The Risk

[Wuffer]

After having read the abstract of the article from Dr. Michael S. Irwig, he states:

Study limitations include a post hoc approach, selection bias, recall bias for before finasteride data, and no serum hormone levels.

From what I can gather, all of the participants in this study are from propeciahelp.com. I don't know if this was an in-person interview (or over the phone or through email), but it sounds like Dr. Irwig picked 71 people who are having persistent sides, and simply wrote an article about it. Also, I am surprised no hormone tests were taken. It's like picking 71 people claiming they got cancer from icecream, then writing an article about their symptoms. It doesn't prove anything!

I am on finasteride, and I won't lie that the prospect of having permanent sexual sides is scary as hell. However, I need to base my decision to quit (and as should everyone else) on accurate studies that definitively prove that finasteride can cause this to happen. When such an article is published, I will get right the hell off the stuff.

This isn't effective science; they really need to do a long-term study on tens of thousands of people using the drug, involving regular medical testing. To my knowledge, the closest we have to that is the FDA trials, which did not uncover these persistent symptoms.

Unfortunately, I don't think a large long-term study will ever happen. I don't know where the money would come from for something like this. Merck would simply pay off all the people claiming persistent sides before ever funding a long-term study like this.

 

[Mens Rea]

After having read the abstract of the article from Dr. Michael S. Irwig, he states:

Study limitations include a post hoc approach, selection bias, recall bias for before finasteride data, and no serum hormone levels.

From what I can gather, all of the participants in this study are from propeciahelp.com. I don't know if this was an in-person interview (or over the phone or through email), but it sounds like Dr. Irwig picked 71 people who are having persistent sides, and simply wrote an article about it. Also, I am surprised no hormone tests were taken.

I am on finasteride, and I won't lie that the prospect of having permanent sexual sides is scary as hell. However, I need to base my decision to quit (and as should everyone else) on accurate studies that definitively prove that finasteride can cause this to happen. When such an article is published, I will get right the hell off the stuff.


Unfortunately, I don't think a large long-term study will ever happen. I don't know where the money would come from for something like this. Merck would simply pay off all the people claiming persistent sides before ever funding a long-term study like this.

WOW.

I see you're currently at denial stage. Fair enough. All i'm saying is, don't spout this all of the board please as you might effect someone else's choices.

I personally was told to not pay any attention to propeciahelp as those guys were crazy. So i went ahead and took finasteride, much to my regret. Enden got screwed up from finasteride, too as has finfighter and monty. Speak to them if you find it so hard to believe.

As for that quote of Irwig's - he HAD to write about his study's weaknesses as its being published in the Journal of Sexual Medicine. The reality is he sourced out 71 PFS victims that were perfectly healthy otherwise and took no other drugs. His next study will include hormone levels etc but you dont need to wait until sometime gets published when its readily available if you actually look on that forum

It's like picking 71 people claiming they got cancer from icecream, then writing an article about their symptoms. It doesn't prove anything!

That's outrageous. Read the whole study, his subjects were extremely specifically chosen.

This isn't effective science; they really need to do a long-term study on tens of thousands of people using the drug, involving regular medical testing. To my knowledge, the closest we have to that is the FDA trials, which did not uncover these persistent symptoms.

There's various studies out there proving the exact reason why 5AR inhibitors like finasteride mess people up for you to read - read them. This isn't icecream and cancer... we're talking about a drug that has been proven to increase your estrogen by 15%, reduce your DHT levels by about 70% and increase your tesosterone levels. This is a HORMONE altering drug. It's a serious, serious drug. It's an ENZYME INHIBITOR So please don't make light of it just to make yourself feel better. It reduces a perfectly natural hormone in your body - DHT. A hormone that is associated with "all things male" - it is the most important androgen and most active form of testosterone. Take oral DHT and you'll see how powerful this hormone is. Suppressing such a powerful hormone completely messes some people up. Some people have very sensitive endoctrine systems. It's not theory, its fact.


As i said in another post - mayube you should read the proscar studies also.

