yes but those warnings are based on user claims, NOT on any type of scientifical research.
Look, they are the regulatory agency in Sweden, and they obviously have enough knowledge, data and insight beyond either of us to make the decision they did in updating the official prescription info for Propecia to include "persistent difficulty obtaining an erection after discontinuation of treatment" as a possible side effect.
Wether that decision came to be made based on scientific data or adverse reaction reports or some other means, we don't know and is in fact a moot point, because they obviously came to the conclusion they did and had enough evidence to do so, despite Merck's wishes.
You cannot argue with the fact that "persistent ED after discontinuation" is now an officially recognized side effect in Europe published in black and white. Wether you choose to "ignore" this or accept it is up to you, it still doesn't change the fact that this side effect is now part of the official stance for this medication in that country.
Furthermore, the fact that MSD lists this potential outcome from use of their drug via their Swedish
http://www.msd.se website should be proof enough for you. Are you seriously going to sit here and claim that Merck is now lying about the updated prescription changes, when it's linked via them directly?
Give me a break.
There is a striking lack of any scientific proof of permanent biologic modification due to any type of anti androgen.
Moreover, there are not reports or evidence of permanent effects on hair after discontinuing finasteride.
This evidence or lack of, further contradicts any suspicion of permanent low DHT or low 5ar after discontinuing such drugs.
That's the thing here, those with PERMANENT problems from the medication are in the minority, and have yet to be documented in a scientific research report because most studies (such as Propecia FDA trials) didn't follow up on a longterm basis with those men who quit due to sexual dysfunction.
However, anecdotally there are certainly a minority of men suffering from these issues despite quitting the medication, even years later, and this is starting to get more and more awareness in the medical community. These men go AGAINST textbook examples of what's supposed to happen after quitting the drug (everything should go back to normal) -- instead, things get worse, the reasons for which are currently unknown.
It may not have to do with low DHT or 5AR2 enzyme activity post-finasteride; it could be another pathway that was inhibited by the drug that has been permanently affected. Until the men suffering from these problems are evaluated via an in-depth research study, we won't know the true reason for these persisting issues.
Since the DHT, testosterone and 5ar level go back to normal levels after stopping any anti-androgenic drugs, and the androgen receptors remain capable of binding to the androgens, the libido issues are not due to the drug usage.
Yes, if everything goes exactly as planned and in a perfect world, everything would go back to normal. But until those suffering from such issues can be tested for AR activity post-finasteride, we won't know if these men were in fact affected by the drug in some unforseen way or mechanism of action, perhaps at the genetic level even.
As for libido issues not being related to the drug, sorry -- Merck lists loss of libido as a possible outcome from usage of their medication.
The lower libido can be due to the fact that the patients got older compared when starting finasteride. We know that testosterone level naturally decrease with age. And add some "placebo" effect and you end up with a signifiact number of cases of permanent low libido.
Yea, except we're talking about guys at like 19, 20, 21... not 60 and 70 year olds here.
These are young men who before taking finasteride have a raging sex drive and rock hard erections/morning wood/spontaneous erections, yet while taking it lose their sexual function (as listed as a possible outcome of usage), and it persists depsite quitting.
Sorry, but ED, impotence, no libido, no ejaculate volume and other outcomes of this medication is not a normal scenario for a 19 year old, especially one who was perfectly sexually normal before taking finasteride.
Finally, your logic is based on attacking finasteride/Merck, and totally ignores the potential effects of a much more potent 5ar inhibitor: Dutasteride(Avodart).
If the permanent side effects on finasteride would be true, it would be evident that the permanent side effects on dutasteride would be a lot more obvious..
dutasteride does have a higher side effect profile from the studies I've looked at compared to Finasteride so I'm not sure what your trying to get at here.
Also FYI, dutasteride behaves differently compared to Finasteride when it comes to inhibiting 5AR enzymes, as noted here:
http://jme.endocrinology-journals.org/c ... l/34/3/617
"
Thus, future trials such as the PCPT and treatment protocols using 5-reductase inhibitors should consider genotyping men for SRD5A2 variants. In fact, we note that the pharmacogenetic inhibition increases for finasteride with time (Table 1) while it decreases for dutasteride (Table 2).
This may suggest that dutasteride has a ‘tighter’ range for allelic and somatic variants, which may lessen the still considerable impact of pharmacogenetic variation in vitro. Thus, this compound may be generally better tolerated in vivo as well."
TRANSLATION: One drug may be a "better" treatment over the other based on a man's 5AR2 & genetic profile, when it comes to inhibition and thus, potential for side effects.
So perhaps that has something to do with things. Again, nobody really knows... yet.
As for permanent sides from dutasteride, there are not as many guys taking it for hairloss, but I and others have already encountered anecdotal stories of men suffering irreversible damage from that drug as well.
Anyway, I'm not here to argue with disbelievers, the truth will come out one day... and you should be glad, because that means there will potentially be a treatment for those suffering from these issues, so these types of debates will no longer be required.
