Finasteride Reassurance Please

[JDS 17]

I really want to get on finasteride however I am scared of the effects it will have on my body, especially sexual side effects.

It's claimed on certain websites namely propeciahelp that finasteride and consequently low DHT can effect the structure of the penis with the argument that DHT is required for maintenance of the tissue. Also it is said that DHT shrinks the prostate and this could be harmful.

This is a very simple interpretation of what is being said however I would greatly appreciate it if someone educated on finasteride could have a look at some of these threads and give a detailed scientific explanation as to why these side effects will not happen/are not detrimental to health and proper function.

I suspect that these people are either misunderstanding the studies they are making reference to or maybe misrepresenting them to support their own theory. Before committing to this drug however I would really like for these issues to be put to rest in my mind.

 

[TEDDYRUXPIN]

I've been on it for more than 8 years. My penis has not shrunk, I have not gained man boobs, and I have not grown an extra leg.

As above, only a minority experience side effects as a result of this drug. Just to tell you, the first 2 weeks on this drug does feel weird. For me, my eyes were extra sensitive to light and I felt a bit dizzy and stupid. After that, nothing...

 

[Jokerman]

After a year on finasteride my dick fell off and I grew a clit. I'm much hotter as a thick haired female than a balding man so it's all good.

 

[somone uk]

ok propeciahelp etc go on about "permanent side effects" but i find they really don't take into account the statistics men get erectile dysfunction systematically

* One in 10 men in the world have erectile dysfunction.
* 30 million men in the United States have erectile dysfunction.
* 50% of men with diabetes have erectile dysfunction, frequently within 10 years of diagnosis.
* The likelihood of erectile dysfunction increases with age: 39% at age 40, 65% over the age of 65.
* Smokers have a higher likelihood of erectile dysfunction. Men who smoke more than 1 pack per day have a 50% higher chance of impotency than nonsmokers the same age.

erectile dysfunction has a number of causes not all are hormonal, therefore going off propecia won't guarantee you stop having ED, people will go off finasteride convinced it's the cause but they are doing that without a proper DIAGNOSIS to why they have ED
drinking and smoking can cause ED, and is much more likely than finesteride to do that and even more scarring but i bet you have smoked and drink without thinking twice about it.
but discontinueing the drug will stop sides, it works by binding to 5AR and then it flushes out your system, it doesn't interact with organs etc
finasteride has been a pretty bad scapegoat

 

[tuncberkay]

i think people exaggerate side effects of dht inhibitors a bit.

 

[TEDDYRUXPIN]

After a year on finasteride my dick fell off and I grew a clit. I'm much hotter as a thick haired female than a balding man so it's all good.

That's what happened to 80% of the propecia users! Can't believe it. Changed sex and my name is now Fox!

:bravo:

 

[JDS 17]

Thanks for the replies guys, I am definitely feeling more confident about finasteride.

I would really like if somone could come along and explain why certain side effects will not be caused by finasteride or are very unlikely, for this reason or that reason backed some sort of scientific explanation.

These are the things that trouble me:
1. The long term effect on the body of altering hormone balance.
2. Is DHT required for maintenance of sexual organs?
3. Is finasterides effect on the prostate dangerous; does it cause sexual dysfunction?
4. Does finasteride have any other effects beside blocking the conversion of t to dht, I'm sure I read somewhere that it affects other conversions in the body, what is the effect of this?

 

[Quantum Cat]

Thanks
2. Is DHT required for maintenance of sexual organs?

not in fully developed adult men. If you're into your 20s then taking finasteride should be no problem.

propeciahelp is run by 2 or 3 demented people dedicated to scaring everyone else off the drug. don't pay much attention to it

 

[JDS 17]

If you are so concerned about these things than you need to ask your doctor these questions, not a bunch of dudes on an internet forum, their are way to many grown men plaing Doctor on this sight, if this is so important to you than ask your doctor!!!!

That is a good idea and I will probably do that. I thought however that someone on here may know enough to give an explanation as to why these things are nothing to worry about.

 

[Nuli]

Think about this, DHT is the most potent natural androgen in the male body. Do you think lowering this 80-90% is a good idea? Also, 5 alpha reductase does much more than just convert T --> DHT, you are messing with other hormones then just DHT when you take finasteride.

