in the GENERAL population, for us younger people.

Most of the studies I found were studies for men aged 40+ (40% of men 40+ have some form of ED, whether mild, moderate, or complete [5% of which fall in this category]).. so that's normal, and it happens with age.

For us younger guys:

In a younger group of men aged 18-29 years from Denmark, FuglMeyer and Fugl-Meyer reported a 5% prevalence of erectile dysfunction even in these younger individuals.

I'll look for more studies... but wouldnt this mirror the incidence of ED for men taking finasteride... well actually, which would be lower for men taking ED (1-2%), and I would theorize that's because we have much higher androgen levels as it is. Perhaps a simplification, but just would like to get a discussion going here...

So are those people experiencing ED on finasteride attributing their ED to finasteride, when perhaps it may be another cause? It seems like the prevalence of erectile dysfunction while on finasteride may mirror the prevalence in the general population.

I purchased finasteride two months ago, and have yet to take it.. and I'm not sure why... although objectively I'm telling myself that people are misunderstanding cause and effect, it still gets to me that there is a rare chance that something bad could happen.. but I don't seem to be willing to take that chance, and my hair is running out of time.


Another study

http://www.ncbi.nlm.nih.gov/pubmed/16422958

During 2001-2003, 11,914 males reported to SPEC (average age 34.8 +/- 7.1 years). Five thousand eight hundred thirty-six of them chose to answer the SHIM questionnaire (compliance of 48.9%). According to the SHIM scores, at least one out of three men (26.9%) suffered from ED (19%, 7%, and 1% had mild, moderate, and severe ED, respectively). ED was prevalent also among young adults: 22.1% of males under-40 had low SHIM scores (<21). Severity of ED correlated with age and diabetes mellitus.

 

[Wuffer]

The incidence of 'true' ED in the young population is very low, as you found, around 5%. What I mean by true ed is persistent problems that are physiological. If we take into account the mental forms of ED (for example, not being able to get it up for sex because you are nervous) I would say it is MUCH higher in the young population. The mental type of ED can be very prevalent in young guys, as well as long lasting.

But yes you are correct; from what I’ve seen, the incidence of spontaneous sexual problems seems to match up closely with what finasteride appears to cause.

Anyway, I’ve seen studies that show that ED and libidinal issues are no higher in people that take finasteride vs. the placebo group. I've also seen ones that show a MUCH higher percentage than what the Merck FDA studies showed. You really need to look at the circumstances and details surrounding these studies, and be able to read into them objectively.

The nocebo effect is an extremely important factor to consider. I personally believe that nocebo is responsible for the vast majority of individuals suffering from sexual problems on finasteride.. I would put this figure up at 90% of people. Also, Finasteride is unique in that it has such a bad rap online that this is making the nocebo effect even more powerful. Guys argue this with me constantly, but there is absolutely no questioning how powerful the nocebo effect would be, especially for Finasteride.

The ONLY way to completely rule this out is with placebo controlled studies. We have a ton of those, so we know where to look for the real data. Anecdotal reports from people are powerful, but not nearly as powerful as these studies are. In the end, you need to determine your own risk, and there is only one way to do that.

 

[Orion]

Yes, the nocebo effect is powerful... After having done so much research on propecia's and people's experiences with it online, I can almost guarantee that Id experience side effects just cause of my mind frame about the drug... except I wouldn't know if it's just me or the actual drug.

It's disappointing to see so many fear mongers on here. They think they're helping people? Bull.

 

[Wuffer]

It's extremely powerful; I experienced it myself a couple months ago. I went through pretty much all the finasteride side effects after getting all wrapped up in what these people are saying. I needed to take some time away from the forums to get a little perspective and realize this was all just in my head.

Make no doubt about it; the nocebo effect can cause long term, significant problems. If you think you are person that may be sensitive to it, then I wouldn't recommend starting on finasteride. If you do chose to start, I strongly suggest you quit the forums. Basically take the stuff and forget about it. If you have problems, then talk to your doctor. Do anything but come online to ask for advice!

I think the fear mongerers are really experiencing some serious problems. Again, this is completely my opinion and I’m pretty sure I’ll be chewed out by saying it, but I think many of them are suffering from some form of this nocebo effect. But that's not to say they aren't suffering all the same. The jury is still out on whether finasteride is actually the cause of these problems in the guys, but there are some interesting new studies underway to get to the bottom of what's going on.