But at the end of the day all the source data you need is on propeciahelp. You aren't a scientist you shouldn't need things written out for you studies that tend to be years behind what we already know anyway as your knowledge base. You are taking the drug now, afterall.

There is over a thousand members most with sexual dysfunction thanks to finasteride. Most were young healthy men otherwise and that includes myself.


FDA approved drugs have KILLED people before. What good do studies do for them?

 

[Wuffer]

I possibly came out as a bit too harsh here; I am not trying to come out with a completely polar-opposite view on the subject as you are, but I am just trying to view this with as much of a level, un-biased head, so that I can present a realistic view on the subject as possible. Hopefully this will allow people to make well educated choices about staying on, or quitting finasteride. Also, when you ask that I don't spout this all over the board, why can I not present my view on the subject, but you guys can? Just because in your mind, my viewpoint isn't correct, doesn't mean it's wrong. It doesn't mean I’m right either, but I am just presenting my view based on the evidence I have seen.

Could you post links to the Proscar studies you mention? I haven't read these and would definitely like to compare them to the Finasteride ones; especially since Proscar has been out for a much longer time than finasteride. From what I’ve read, there is a higher incidence of side effects while taking Proscar, but I didn’t see anything relating to persistence of side effects.

I know several people on this board have serious problems, and I will not discount that they were caused by finasteride. I can’t imagine what they are going through, and won’t even say that I can empathize. However, I really need to point out that it is a handful of people on an internet forum. I know that I cannot use this as a reliable sample to judge my own actions on. I don't know these people, I don't know what their medical history is, or if they even took finasteride. No rational person should ever base their decisions on something like that. Again, no disrespect to the individuals experiencing these issues. When you have millions of users of the drug for two decades with no medical studies supporting these claims, how can I or others take this as evidence?

I have tried to gather reasonable evidence from the sources cited at propeciahelp. I found that they are extremely skewed and biased. It seems that literally every document that exists on the internet that mentions Finasteride or dht deprivation in a negative way are cited there. Nothing conclusively supports this phenomenon. Again, if I have missed something, please post a link!

Again, there needs to be a large scale, unbiased study of what is going on here. There are absolutely thousands of seriously messed up people on Propeciahelp. I am not convinced that all, or even most of those cases are caused by finasteride. I think a lot of these guys are having some serious problems, and chalking it down to finasteride as the scapegoat. Unfortunately, the general consensus there is that doctors are useless and they shouldn’t go to see what’s wrong. Even worse, in desperation, so many of them are resorting to taking hormones ordered over the internet in an attempt to fix themselves.

I keep mentioning this, and people keep shrugging it off; all of the commonly reported post-finasteride side effects are well known and documented side effects of Anxiety and Depression. I’ve been through both, and experienced these sides to a degree I wouldn’t wish on anybody.. And I experienced them for years on end in my early 20’s. ED, loss of libido, fatigue, brain fog, headaches, dizziness, panic attacks, and the list goes on. After reading through many propeciahelp posts, people describe exactly what I went through when I had Anxiety (way before I ever touched finasteride). No one will even consider this as a cause, and get angry at the mere mention of it.

It’s not the right way about helping the people there. They don’t even mention that these problems could be caused by something like a mental disorder, or that they should go to the doctor to rule out anything else wrong with them. I’m genuinely heartbroken for these people, since I believe they are going through hell with anxiety and depression, and convincing themselves and each other that finasteride has caused this horrible, incurable state of affairs. Anxiety and depression are very treatable, and it’s terrible that no one even considers this a possible cause.

 

[Wuffer]

Just to add on to my long-*** post, I hope that it has maybe rang true with a few people feeling they have been experiencing persistent sides from finasteride, or even if they believe they suffer from Anxiety and/or depression not related to finasteride.
If finasteride has caused persistent sexual sides, I can almost guarantee that there would be a severe emotional aspect to go along with it. Severe depression and anxiety would almost certainly result, which would almost definitely result in the associated symptoms. If even the strongest, most well put-together man in the world had his sex life crushed, it would result in a huge depression that I couldn’t even imagine.