It's really up to you if you want to risk the sides. I was on it for 6 months and suffered ED, lower libido, and water sperm. After two months off, I felt 10 times better in sexual terms. The difference was huge.

Most of the guys on here saying there's only 2% sides, just take it these people claiming they have side effects are out of their minds, blah blah blah are in denial that what they are taking for hairloss (pretty much the only that DOES work) could be detrimental to their health. They don't want to worry about the side effects, because the only other option is letting the natural baldness take its course, i can understand that though.

 

[barcafan]

[quote="JDS 17":zt43lbig]Thanks
2. Is DHT required for maintenance of sexual organs?

not in fully developed adult men. If you're into your 20s then taking finasteride should be no problem.

propeciahelp is run by 2 or 3 demented people dedicated to scaring everyone else off the drug. don't pay much attention to it[/quote:zt43lbig]


There's alot more than 2-3 people on those boards, and many who are unspoken.

You have to look at motive. Are these guys peddling their own hairloss products? Do they have anything to gain from slandering propecia ? How about the numerous studies which shine a negative light upon propecia? How about the whole swedish incident? Also what about Dr John Crisler's (World renowned male hormone specialist) views on it. Unless all of these people are f*****g psychotic or have their own agenda, something must be up. Not saying take it / dont take it, but please make an informed decision instead of being sheeple. And stop having such naive opinions on the FDA, they're not your f*****g gammy looking out whats best for your health

 

[JDS 17]

Thanks for the input guys. Does anyone know what other effects finasteride has other than blocking the conversion of T > DHT?

I thought finasteride reduced DHT by around 70%, is the remaining DHT enough to remain healthy and functional?

What are DHTs functions in the body, surely the body produces it for something?

Is it conceivable that some finasteride sides are caused by a rise in estrogen and taking something to balance/reduce estrogen would deal with the sides?

Thanks in advance to anyone who has some information on these questions.

 

[Nuli]

I made a post awhile back about the functions of DHT:

viewtopic.php?f=46&t=52597

Read up on some of those links.

 

[Mew]

not in fully developed adult men. If you're into your 20s then taking finasteride should be no problem.

Yawn... same old naysayers who just throw out opinions with no research to backup their claims. Quantum Cat and finfighter, time for a reality check.



Regarding comments that DHT has no use in the human male after puberty:
http://www.biolreprod.org/content/72/4/851.full

"Testosterone, the most abundantly produced androgen, is reduced by 5?-reductase to the more potent dihydrotestosterone (DHT). DHT mediates many of the actions ascribed to androgens, including the differentiation of the male external genitalia and prostate during fetal development, virilization at puberty, and male sexual and aggressive behavior [1–3]. "


DHT is also important for mainting spermatogenesis and FERTILITY in human males:
Propecia, Infertility Link Suspected
http://www.renalandurologynews.com/Propecia ... le/104651/


DHT mediates nitric oxide release which is essential for erectile function:

http://www3.interscience.wiley.com/jour ... 1&SRETRY=0
"Sexual AEs are reported in clinical trials at rates of 2.1% to 38%. The most common sexual AE is ED, followed by EjD and decreased libido. These effects occur early in therapy and attenuate over time. A proposed mechanism for sexual dysfunction involves decreased nitric oxide synthase activity due to decreased dihydrotestosterone. "

---------

propeciahelp is run by 2 or 3 demented people dedicated to scaring everyone else off the drug. don't pay much attention to it

Riiight... we're the ones who are demented despite having documented, permanent adverse effects from the drug. I guess everything below is just make-believe, too?


[youtube:3nmu4tp8]http://www.youtube.com/watch?v=BEGCTMtlgoc[/youtube:3nmu4tp8]

[youtube:3nmu4tp8]http://www.youtube.com/watch?v=2nXWVTStnHs&feature=response_watch[/youtube:3nmu4tp8]

Translation: viewtopic.php?p=495781#p495781


Permanent side effects now official as concluded by Swedish Medical Agency (equivalent to FDA in Europe):

http://en.wikipedia.org/wiki/Propecia
In December 2008, the Swedish Medical Products agency concluded a safety investigation of Propecia and advise that use of Propecia may result in persistent sexual side-effects. The Agency's updated safety information lists difficulty in obtaining an erection that persists even after discontinuing Propecia as a possible side-effect.[8]

