How many people suffered sexual side effects on Propecia?

[RaginDemon]

2% sounds unrealistic to me

Many have experienced at least some side effects. I don't believe the 2% B.S at all.

 

[Pondle]

Ragin Demon, I think I might have an idea why reports of sides are seemingly more widespread than 2 per cent. Look at the adverse reactions from the dutasteride phase II hair loss trial below. 4 out of 70 men experienced a loss of libido by taking a 5mg daily dose of finasteride. That's nearly 6 per cent (higher than the results for Propecia, but it is a larger dose). Look at the results for "any adverse reaction". That's a whopping 34 per cent. However, compare that to placebo. 3 out of 64 men taking a sugar pill experienced a decrease in libido Nearly 5 per cent. And the results for "any adverse reaction" are a massive 42 per cent. Clearly it is ridiculous that a sugar pill could make 42 per cent of men experience a negative reaction! There are obviously issues of attribution here.

 

[RaginDemon]

I see, thanks for clearing it up Pondle!

 

[evildude]

of course the 2% reported is nonsense. first of all, how many dropped out of the merck study in the first place as a result of unwanted side effects? secondly, any study such as this depends on the validity of the people surveyed. merck have no way of knowing how many actually experienced side effects. any science dealing with human psychology and behavior is, at best, a soft science.

 

[Pondle]

Drop out is a fair point, but I don't really get second argument. How would you practicably assess sexual side effects, other than through self-reporting?

Besides, the total number of people reporting a given side effect doesn't really matter that much - the important thing is whether there is a statistically significant difference between the incidence with a given treatment versus placebo.

 

[evildude]

Drop out is a fair point, but I don't really get second argument. How would you practicably assess sexual side effects, other than through self-reporting?

Besides, the total number of people reporting a given side effect doesn't really matter that much - the important thing is whether there is a statistically significant difference between the incidence with a given treatment versus placebo.

the second argument is neither for nor against propecia. just a comment in general about soft science and how unreliable it can be. i only trust hard science. soft science can give you an indication of something, but chances are it might be completely wrong. people are unreliable.

 

[Pondle]

Some people might 'under-report' sides, others 'over-report' them - it could just balance out! Assuming we have done our research properly, and randomly assigned people to a treatment group and a placebo group, I don't think it matters that much for our purposes.

 

[evildude]

as you say, it 'could' balance itself out, but you don't know. maybe the results are valid, maybe not and that's my point. you don't know.

the more prudent approach would be to say that side effects of finasteride us are relatively rare, but they do happen. exactly how common they are, no one really knows. i think everyone who suffers from hairloss should try it, but either stop if they're experiencing side effects or be prepared for whatever consequences may follow. for instance, if one experiences libido problems early on, but they subside, how do you know that the side effect actually went away and your body didn't just adjust. meaning, the damage could still be done, couldn't it? only to reappear much later...

btw, who are these 'we' you refer to?

 

[Pondle]

The problem with assessing the prevalence of side effects is the question of attribution. I might take drug A and experience phenomenon B, but did A cause B? Maybe, maybe not.

Things like libido and erectile dysfunction are affected by so many 'extraneous variables', it's very hard to prove direct causation. That's why we compare the incidence in a treatment group to the incidence in a placebo group - we can only really talk in terms of relativities.

Ceteris paribus (all things being equal, the term economists use) you are more likely to experience erectile dysfunction on Propecia versus placebo. But how many of the 2% (or whatever number) of men who report erectile dysfunction in the Propecia group can attribute that directly to the treatment is a moot point.

BTW I use the term 'we' in the sense of 'we' as a society or as a group of interested people!

 

[RaginDemon]

still 2% is unrealistic

 

[harold]

2% is unrealistic. I have seen more recent studies with higher figures - might have been as high as 10%. Was higher than 2% Will dig it out if forced to. A bit annoying that the 2% figure gets repeated around here as if it is some God-given truth.
At any rate there are ways to lower the reports of these types of sides while on a drug. If asked a general question of "Have you noticed any side effects?" few men would jump up and say "my dick wont get hard anymore" whereas if you ask the specific question "have you had trouble getting your dick hard during the trial?" you are going to get a different result. Not saying this is how it was done with these studies (really havent looked into it) but it is how it is done in some studies and so is something to look out for.
And as for the guy who mentioned reduced sensation of orgasm - that is an area that being on or off finasteride makes a massive difference in in my experience. some have theorised that DHT helps to coordinate the ejaculatory response and I find orgasms to be in general much less intense while on finasteride apart from anything else.
At least one study found that DHT was necessary for the erectile response in rats and that testosterone could not replace it. Though the fact that some people can function normally with very little DHT makes it all very complex. And BTW if you ever dig up any of those 5AR2 deficient men who never go bald sexual dysfunction in the adult men was relatively common in at least one of the ones I read. Its a complicated issue.
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