I got over my 7-year long battle with this mental problem with Cognitive Behavioral Therapy (CBT). After doing this for about 3 months, I completely recovered from my mental problems and they haven’t come back since. All of the accompanying symptoms also abated, and it was the best feeling in the world.
I can almost guarantee that any person that believes they have post-finasteride syndrome would significantly benefit from CBT therapy. Since sexual ability has such a strong mental aspect tied to it, I think there would be fantastic results if people began treating themselves with it.

CBT has also been proven to significantly help people that suffer from Chronic Fatigue Syndrome, the previously thought untreatable disorder that affects many millions out there.

I won’t bother posting links about CBT when Google and Wikipedia are so accessible, but I hope at least a few people consider this treatment course. I swear by CBT; it quite literally saved my life, and also several of my friends through my recommendation.

 

[Ende]

Morning erections don't disappear because of mental problems.

 

[Wuffer]

@Wuffer

Read this, link!

Persistent Side-Effects from Propecia
viewtopic.php?f=61&t=64629&start=0&st=0&sk=t&sd=a

I actually read this article this afternoon. I didn't see any section in the article that shows any evidence that finasteride causes persistent sexual side effects. I saw a ton of references that it can cause sides during use (which we all know is true) but nothing other than a case study of an individual claiming persistent sides.


Actually, on second look, I saw this:

In the study by Wessells et al. [25], only 50% of patients experienced resolution of their sexual adverse events after discontinuation.

I was interested in reading this cited article, as it would have been the first statistic with proof of the persistent sexual sides.. But after having read the article:

Only 4% of finasteride and 2% of placebo patients discontinued the study because of sexual AEs. In men who discontinued with a sexual AE, 50% and 41% experienced resolution of their sexual AE after discontinuing finasteride or placebo therapy, respectively.

http://www.ncbi.nlm.nih.gov/pubmed/12639651

Am I misreading that? It says that even more people in the placebo group had persistent sides than people in the Finasteride group! How can the main article make a claim that half of the patients didn't have resolution in their sexual sides when even more in the placebo group didn't either?? This throws the validity of this article into question. Please correct me if i'm misreading that.

 

[Orion]

The original article is a load of crock, and shows how deceitful media can be. 92% of men do NOT experience long term side effects. It's 92% of the men in the sample of 71 men who experienced symptoms 3 months after discontinuing finasteride use.

But with that said, I bought generic proscar a few weeks ago, along with a pill cutter... haven't popped one of those guys yet. Need to be 100% sure it won't do me any harm before going through with it.

 

[Mens Rea]

The original article is a load of crock, and shows how deceitful media can be. 92% of men do NOT experience long term side effects. It's 92% of the men in the sample of 71 men who experienced symptoms 3 months after discontinuing finasteride use.

But with that said, I bought generic proscar a few weeks ago, along with a pill cutter... haven't popped one of those guys yet. Need to be 100% sure it won't do me any harm before going through with it.

You'll never be 100% sure but if you read selectively im sure you'll be content that there's no "real" risk despite the obvious now being showcased.

 

[Wuffer]

Am I misreading that? It says that even more people in the placebo group had persistent sides than people in the Finasteride group!

Yes you are misreading it.

Would you care to clarify how I misread that?

Look, everyone knows that there is no evidence that proves conclusively that Finasteride causes permanent sexual problems in humans. I've read through the articles you posted, as well as the ones on propeciahelp, and they don't state that; everybody knows it. They are definitely scary with all the bolded and highlighted lines, but they are anecdotal evidence at best. Proof would involve a study of a large number of individuals, and a study of the ones that experienced persistent symptoms after stopping the drug. There is absolutely no study that found these results!

That being said, I am not saying that it's not possible to happen. I'm just saying that if a person is to base their decision of either taking, or not taking the drug, they need to base it on significant, long-term studies of the drug. There are dozens of these, involving tens of thousands of patients. Incidences of persistent sexual symptoms were not found in any of these studies. Maybe they will come out with a study tomorrow, which completely supports persistent sides. That would be great; I would get off the stuff in a heartbeat and change my entire optionion about the subject in a second. However, we all need to live our lives based on the information we have today. That's really all there is to it.