I believe many of the guys think they are helping people, but I agree; for the most part, it is a detriment to the community. They are extremely effective though; I’ve seen so many guys quit finasteride from the fear mongering. In the end, it's up to you whether you chose to be affected by it or not. I’ll admit the fear mongering hasn’t been nearly as bad as it was a while ago, which is absolutely a step in the right direction.

 

[Rawtashk]

Sides scared me from starting finasteride for 2 years. Finally bit the bullet after my boss commented on my "thin spot". Have yet to have any sides. Shoulda started 5 years ago instead of 3!!!

 

[DIYtony]

Thing is my erections are sometimes smaller, sometimes larger, sometimes I cba to have a wank, sometimes I can. Some days its big flaccid, other days it isn't, some days I get strong morning erections, some days slightly weaker.

I know that if I was on finasteride I would be analysing this beyond belief, I bet I would attribute it to finasteride.

TBH I have come to the conclusion that I am going to try it. I've ordered it and just waiting. I reckon the realistic scenario is that nothing will happen including any benefits to my hair.

 

[Spanishlad]

:agree:

 

[Wuffer]

DIYTony, you've just described this problem very well.

A lot of guys are just concerned about their hair loss, and decide to start on finasteride right away. After a while, they read on the forums all these problems they are having, then start checking (and checking and checking and checking) themselves for all these things. At first, you dont notice this stuff.. but when it's on your mind 24/7, your mind starts playing tricks on you. As you mentioned, your dink changes in sizes all the time. Some days its small, some days it isn't. Anxiety and stress can make this change, and sometimes it just does on it's own.

Really, none of us have had any question to make note of this before. When you are on finasteride for a year, it's impossible to accurately think back and know for certain exactly how you felt before starting. Again, the mind really plays tricks on you.

If you are particularly concerned about this, I would spend maybe a couple weeks or even a month with a daily logbook, rating these things.. Rate your libido and all that, and even take pictures if you are so inclined. Also, get a good hormonal bloodtest done, just in case.

When I was having my problems a few months ago, I swore my breasts were getting bigger.. I would check them all the time, and I was 100% convinced it was happening. I remembered I had a few shirtless pictures of myself from a few months earlier (from before starting finasteride) and after checking them, I saw they were actually SMALLER instead of larger (on account of weight loss). It was a real wake-up call to just chill out and stop obsessing so much.

 

[Primo]

Well personally my sides on finasteride were unmistakably REAL... I was completely ignorant about the drug beforehand and only found out about sides after researching a couple of weeks after taking it when I had began to feel like shite.

The ED was severe and and had a noticeable negative effect on my bedroom performance. Also in terms of general mood and cognitive performance, it felt like I was permanently hungover, on a downer everyday.

 

[Mens Rea]

Honestly this whole bunching of generic ED stats together with finasteride ED stats is really useless.

In most cases finasteride induced ED (etc) will be as a result of hormonal imbalance and will be occupanied by other sides such as watery semen and even gential shrinkage.

Since you can, in many cases, clearly differentiate one from the other, i don't see how bunching the figures together really helps. If these are included as one, it just creates misleading figures for all parties involved.

Such figures wouldn't even begin to explain how people get "spontaneous ED" within weeks of beginning finasteride either. Surely noone is trying to say that "you might have developed that spontaneous ED that week anyway". The devil always lies in the detail.

 

[wessneijder]

What if I notice a loss of morning wood but I can fap and ejaculate every day from watching p**rn while on the drug?

 

[wessneijder]

Bump

 

[slurms mackenzie]

What if I notice a loss of morning wood but I can fap and ejaculate every day from watching p**rn while on the drug?

I'd say that's a problem if you were the kind of person to get morning wood in the past.

I think your body needs to have wood whilst you're sleeping to keep things working.

Even with massively reduced libido and no morning wood i used to be able to 'do the deed' it's just it felt like sometimes i'd have to whack my c*** against the wall just to get it in first gear.

 

[slurms mackenzie]

I think it's important that people digest this (erm not literally),

http://en.wikipedia.org/wiki/Nocturnal_ ... tumescence

Nocturnal penile tumescence (also known as "morning wood" or "morning glory") is the spontaneous occurrence of an erection of the penis during sleep. All men without physiological erectile dysfunction experience this phenomenon, usually three to five times during the night.[1] It typically happens during REM sleep.
The existence and predictability of nocturnal tumescence is used by sexual health practitioners to ascertain whether a given case of erectile dysfunction (E.D.) is psychological or physiological in origin. A patient presenting with E.D. is fitted with an elastic device to wear around his penis during sleep; the device detects changes in girth and relays the information to a computer for later analysis. If nocturnal tumescence is detected, then the E.D. is presumed to be due to a psychosomatic illness such as sexual anxiety; if not, then it is presumed to be due to a physiological cause.

