Propecia - Sexual side effects

[He-Bat]

Hi. I am considering Propecia but I must say, the possible sexual side effects scare me. Have you guys taken a look at Propeciahelp.com or seen some of the horror stories on youtube. The thing is I was on antidepressents for 10 years which caused erectile dysfunction. After I stopped taking the pills, the problem didn't go away. I still have this problem but I am using cialis and that fixes the problem. I have a girlfriend and we have regular sex, and everything is ok, as long as I take Cialis or v****. So now I am wondering, since I already have ED problems, should I start taking Propecia and say to myself that I won't get ED because I already have it or does it mean, since I have it, Propecia will most likely take away the little I have left? Plesae advice. Thanks

 

[Ende]

I'm not sure what's causing the problem with antidepressants, but the problem with finasteride is that it may cause muscle atrophy due to low testosterone level, if your testosterone/estrogen ratio is altered. Muscle atrophy means that you will suffer from ED despite of using PDE-5 inhibitors. I wouldn't worry too much about this though. Just try the drug and see how it goes, and quit if you experience reduced libido.

 

[He-Bat]

Thanks for the info. I think I will try it. But I am still worried. What about all those people claiming permenent sexual side effects?

 

[Ende]

We didn't listen to our body...

 

[timbo]

Thanks for the info. I think I will try it. But I am still worried. What about all those people claiming permenent sexual side effects?

Cases of permanent sexual side-effects tend to be missing in official trials and medical studies. You mostly only hear about them on websites and internet forums. I believe a lot of them are incorrectly attributed to finasteride, psychological, or shamelessly fabricated for no good reason. I would imagine they are very rare. You, however, might be in a category where finasteride is not a good choice. I would speak with a doctor.

 

[HerosDuJour]

He-Bat,

I strongly advise you against taking finasteride.

Although the previous poster has a point, the fact is that (a) this drug has a powerful effect on your neuro-endocrine system, and (b) researchers don't know what the longterm effects are (beyond 5 years). And that's assuming the drugmaker told us everything we should know regarding their trials - on past form, that's not a good bet.

I myself have been experiencing erectile dysfunction for the last year, after 8 years on Propecia. I do not attribute this to Propecia as a matter of course, it could well be something else, and I am keeping an open mind.

In your situation though, with an already vulnerable sex drive/erection, you should not even dream about taking it, even just once. What is more important to you, your hair or your sex life? Judging by your post, you are old enough to go bald without social anxiety. If your erections deteriorate in the future, you need to be able to squarely rule out Propecia, never having taken it.

 

[FSHGLD]

For what it's worth, I've been taking 0.5mg of propecia for about a month and my erections seem better. I wasn't exactly impotent before, I could always get an erection by myself but have had some problems before with women. Now they seem more consistently strong, and I think it might be because the fact that I'm taking propecia is making me slightly more positive about life- i.e that I might be able to keep some of my hair. Don't forget that erections start in the brain and your state of mind is every bit as important a determinant of your ability to get one as the state of your body.
I know I'm not speaking from a scientifically knowledgeable point of view, but if you're prone to depression, and losing your hair is getting you down, you mind find that propecia improves your outlook on life and actually improves your ability to keep an erection. I'm not telling you to ignore your anxiety about the drug, but just consider this.

 

[He-Bat]

You all make good points. I am 28 years old with mild-moderate thinning in the crown and some in the front. I am also considering hairtransplant. I have even contacted a few doctors, even dr. Cole. My hair means alot to me as I am into acting, so going bald now is out of the question. I probably won't care as much when I am older, but now, I care alot. I use Nanogen (works like Toppik only better) and that works wonders and no one can tell I am losing any hair, but If I didn't use it, I'd be out of a job. So I don't know what to do. I don't mind using Nanogen the rest of my life but If I lose much more hair I won't be able to use it. I need advice please.

 

[HerosDuJour]

If things are as you say re your acting career, then that obviously complicates things a bit.

My basic point is that even if you ignore the scare stories on the net, the 2% of erectile dysfunction reported in the original trials shouls be reason enough to steer clear of Propecia if you already have that condition.

I have tried Cialis and found that it does help me, but not always, and is definitely not targeting the actual problem. Then again, I don't know if my problem is Propecia (although I have just cut back to 0.5mg/day).

My advice would be to fully investigate and implement the alternatives to Propecia. I believe that actors are big users of hair plugs (Nicholas Cage, Mickey Rourke are obvious examples). If you can spare the money then they do good work these days. There is also a topical treatment I believe. Also it seems there are real breakthroughs on the horizon that won't mess with your hormones.

Lastly find out how to naturally reduce your production of DHT. Cutting down on ejaculation/orgasms is a good start. You can have great sex without blowing your load every time.

