Just started finasteride and have a couple of questions.

[michalek]

Hi everyone,

I started taking finasteride a few days ago. I managed to get a prescription for finasteride 5mg (Accord) from my doctor. I decided to cut it into 4 parts but after reading some posts on this forum I am thinking about cutting it into 8 parts instead, what are your opinions about this?

Also, I got a little bit scared after reading about the Post-finasteride symptom as I simply do not want this to happen to me. How likely is it to get such severe symptoms ? Is it possible to take finasteride for 3 months and then quit without having any severe side effects? I am thinking about quitting it after 3 months and getting a hair transplant instead. The only reason why I can't get a hair transplant right now is finances but I am expect to save up in the next three months.

I am 22 and NW2 btw

Thanks so much!

 

[Tim45678]

Know one knows what the 'true' likelihood of symptoms because obviously the company that makes money off it can't be trusted and many users suffer in silence, and I suspect it is much higher than 2%. There is no way that something that lowers an important hormone dht and enzyme in the body could only produce side effects in 2% of people. DHT is not an insignificant hormone like the sellers of it say it is.

From my experience, I don't recommend you take it at all. It is a hard drug that messes with the complex endocrine system of the body that isn't well understood. It was developed to treat prostate cancer and enlarged prostate as a potentially life saving medication and happened to have the side effect of helping hair loss. What can happen is that you start to get sides that could take weeks or months to appear, then you go off the drug, return to normal for a week or two, then your body stops producing DHT again along with the neurosteroids that are needed for mental health that are also produced by 5a enzyme, probably because it now thinks that the lower level is the normal one. Although it is not understood why.

It is impossible to know if you will get permanent sides or the post finasteride crash without actually taking it. But by then it will obviously be too late. I recommend you read the homepage of propeciahelp which includes many independent excerpts by medical professionals (that actually know about the dangers of finasteride) and recent studies. It is not worth the risk. Do you really want to risk your permanent mental and sexual function based on some clinical trial back in study in 1997 that a drug company used to get FDA approval so they could make millions of dollars?

Think about it, if this drug is so good then Merck wouldn't be getting sued by thousands of people also Merck's profits from Propecia are falling. Also the drug would obviously be more popular and more people would use it as good news of it would spread by word of mouth, instead people get side effects and then most of them just suffer in silence.

I myself took a quartered Fincar (generic proscar) tablet for about a week and on day 7 noticed a 'weird numb type' feeling in my dick that I had never felt before, ball ache, less intense orgasms (probably because it shrunk my prostate), less blood in my penis when flaccid and erect. So I quit the drug immediately and was normal after a week, then after another week suddenly the weird numb feeling came back (but definitely not as bad as before) and I think it might be getting better again but it has only been a couple of days. The post finasteride crash is definitely real. I think I might have gotten off lightly because I was only on it for a week. So I am obviously hoping it isn't permanent. I am glad I quit immediately instead of trying to 'ride out the side effects'. Also I couldn't be more healthy. I am a healthy body weight, 28 years old and exercise regularly. Also I have never taken any other medication or had other major medical issues before. My opinion is: DON'T TAKE IT.

You might be able to hold on to what you have got with Nizoral shampoo, minoxidil or a topical like azelaic acid cream or spironolactone. Though out of these I only have experience with using Nizoral for a week and minoxidil for 2 months as I am relatively new to hair loss treatment.

also this guy had a similar story to me: http://www.hairlosstalk.com/interac...e-plunge-with-Finasteride-Couple-of-questions

I am sure there are people who take it and don't have sides or they weren't permanent (it is unpredictable and tolerated differently in different people because the endocrine system is very complex and not well understood) but they took a very big risk whether they knew it or not and got lucky.

 

[michalek]

Hey, Thanks so much for your reply. I have been on finasteride for about 2 weeks now and feel no side effects at all. I had a very little, hardly noticeable ball ache for a few days and then it went away. Do you think that this no-side effect feeling will remain? I've had sex a number of times during these two weeks and everything was fine.