 

[Mens Rea]

Am I misreading that? It says that even more people in the placebo group had persistent sides than people in the Finasteride group!

Yes you are misreading it.

Would you care to clarify how I misread that?

Look, everyone knows that there is no evidence that proves conclusively that Finasteride causes permanent sexual problems in humans. I've read through the articles you posted, as well as the ones on propeciahelp, and they don't state that; everybody knows it. They are definitely scary with all the bolded and highlighted lines, but they are anecdotal evidence at best. Proof would involve a study of a large number of individuals, and a study of the ones that experienced persistent symptoms after stopping the drug. There is absolutely no study that found these results!

That being said, I am not saying that it's not possible to happen. I'm just saying that if a person is to base their decision of either taking, or not taking the drug, they need to base it on significant, long-term studies of the drug. There are dozens of these, involving tens of thousands of patients. Incidences of persistent sexual symptoms were not found in any of these studies. Maybe they will come out with a study tomorrow, which completely supports persistent sides. That would be great; I would get off the stuff in a heartbeat and change my entire optionion about the subject in a second. However, we all need to live our lives based on the information we have today. That's really all there is to it.

You mean there's one....a MERCK one....

I just think its sad that you need a study.

If your brother got knocked down tomorrow would you need a study to confirm it? No. Well, there's plenty of people you can speak to to confirm finasteride's persistent side effects, too. Including me. The science proves these effects are definately possible, so why doubt it so much?

PERMANENT SIDE EFFECTS AND INFERTILITY ARE NOW ON THE WARNING LABEL FOR PROPECIA IN EUROPE. There is law suits popping up everywhere.

Stop burying your head in the sand. This isn't some alien sh*t where people are thinking this stuff up- the science is there. These people experience the effects of androgen deprivation and this is barely a surprise considering finasteride inhibits DHT synthesis. DHT is THE most important androgen in the male body. Read up on the in's and out's please. The side effects are real, i konw because i have them as do 1000's of others.

I actually ignored my side effects until it got too undeniable. I am the opposite to someone who would be mentally influenced. I assumed id be better when i quit but i didn't - my penis f*****g shrank. I had shooting penis pains (almost unbearable) for 2 months - i very notiably lost girth. Placebo's is nothing to do with the guys that actually have been screwd up. Keep that seperate please because its bloody hard to read.

 

[Wuffer]

Okay; You and I can keep posting articles and arguing like this, but it's a waste of time for both of us. We are both dead set in our beliefs, and I don't think anything will change our minds! Besides, this topic has been argued thousands of times before, and nothing ever comes from it!

I still believe a significant number of post-finasteride sufferers are experiencing a mental disorder. I hope that any people that feel they fall into this category would PM me and I can point them in the right direction with CBT therapy. I also believe that even if a person is suffering very real persistent sides from finasteride, that CBT would significantly increase their quality of life and relieve at least some of the mental symptoms they are experiencing. I say again, CBT is shown to successfully treat people with chronic fatigue syndrome, which presents with symptoms that are almost identical to what post-finasteride suffers complain about. This isn't whacky new-age sh*t, it is one of the most important and successful mental therapies out there, and is recommended by many psychologists.

 

[Mens Rea]

Okay; You and I can keep posting articles and arguing like this, but it's a waste of time for both of us. We are both dead set in our beliefs, and I don't think anything will change our minds! Besides, this topic has been argued thousands of times before, and nothing ever comes from it!

.

But you're posting generic articles about placebos. Nothing substantive.

