All Medications Have Side Effects
I was watching TV last night and saw a commercial for a depression medication called Abilify (aripiprazole). I often treat and see patients on anti-depressant medications and it is a great benefit for them (for treating their depression). What struck me about the TV commercial was the lengthy side effect warnings, including stroke, high fever, muscle rigidity, high blood sugar, higher risk of infection, etc. These side effects are very rare, and many other anti-depressant medications have very similar possible side effects.
Then I turned on my computer to look up the common side effect of a popular erectile dysfunction medication most of you probably heard of: Viagra (sildenafil). Some reported and documented side effects include blindness, heart attack, hearing loss, etc.
Which brings me to the controversy of Propecia (finasteride) and its negative sexual side effects. I acknowledge there are websites devoted to the unreported side effects of Propecia (as well as other medications) and that there are men who are experiencing something. I really cannot say if what they are experiencing is due to Propecia, but for the sake of argument, let’s give them the benefit of doubt. I think we can all agree the chances of getting these side effects are relatively low. From personal experience in treating thousands of patients for over 10+ years I personally have not seen any permanent side effects associated with Propecia, and about 1 to 2% of men do experience negative sexual side effects (which have been all reversible). Again, this is from my personal experience among thousands of patients I have seen.
My point is this: ALL MEDICATIONS HAVE SIDE EFFECTS. You must understand this and discuss the benefits as well as the risks with your doctor and make an educated and informed decision. Millions of people use Viagra knowing that they can go blind or have hearing loss… but the risk of this happening is extremely low! If you believe the extreme side effects associated with Propecia, it is your choice not to take it. To some, sex may be more important than their vision or hearing. And to others, hair is more important than their sexual activities. Of note, I can say that I have prescribed Viagra to men who are taking Propecia and they still have their hair, sight, and hearing.
An addendum to my post above: the Product Label of a drug (also available publicly and free) is also a good starting source to read about risks and frequency of the most common side effects with a drug vs placebo. The above sources are if more detailed information is desired.
I appreciate the message of this article over some of your other posts. But the important thing is that patients are not given the correct information by Merck’s PPI and doctors. The risk of have an adverse experience is low (but probably underestimated by the official literature) but so overwhelmingly catastrophic that they can cause lifelong depression in many cases and suicide at its extremes.
Being able to prevent one’s hairloss is a nice thing, but it does not provide such a great benefit that I would knowingly gamble my sexual, mental, and physical health for it. Perhaps I would risk a higher rate of infection, fever, temporary ED, maybe even a heart attack, but not something that has literally destroyed my quality of life and sense of well-being for the rest of this lifetime.