Article about persistent sexual side effects after taking finasteride greater than 5 years
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5346286/
I personally feel that it is my job to inform patients of risks associated with anything I do, so consistent with this believe, I have included this article for the readers consideration without further comment. There is a balance of taking such risks against the value of stopping of slowing the hair loss. These are decisions that only the patient can make. These published “studies” were unfortunately done without adhering to ‘evidence based medicine guidelines’…like having an age matched control group. There are many causes of ED that aren’t age related, too. Marijuana use, for one, appears to have a negative effect and as this becomes more widely legalized we can anticipate higher incidence.
Authors Conclusions: “In conclusion, among men with 5?-RI exposure, duration of 5?-RI exposure was a more accurate predictor of PED than all other assessed risk factors except prostate disease and prostate surgery. Among young men with 5?-RI exposure, duration of 5?-RI exposure was a more accurate predictor of PED than all other assessed risk factors. For each 108 young men exposed for >205 days to the finasteride dose typically used for androgenic alopecia (?1.25 mg/day), one additional young man experienced PED when compared to those men with shorter exposure. The median duration of PED in young men was 1,534 days. We expect that our finding of an association between debilitating sexual dysfunction and exposure to finasteride or dutasteride will be of particular interest to prescribers and patients considering medical management of androgenic alopecia or symptomatic treatment of prostatic hyperplasia.”
The good news is that most men who take finasteride, don’t have the sexual side effect, or any side effects, nevertheless, everyone who does take it must be aware of the risks as outlined in this article.
This is the kind of article that deserves further comment. The publication showed that 1.4% of the men treated with a 5-ARI developed persistent erectile dysfunction. This is consistent with the thousands of anecdotal reports that have appeared on forums on the internet. The methodology of the study is notably very rigorous.
While the chances of developing permanent side effects are small, they are life altering. It is so critical that patients realize they are taking a very real risk if they decide to take a drug for hair loss. It is also a shame that this blog has more or less ignored the negative evidence about this drug for nearly a decade.
I see you’ve added some comments since the original post. It appears you haven’t read or understood the whole article because the study was controlled for age in addition to other non-age related controls as well.
5ARI use was the most predictive exposure factor of persistent sexual side effects behind prostate disease and surgery.
“Our data show that, in a cohort of men exposed to 5?-RIs, the duration of 5?-RI exposure was a more accurate predictor of PED than many known risk factors, including age, hypertension, diabetes mellitus, cigarette smoking, ethanol abuse, obesity, and depression. In our data, confounding by age or extent of healthcare utilization did not account for the increased risk of PED associated with longer 5?-RI exposure duration.”
Third rate journal (“Peer Journal”) that requires author to pay for publication.
So the article says 2.6 million men in the US are prescribed fin every year. If the rate of PED is 1.4%, that’s ~ 36 000 USA men with PFS? If you extrapolated those numbers globally, you’d get a rather large number. So, why isn’t there way more press?