See page 3, section 4:
http://www.lakemedelsverket.se/upload/S ... %20ENG.pdf

- persistent difficulty having an erection after discontinuation of treatment


Update on the Swedish TV piece -- a new news article published August 10, 2009 with video segment:

http://svtplay.se/v/1649128/rapport/har ... verkningar

News Story (swedish) http://svt.se/2.22620/1.1649111/haravfa ... rt527895=0

Google Translated version of news story with some minor edits for grammar:

http://translate.google.ca/translate?u= ... n&ie=UTF-8

August 10, 2009
Hair loss medicine may cause permanent erection problems

Now note that hair loss drugs Propecia can lead to permanent erection problems. This despite the fact that manufacturer Merck Sharp & Dome, MSD, long denied it.

Propecia is a prescription drug, marketed as a unique solution to the problem of male hereditary hair loss. Manufacturers writes on its website that ninety per cent of those who use Propecia may be the hair back.

MSD warns nevertheless that Propecia can have some effect on potency, but less than two percent have suffered side effects, according to MSD, however, stopped when they left with Propecia.

One of those who received permanent disability is Nicholas O'Neill, who in a story for over two years ago testified about side effects. He told me that he was impressed by the product results. But, after a time, problems accumulate. Nicholas became depressed, had hormone changes, began to develop breasts and became impotent.

Although the information did not cease the side effects when Nicholas stopped taking Propecia.

On the Internet there are several forums where people have been using Propecia discussing the problems they are experiencing. After the story was made, several people heard of the SVT. A Swedish saying that he feels cheated of a large part of his life.


Hard to criticize
According to the manufacturer uses around half million men around the world propecia. In the U.S., where most users are concerned about many doctors of the risks of permanent side effects. However, it is difficult to get doctors to openly criticize a powerful pharmaceutical companies. An American doctor wrote in an email to SVT that it is too risky to do it publicly.


Ulrik Kvist.
Ulrik Kvist, Chief of the Center for andrology and sexual medicine confirms the picture.

-"They can basically do whatever they want", he says. Now Swedish researchers warn that the drug Propecia may also affect male fertility.

-The substance called finastirid affect sperm ability to fertilize and contribute to the development of normal embryos. At worst, children and grandchildren be affected by developmental disabilities, "says Ulrik Kvist.

After the SVT's story, Läkemedelsverket began a review of Propecia, which led to MSD have to amend the text of the leaflet, so it is clear that the drug may cause lasting harm. In order to get the amendment, Läkemedelsverket first had to threaten MSD to suspend the authorization.

MSD has been invited to participate in the News, but declined this. The company writes, however, in a written comment that it has received reports that people who use Propecia suffered permanent impotence, after treatment but it is not possible to establish that it was caused by Propecia.

---------


As for wether 5AR does more than convert T--> DHT, YES:

Lookup the 2006 study "A new look at the 5alpha-reductase inhibitor finasteride." See page 3 for DIAGRAM showing pathways affected (also attached to this post).

http://www3.interscience.wiley.com/cgi- ... 4/PDFSTART

ABSTRACT:

Finasteride is the first 5alpha-reductase inhibitor that received clinical approval for the treatment of human benign prostatic hyperplasia (BPH) and androgenetic alopecia (male pattern hair loss).

These clinical applications are based on the ability of finasteride to inhibit the Type II isoform of the 5alpha-reductase enzyme, which is the predominant form in human prostate and hair follicles, and the concomitant reduction of testosterone to dihydrotestosterone (DHT).

In addition to catalyzing the rate-limiting step in the reduction of testosterone, both isoforms of the 5alpha-reductase enzyme are responsible for the reduction of progesterone and deoxycorticosterone to dihydroprogesterone (DHP) and dihydrodeoxycorticosterone (DHDOC), respectively.

Recent preclinical data indicate that the subsequent 3alpha-reduction of DHT, DHP and DHDOC produces steroid metabolites with rapid non-genomic effects on brain function and behavior, primarily via an enhancement of gamma-aminobutyric acid (GABA)ergic inhibitory neurotransmission.

Consistent with their ability to enhance the action of GABA at GABA(A) receptors, these steroid derivatives (termed neuroactive steroids) possess anticonvulsant, antidepressant and anxiolytic effects in addition to altering aspects of sexual- and alcohol-related behaviors.