 

[He-Bat]

Thanks for the reply. I have been thinking about hair transplant I just don't know what Dr. I want. I have the money. If I lose alot more, maybe end up a nw5, is it possible I can have multiple hair transplant that will give me good enough density that with the help of Topik/Nanogen, I can look like I have normal hair and and good enough density that my Toppik doesn't look like saw-dust on y scalp? BTW, I just started using Minoxidil 2% Too early to tell about results.

 

[HerosDuJour]

Good show. I'm switching to Minoxidil, and phasing out Propecia with smaller doses over the next 12 months.

 

[He-Bat]

If I lose alot more, maybe end up a nw5, is it possible I can have multiple hair transplant that will give me good enough density that with the help of Topik/Nanogen, I can look like I have normal hair and and good enough density that my Toppik doesn't look like saw-dust on y scalp?

 

[HerosDuJour]

I don't know enough about hair transplant to have an opinion, you should find lots of info on the relevant threads. There are risks and rewards with both treatment options, but on balance I know which one I would take. I got started on Propecia when I was your age, nowadays I'm a lot more clued up (I like to think) about the medical profession and industry. What rings an alarm bell in your case is that you have already been affected in this way by medication, and I think any responsible doctor or urologist would give you the same advice.

 

[captain_que]

For what it's worth, I've been taking 0.5mg of propecia for about a month and my erections seem better. I wasn't exactly impotent before, I could always get an erection by myself but have had some problems before with women. Now they seem more consistently strong, and I think it might be because the fact that I'm taking propecia is making me slightly more positive about life- i.e that I might be able to keep some of my hair. Don't forget that erections start in the brain and your state of mind is every bit as important a determinant of your ability to get one as the state of your body.
I know I'm not speaking from a scientifically knowledgeable point of view, but if you're prone to depression, and losing your hair is getting you down, you mind find that propecia improves your outlook on life and actually improves your ability to keep an erection. I'm not telling you to ignore your anxiety about the drug, but just consider this.

Good point! A lot of ED is because of depression/your mind focusing on something else, so I can see how it could work out like this for some..

 

[He-Bat]

The reason for my low sex drive is because I took Paxil for 10 years and that caused dopamine downregulation (dopamine is important naurotransmitter when comes to sex). I am now taking Wellbutrin (which is a dopamine booster) and the sex drive is better but nowhere near as good as before Paxil. Maybe because I already have low sex drive and the occational ED, I won't notice the difference on finasteride. Am I dreaming?

 

[HerosDuJour]

At least the antidepressant drugmakers have fessed up to major ED side-effects... after they were effectively forced to.

The thing with Propecia is that if it does interfere with sexual functioning (and we don't know that for sure), they just don't know what the mechanism is. It could well impact the neurotransmitters, dopamine, adrenaline or noradrenaline (indeed, some people are complaining of depression side effects elsewhere on this forum). Do you really want to find out for yourself?

 

[Mew]

The thing with Propecia is that if it does interfere with sexual functioning (and we don't know that for sure),

Uh, sure we do. Merck and FDA list sexual side effects as a possible outcome from usage.

http://www.propecia.com/finasteride/pro ... ffects.jsp

"A small number of men had sexual side effects, with each occurring in less than 2% of men. These include less desire for sex, difficulty in achieving an erection, and a decrease in the amount of semen."

Also, from 2008 - http://www.ncbi.nlm.nih.gov/pubmed/19090946

"RESULTS: Sexual AEs are reported in clinical trials at rates of 2.1% to 38%. The most common sexual AE is ED, followed by EjD and decreased libido."

"A proposed mechanism for sexual dysfunction involves decreased nitric oxide synthase activity due to decreased dihydrotestosterone. "

"CONCLUSIONS: The connection between 5ARIs and sexual dysfunction is apparent upon review of the literature. Though theories have been proposed, little is known about the exact mechanisms behind 5ARI-related sexual dysfunction. Since the connection between 5ARIs and sexual AEs is established in the literature, future research should be directed toward deciphering the pathophysiologic mechanisms. When more basic science knowledge is attained in this area, the focus can shift toward prevention and treatment."

Besides impacting Nitric Oxide Synthsase activity, considering the drug also impacts neurosteroid production (thereby affecting the GABAergic system in the brain, leading to depression, anxiety), it does far more than just "inhibit DHT".

Btw He-Bat, if you're so gung-ho on finasteride and think you'll be invincible from side effects, then go ahead and take it. Just don't say nobody warned you in advance, especially if you get them and they don't resolve after quitting -- as is now being written about by medical professionals:

http://blog.alanjacobsmd.com/alan-jacob ... n-men.html

http://blog.alanjacobsmd.com/alan-jacob ... erone.html

http://blog.alanjacobsmd.com/alan-jacob ... eride.html

 

[He-Bat]

I get what you are saying I am glad you guys are being forward. I guess Rogain and hair transplant are my only options then. I have the money so i need to find a doctor. What doctor do you recommend?