The cause of NPT is not known with certainty. Bancroft (2005) hypothesizes that the noradrenergic neurons of the locus ceruleus are inhibitory to penile erection, and that the cessation of their discharge that occurs during REM sleep may allow testosterone-related excitatory actions to manifest as NPT.[2]
Evidence supporting the possibility that a full bladder can stimulate an erection has existed for some time and is characterized as a 'reflex erection'.

 

[I AM AWESOME]

What if I notice a loss of morning wood but I can fap and ejaculate every day from watching p**rn while on the drug?

I'd say that's a problem if you were the kind of person to get morning wood in the past.

I think your body needs to have wood whilst you're sleeping to keep things working.

Even with massively reduced libido and no morning wood i used to be able to 'do the deed' it's just it felt like sometimes i'd have to whack my c*** against the wall just to get it in first gear.

So did you get off the finasteride ?

 

[slurms mackenzie]

I did after about 10 years, i think the sides crept up on me after about 8 of them it's hard to judge, it's only when i stopped through lazyness / cockyness and things got back to normal after about a month that i realised whoops, i might not have been quite myself.

Since then i've tried twice to go back on it, both times within a few days i got sides, so i'm not going back on, the sides are probably more noticeable now because i'm older 36, like it or not the old hormones are shifting so best to err on the side of caution, the fact that i tea without milk and take lysine for rosacea may have also contributed as i've read tea can suppress dht and lysine is like a turbo booster for dht inhibitors.

finasteride helped me out at a difficult time, and anybody else going through a similar ordeal the pros are gonna outweigh the cons, with what i've read about the stuff since coming back to the boards i'd be scared to recommend someone get on it for a lifetime, but as a short term solution i thought it was fine.

Anyway afaic if you're noticing sides after two weeks, get off the stuff, and see what happens.

 

[I AM AWESOME]

I did after about 10 years, i think the sides crept up on me after about 8 of them it's hard to judge, it's only when i stopped through lazyness / cockyness and things got back to normal after about a month that i realised whoops, i might not have been quite myself.

Since then i've tried twice to go back on it, both times within a few days i got sides, so i'm not going back on, the sides are probably more noticeable now because i'm older 36, like it or not the old hormones are shifting so best to err on the side of caution, the fact that i tea without milk and take lysine for rosacea may have also contributed as i've read tea can suppress dht and lysine is like a turbo booster for dht inhibitors.

finasteride helped me out at a difficult time, and anybody else going through a similar ordeal the pros are gonna outweigh the cons, with what i've read about the stuff since coming back to the boards i'd be scared to recommend someone get on it for a lifetime, but as a short term solution i thought it was fine.

Anyway afaic if you're noticing sides after two weeks, get off the stuff, and see what happens.

Man I think if I got on finasteride/minoxidil it would do wonders for me now. However I've just got that thought about what if I get permanent Side effects. I'm only 18 and still got a whole life ahead of me. But afterall you did manage to get on finasteride for 10 years and get off without noticing anything afterwards...

 

[slurms mackenzie]

You see if you were 21 my message would be get on it, and then wait to see what happens with CB 03 01, hopefully in year, we'll know a lot more about it.

I'd stop short of recommending an 18 year old get on finasteride though as i just don't know enough.

In terms of permanent sides we just don't know the odds, we don't even know if they're permanent, we just know they're long term (I'm sure for those it feels permanent but hopefully you know what i'm getting at)

 

[I AM AWESOME]

You see if you were 21 my message would be get on it, and then wait to see what happens with CB 03 01, hopefully in year, we'll know a lot more about it.

I'd stop short of recommending an 18 year old get on finasteride though as i just don't know enough.

In terms of permanent sides we just don't know the odds, we don't even know if they're permanent, we just know they're long term (I'm sure for those it feels permanent but hopefully you know what i'm getting at)

Well I'm 18 and 9 months if that helps.

 

[DIYtony]

Well I wouldn't go on finasteride at 18. I am pretty sure DHT causes growth of body and facial hair and I know that I grew a lot of chest hair between 18-22, and my beard definitely got thicker, although I always had a thicker beard than anyone really anyone else at school - I never had much body hair.

Its not really the body hair that is the issue there, more the fact that it is obvious I was (possibly still) maturing.