Thus, finasteride, which inhibits both isoforms of 5alpha-reductase in rodents, has been used as a tool to manipulate neuroactive steroid levels and determine the impact on behavior. Results of some preclinical studies and clinical observations with finasteride are described in this review article.

The data suggest that endogenous neuroactive steroid levels may be inversely related to symptoms of premenstrual and postpartum dysphoric disorder, catamenial epilepsy, depression, and alcohol withdrawal.

Anyone considering Finasteride should do their due dilligence via researching what the drug ACTUALLY does via scientific published studies, not what Merck tells you in it's marketing (labelling DHT as just some "substance" in the human body, like it's worthless).

 

[Mew]

Oh, and one more thing, to respond to your original question.

You asked:

It's claimed on certain websites namely propeciahelp that finasteride and consequently low DHT can effect the structure of the penis with the argument that DHT is required for maintenance of the tissue. Also it is said that DHT shrinks the prostate and this could be harmful.

This is a very simple interpretation of what is being said however I would greatly appreciate it if someone educated on finasteride could have a look at some of these threads and give a detailed scientific explanation as to why these side effects will not happen/are not detrimental to health and proper function.

I suspect that these people are either misunderstanding the studies they are making reference to or maybe misrepresenting them to support their own theory. Before committing to this drug however I would really like for these issues to be put to rest in my mind.

No, it is not some "misrepresentation" to support some "theory". This should answer your question:


Androgens Play a Pivotal Role in Maintaining Penile Tissue Architecture and Erection: A Review
Journal of Andrology, Vol. 30, No. 4, July/August 2009

http://www.andrologyjournal.org/cgi/con ... l/30/4/363

PDF: http://www.andrologyjournal.org/cgi/rep ... /4/363.pdf

ABSTRACT:
Androgens are essential for development, growth, and maintenance of penile structure, and regulate erectile physiology by multiple mechanisms. Here we provide a concise overview of the basic research findings pertaining to androgen modulation of erectile tissue architecture and physiology. body of evidence exists pointing to a critical role of androgens in erectilA significant e physiology. Studies in animal models have provided fundamental knowledge on the role of androgens in modulating tissue architecture and cellular, molecular, and physiological mechanisms. Based on data from our laboratory and those reported by others, we believe that androgens play a pivotal role in maintaining the structure and function of the peripheral penile nerve network, the structural integrity of the corpora cavernosa, the tunica albuginea, and the endothelium of the cavernous spaces. Further, androgens play an important role in regulating the differentiation of precursor cells into trabecular smooth muscle. In this review, we will focus our discussion on findings pertaining to the role of androgens in regulating penile tissue architectural elements in modulating penile function. This knowledge has a profound impact on the potential use of androgens in the clinical setting to treat patients with erectile dysfunction.


---------

Here's a brief section on 5AR inhibitors:

"A recent study by Lu et al (2007) demonstrated that androgen deprivation by castration or 5-reductase inhibitor treatment produced damage to the endothelium structure, as determined by electron microscopy. The endothelium from intact animals exhibited smooth surfaces with regular ultrastructural features. The endothelium from castrated animals had coarse and protuberant surfaces, and appeared to be irregular. The cell-cell contacts were altered and adhesion of red blood cells to the surface of the endothelium was noted."

----------

Finasteride inhibits androgen (DHT). Androgen deprivation has been correlated with penile tissue changes in both human and animal models, changing smooth muscle fibers into collagenous, irregular deposits.

This knowledge is available to you, what you choose to do with it is up to you in terms of deciding to take the drug or not.

 

[Mew]

BTW, here some of those "studies" you were referring to regarding tissue changes due to 5AR inhibitors. The first one relates to aortic endothelium:

Changes in aortic endothelium ultrastructure in male rats following castration, replacement with testosterone and administration of 5-reductase inhibitor
http://www.nature.com/aja/journal/v9/n6 ... 07105a.pdf

... "In 5?-reductase inhibitor treated rats with resultant
low DHT levels, there were a lot of red cells adhering to
the endothelial surface. The vascular endothelial structure
was apparently damaged. This was suggested that
prolonged low DHT level might lead to increased blood
viscosity which could induce thrombosis and endothelial
destruction. Norata et al. [10] thought that DHT could
positively regulate endothelial function through the control
of the inflammatory response mediated by nuclear
factor-kappaB in endothelial cells."