I still believe a significant number of post-finasteride sufferers are experiencing a mental disorder. I hope that any people that feel they fall into this category would PM me and I can point them in the right direction with CBT therapy. I also believe that even if a person is suffering very real persistent sides from finasteride, that CBT would significantly increase their quality of life and relieve at least some of the mental symptoms they are experiencing. I say again, CBT is shown to successfully treat people with chronic fatigue syndrome, which presents with symptoms that are almost identical to what post-finasteride suffers complain about. This isn't whacky new-age sh*t, it is one of the most important and successful mental therapies out there, and is recommended by many psychologists

Im sure the odd sufferer does have this but it has got to be the exception rather than the norm. Most of these guys developed it directly due to the mechanisms of finasteride which distort the neurotransmitters in the brain. Most of these guys weren't and aren't prone to any mental problem other than those caused directly from finasteride. I think you have to accept people's personal experiences. If you actually read their stories they literaly crash and their minds be swept from under them completely suddenly and unexpectedly.

I am interested in CBT myself. Not because i have any mental problems but would love to sharpen up generally as im in a tough career (law).

 

[Wuffer]

Glad to hear it; it takes some time and when you start it seems like it is useless.. But then suddenly, things start to get ALOT better. It's great at handling daily stresses, and I honestly think it should be taught to kids in school. I don't think kids have very good stress management abilities, which can lead to unfortunate problems like substance abuse and mental disorders. I think alot of this could be avoided.. But that's another subject.

When CBT is properly 'implanted' in your brain, your response to negative thoughts are automatically thwarted. Instead of thinking, for example "I'll probably get fired for this" and then drowning the resulting negative thoughts resulting from that (i'll lose my house, my family, no one will respect me, i'll be on the street) or whatever, your mind automatically kicks in from CBT and says that thought is bullshit, and puts an end to the resulting train of negativity. This might sound a lot like when people tell you to "just think positive", which is useless, throw-away advice, but when you actually train yourself to think this way on subconscious level, it really has a profound effect.

All of our heated finasteride arguments aside, you are welcome to PM me for advice when you want to get started with it; it's a fantastic tool in helping us all deal with the complexities and bullshit that life throws at us!

 

[Wuffer]

I should have been more clear; my last response was directed at Mens Rea, mentioning he would be interested in using CBT to help deal with his work stress. I am content to drop this subject about finasteride pending further studies / evidence that support our cases

 

[Mens Rea]

Wuffer is one of the many who wish to play things down. It's understandable.

I remember when i started finasteride i was aware of PH but figured i wasn't going to be one of those guys and that worst case scenario my sides would leave if i stopped (like almost everyone, right?).

Wuffer for your information the MERCK study had some 16,000 people in it. I suppose that is pretty large scale but on the grand scheme of things, especially given the type of drug it is, you shouldn't be surprised that the study was limited.

Another thing...read this:

http://www.propeciahelp.com/forum/viewt ... f=8&t=4768

Merck said themselves there was little difference in effect between teh 1mg and 5mg dosage yet when they decided to promote it for hairloss their new study reports 2% side effects instead of the proscar studies of 8%.

I personally think 20-30% of men have some side effects, that may just be slight ball ache or something else minor.

 

[Orion]

Merck said themselves there was little difference in effect between teh 1mg and 5mg dosage yet when they decided to promote it for hairloss their new study reports 2% side effects instead of the proscar studies of 8%.

Isn't the proscar study done for prostate cancer? That is, the mean age of the sample is much higher than that of the study done for male pattern baldness with propecia? Hence why the incidence of side effects for the drug (and the placebo) is higher?

 

[Ende]

Isn't the proscar study done for prostate cancer?

BPH; enlarged prostate. It's not cancer.

 

[Wuffer]

I believe what he was referring to was the large-scale study of Proscar that showed a reduction in prostate cancer. I think around 17,000 patients were involved (half of those on placebo).

And yes, the age of the patients would have been reflected in the results. Especially since the study took place over the time of 7 years, age-related sexual problems would have been commonplace. However, this variable would have been negated by the placebo arm, and effectively, the differences between the two groups results in the 'actual' incidence of side effects. I'm not sure if there is more to how they measure things out, but 5MG finasteride showed a higher incidence of sexual sides than 1MG did in trials.

*edit*

Here is the study:

http://www.nejm.org/doi/pdf/10.1056/NEJMoa030660

Just about 10,000 from each group (finasteride/Placebo). There are huge amounts of sexual sides from both groups, but the ones on finasteride were slightly higher.