(Article changed on July 16, 2014 at 12:49)
No one should have to choose between their hairline and their health. But increasingly, men who use finasteride, commonly known as Propecia, to treat their male pattern baldness are making that choice, often unwittingly. In the 17 years since Propecia was approved to treat hair loss from male pattern baldness, so many disturbing urogenital and other side effects have emerged, the term Post Finasteride Syndrome (PFS) has been coined and hundreds of lawsuits have been brought.
Finasteride inhibits a steroid responsible for converting testosterone into 5Î±-dihydrotestosterone (DHT) the hormone that tells hair follicles on the scalp to stop producing hair. Years before Propecia was approved to grow hair, finasteride was used in drugs like Proscar, Avodart and Jalyn to treat an enlarged prostate gland (benign prostatic hyperplasia). Like Viagra, which began as a blood pressure med, or the eyelash growing drug Latisse, which began as a glaucoma drug, finasteride's hair restoration abilities were a fortuitous side effect.
Since Propecia was approved for
sale in 1997, its label has warned about sexual side effects. "A small
number of men experienced certain sexual side effects, such as less desire
for sex, difficulty in achieving an erection, or a decrease in the amount of
semen," it read. "Each of these side effects occurred in less than 2%
of men and went away in men who stopped taking PROPECIA because of them."
(The label also warned about gynecomastia, the enlargement of male breast
But increasingly, users and some doctors are saying the symptoms sometimes do not "go away" when men stopped taking Propecia and that their lives can be changed permanently. They report impotence, lack of sexual desire, depression and suicidal thoughts and even a reduction in the size of penises or testicles after using the drug which do not go away after discontinuation.
According to Dr. Andrew Rynne, former head of the Irish
Family Planning Association and well known surgeon, Merck, who makes Propecia
and Proscar, knows that the disturbing symptoms do not always go away.
"They know it is not true because I and hundreds of other doctors and
thousands of patients have told them that these side effects do not always go
away when you stop taking Propecia. We continue to be ignored of course."
Not all side effects go away, say finasteride users by Martha Rosenberg
In some cases, says Dr. Rynne, men who have used the finasteride for even a few months "have unwittingly condemned themselves to a lifetime of Sexual Anhedonia," a [condition in which an individual cannot feel pleasure from orgasm], the most horrible and cruel of all sexual dysfunctions."
"I have spoken to several young men in my clinic in Kildare who continue to suffer from sexual anaesthesia and for whom all sexual pleasure and feelings have been obliterated for all time. I have felt their suffering and shared their devastation," he says on a Propecia help site.
Sarah Temori, who launched a petition to have finasteride taken off the market on Change.org, agrees. "Many who have taken Propecia have lost their marriages, jobs and some have committed suicide due to the damage this drug has done to their bodies," she writes. "One of my loved ones is a victim of this drug. It's painful to see how much he has to struggle just to make it through each day and do all the daily things that we take for granted. No doctors have been able to help him and he is struggling to pay for medical bills. He is only 23." Stories about Propecia's disturbing and underreported side effects have run on CNN, ABC, CBS, NBC, Fox and on Italian and English TV news.
The medical literature has also investigated finasteride effects. A study last year in Journal of Sexual Medicine noted "changes related to the urogenital system in terms of semen quality and decreased ejaculate volume, reduction in penis size, penile curvature or reduced sensation, fewer spontaneous erections, decreased testicular size, testicular pain, and prostatitis." Many subjects also noted a "disconnection between the mental and physical aspects of sexual function," and changes to mental abilities, sleeping patterns, and/or depressive symptoms.
A study this year in the Journal of Steroid
Biochemistry and Molecular Biology finds that "altered levels of neuroactive
steroids, associated with depression symptoms, are present in androgenic
alopecia patients even after discontinuation of the finasteride
Approved in Haste, Regretted in Leisure
The rise and fall of Propecia parallels other drugs like Vioxx or hormone replacement therapy that were marketed to wide demographics even as safety questions nipped at their heels. Because two thirds of American men have some hair loss by age 35, and by age 50, 85 percent of men do, Propecia had the promise of a blockbuster like Lipitor or Viagra.
Early ads likened men's thinning scalps to crop circles. Later, ads likened saving scalp hair to saving the whales and won award s. Many Propecia ads tried to take away the stigma of hair loss and its treatment. "You'd be surprised who's treated their HAIR LOSS" said one print ad depicting athletic looking, twenty-something men. In 1999 alone, Merck spent $100 million marketing Propecia directly to consumers, when direct-to-consumer advertising was just beginning on TV.
Nor was Propecia only sold in the U.S. Oversees ads compared twins who did and did not use the product. In the U.K., the drug store chain Boots aggressively marketed Propecia at its 300 stores and still does. One estimate says Propecia was marketed in 120 countries--half the world.
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