Photos:

GROUP A - CONTROL
GROUP B - CASTRATED
GROUP D - Underwent 5?-reductase inhibitor treatment.


---------------


Seperate from that is a screenshot of PENILE TISSUE CHANGES from use of Finasteride.


Effect of androgen deprivation on penile ultrastructure.
http://www.ncbi.nlm.nih.gov/pubmed/12647000


Aim:
To investigate the ultrastructural changes of penile corpus cavernosum and tunica albuginea in rats treated with castration or finasteride.

Methods:
Eighteen male Sprague-Dawley rats of nine weeks old were randomly divided into three groups with 6 rats each.

Group A served as the control, Group B was castrated and Group C, treated with finasteride. Four weeks later, rats were anesthetized and blood samples obtained for the determination of serum testosterone (T) and dihydrotestosterone (DHT) levels; penile tissues were taken for scanning electron microscopy.

Results:
The T, free T and DHT levels in Group B and the DHT level in Group C were significantly lower than those in Group A (P<0.05). The tunica albuginea was significantly thinner in Group B than that in Group A (P<0.05), but there was no significant difference between Group C and Group A (P>0.05). Elastic fibers in the tunica albuginea of Group A were very rich and arranged regularly and undulatedly, but in Group B, most of the elastic fibers were replaced by collagenous fibers. In Group C, the tunica albuginea was mainly composed of thick and irregular-arranged collagenous fibers. In Group A, there were abundant smooth muscle fibers in the trabeculae of corpus cavernosum, but they were much less in Group C and scarce or even disappeared in Group B. In Groups B and C, the diminished/disappeared smooth muscle fibers were replaced by irregularly arranged collagenous fibers.

Conclusion:
In rats, androgen is essential for maintaining the normal structure of penile tunica albuginea and corpus carvenosum.

 

[treeshrew]

Mew, what's up with the scare mongering?

I respect what you're doing, and that you help people and offer a forum, but it's kind of annoying the way you come here trying to scare people when even you admit the basic fact that only a VERY VERY small percentage of people experience these "life ruining" sides.

FACT: I've been on finasteride 2 years, the only side I've experienced is thicker hair.

 

[nyny12]

might be a stupid question...but if baldness increases with age, which most likely means dht/androgens increase with age, then why does ED increase with age as well??? Wouldn't it be the other way around??? Also don't a lot of people also report an increase in sex drive while on finasteride, why is this?

 

[Hiker]

ED increases with age because testosterone levels drop as you get older.

 

[Mew]

Mew, what's up with the scare mongering?

That's completely subjective and is a matter of perception.

You consider this scare mongering, I consider it bringing information to light so people can make an informed decision beyond what the manufacturer chooses to tell us. What is your motive to be against that?

Regardless, the information is provided to the reader so they can make their own decision. All of this info is freely available on the Internet, anyone can find it and post it, I've just taken the task of doing so.

If you have a problem with the research, argue with the researchers themselves, not the messenger. If you are suggesting such information NOT be posted, then you are talking about censorship and a hidden, pro-pharmaceutical agenda.

it's kind of annoying the way you come here trying to scare people when even you admit the basic fact that only a VERY VERY small percentage of people experience these "life ruining" sides

First, the original poster specifically asked for information and I provided answers to his questions based on information presented. You can choose to ignore such information, and continue the drug.

I'm not against people taking this medication -- it's more the fact that Merck does not disclose or advertise the entire truth about how it works that's at issue here. Do you enjoy being lied to by the manufacturer? I would think most people would like to know as much as they can about the product they are ingesting, so they can understand what it's potentially doing to their health and body.

Second, nobody knows the true percentage of men experiencing side effects -- Merck claims 2%, other papers say the range can be up to 38%. Nobody knows the percentage of men who end up with permanent side effects, out of those who take the drug. It is likely a small percentage of the overall consumer base but the more men that take the drug unaware of what they might be risking, however small that risk may be, will not be able to make an informed decision.

Hence, such information being provided for readers to evaluate and make their own choice. At least if you are aware of this info and still take the drug and end up with problems, you'll understand why and really have nobody to blame but yourself. But if you weren't aware of this info and went on Merck's word alone, you'd have Merck to blame.

Unfortunately, the latter is the predominant case until enough men with these problems reach the tipping point, and the mass media and medical community gain the necessary awareness.