Are finasteride's side effects REALLY worse than what Merck claims?

[harold]

Yeah... and I may eat these words in a couple of days when I start finasteride, but DHT hormonal stimulation is an extremely small aspect of sexual function, if it is at all.

Hormones PREDISPOSE you to certain things. It is true DHT may predispose you to being more easily aroused, however it is almost laughable that it causes complete impotence.

Its not laughable - obviously DHT is not the only factor in sexual function or erectile capability but while the area is far from well understood there is more than enough evidence that there are links and any reduction in ones sexual functioning is not fun - it doesnt have to be complete impotence.

There are so many other factors that play an enormous role, such as the parasympathetic/sympathetic autonomic nervous systems. To be frank, while lower levels of DHT may make you feel less subjectively "horny" I have strong doubts as to whether propecia alone can cause impotence, inability to achieve erection etc.

well Merck themselves proved it can - they got a statistically significant difference in the number of men that report these problems on finasteride compared to those on placebo.
Male to female transexuals retain potency after the reduction of testosterone yet few would laugh at the notion that adequate tesosterone is helpful or even necessary for satisfactory male sexual function.

Int J Impot Res. 2004 Dec;16(6):544-6.
The effects of androgen depletion on human erectile function: a prospective study in male-to-female transsexuals.
Bettocchi C, Palumbo F, Cormio L, Ditonno P, Battaglia M, Selvaggi FP.

University of Bari, Bari, Italy. bettocchi@urologia.uniba.it

The objective of the study was to determine the effects of androgen depletion on erectile function in a population of male-to-female transsexuals. The erectile function of 25 consecutive male-to-female transsexuals on androgen depletion treatment and scheduled for surgical gender reassignment was prospectively evaluated using medical and sexual history, physical examination, total serum testosterone, International Index of Erectile Function (IIEF-15) questionnaire, penile colour-coded Doppler ultrasonography (CDU) after pharmacological stimulation and nocturnal penile tumescence (NPT) test. All but one had undetectable or low testosterone. Subjective erectile function, according to IIEF-15 scores, and penile CDU findings did not correlate with testosterone levels, whereas NPT test findings correlated well with testosterone levels. These findings would suggest that nocturnal erections are androgen-dependent whereas sexually induced erections are androgen-independent. It can also be assumed that testosterone is important but not essential for male erectile function and that other androgen-independent pathways can be responsible for sexually induced erections.

Other factors more likely to interfere would include partial or complete blood flow obstruction often caused by thrombosis linked to inactivity and a sedentary lifestyle and genetics.

Obviously there are other factors that can knock out erectile function just as well or better. But as a hormone DHT works to coordinate many different aspectss of sexual function and while a dose of v**** or cialis can probably help with impotence they dont help with issues of libido and sensitivity if these trouble you.
hh

Something far more likely to be caused by low levels of DHT would be ejaculatory :agree: volume. Males, like females, have a reproductive cycle that is completely controlled by hormones. I think that this explains why this is a very common side effect and also one that is far less prone to placebo effect. It also makes the "nut" pain more likely, because that is where the epidydimis and seminiferous tubules reside...The site of sperm production, etc etc etc. More likely the "nut pain" is transferred from where the prostate encircles the urethra. Since finasteride is so active by atrophying the prostate, there is probably a good chance you get pain in that area as well at least initially.

When I begin finasteride, I will give daily updates for the first few weeks then probably post a picture up once per month in my "story" page. Best of luck to all in their struggle with hair loss! :firing:

 

[medmax84]

Androgen depletion therapy... I hope you know that there is a transient increase in testosterone when DHT is depleted. While DHT is a more potent androgen, testosterone increases to make up for its shortfall. Both act on the same receptors, even though DHT binds preferably.

I've since realized the err in my stance, however, as I did suffer sides at first with my propecia regimen.

 

[harold]

Androgen depletion therapy... I hope you know that there is a transient increase in testosterone when DHT is depleted. While DHT is a more potent androgen, testosterone increases to make up for its shortfall. Both act on the same receptors, even though DHT binds preferably.

These kids were getting the works though so for most of them (one was on finasteride only) testosterone would have been way down also.
"Patients underwent for a mean period of 55 months (range 29–96 months) pharmacological androgen suppression arranged by their endocrinologist and consisting of ciproterone acetate (100 mg/day orally) in 12, LHRH analogues in six, LHRH analogues+ciproterone acetate in six and finasteride (5 mg/day orally) in one. To induce female sex secondary characters, they also received estradiol, 100 mg/day transdermally."

I've since realized the err in my stance, however, as I did suffer sides at first with my propecia regimen.

Sorry to hear that. So they resolved in time?
Sorry also if I came across a little brusque in that last post.
hh