 

[msab1990]

i'm with tim, just stop taking it. i'm in the process of writing up a thread/kind of warning to people considering taking the drug. i'm in the grips of pfs after 3 months off the drug, and i can tell you man, it is hell. mental, sexual, physical hell. i honestly just don't understand why people play chicken with such a delicate and not fully understood system, for the sake of hair. like honestly, look yourself in the mirror and just ask, what is more important - my hair or my mental, sexual and physical health? i was like you, messed around with it, got initial ball ache and minor sides, things went well, then bad, and then i rode it out hoping it would go away, listening to anecdotal evidence from a bunch of dudes with no medical knowledge other than a few studies they don't fully understand telling me it most likely would. and then i crashed hard, and am currently in the early stages of something that could prove to have massive long term, life altering ramifications. i don't blame anyone else, and honestly i think most guys out there on it for long periods of time know the risks, and just choose to ignore them. i don't blame them, and if they haven't experienced side effects, good for them. but there's guys i've spoken to who take the drug for 5 + years with no issues and one day their system just fails. nobody knows why, it just happens. that's what's scary about this, because nobody fully understands why it happens or when it will, and when - if ever - it can be reversed or in fact how to reverse it.

not trying to be over dramatic, or fear monger against the 'good' of finasteride, but just my own experience.

 

[swingline747]

took 8 months for sides to show on me.
read my blood test thread and what it did to my T levels.

Its messy stuff, miracle for some but hell for others. Problem is there is no way to know unless you try.

 

[Wuffer]

Keep in mind when you post something in a 'side effects' section of a forum, you're probably only going to hear from minority who have had side effects. Most people who have a positive experience and tolerated finasteride don't really have a reason to post here anymore.

Post-finasteride syndrome has yet to be proven or recognized as a legitimate condition in mainstream medicine. That doesn't mean that it doesn't exist, but it probably means it's very rare if it does.

If you want to treat your hair loss, finasteride is currently your best option. It's very effective and generally well tolerated. Check out the 'success stories' section for hundreds of positive experiences, mine included. I personally think finasteride is great, and reports of severe reactions are overblown and unproven by controlled studies. Post-finasteride syndrome has yet to be encountered in a controlled environment, which to me is very telling of it's rarity.

I recommend you read the homepage of propeciahelp which includes many independent excerpts by medical professionals (that actually know about the dangers of finasteride) and recent studies. It is not worth the risk. Do you really want to risk your permanent mental and sexual function based on some clinical trial back in study in 1997 that a drug company used to get FDA approval so they could make millions of dollars?

While I agree that people should take an objective look at the evidence available, I disagree with looking to only propeciahelp for studies. It's an incredibly biased webpage, and only contains a small amount of medical data, all of which is hand-picked to show that finasteride is dangerous. It leaves out some of the largest studies ever conducted the drug, including one involving almost 20,000 men, that showed it was safe.

You may be unaware that there have been an abundance of studies done on the drug since 1997, including this excellent recent one: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3481923/ which reviews and summarizes all existing data on finasteride and side effects.

 

[dutchdude]

Post-finasteride syndrome has yet to be proven or recognized as a legitimate condition in mainstream medicine.

This isn't true. A Harvard Affiliated research institution is studying the problem. If Harvard recognized Post Finasteride Syndrome, so does the rest of the medical community. Post Finasteride Syndrome is well recognized, especially here in Europe.

I personally think finasteride is great, and reports of severe reactions are overblown and unproven by controlled studies. Post-finasteride syndrome has yet to be encountered in a controlled environment, which to me is very telling of it's rarity.

This simply isn't true. The Proscar controlled clinical trials had men suffering from long term Finasteride side effects. That's why they warned about it.

While I agree that people should take an objective look at the evidence available, I disagree with looking to only propeciahelp for studies. It's an incredibly biased webpage, and only contains a small amount of medical data, all of which is hand-picked to show that finasteride is dangerous. It leaves out some of the largest studies ever conducted the drug, including one involving almost 20,000 men, that showed it was safe.

No one said only look to Propeciahelp, only that there are links there that could prove useful.

You may be unaware that there have been an abundance of studies done on the drug since 1997, including this excellent recent one: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3481923/ which reviews and summarizes all existing data on finasteride and side effects.

The Indian Online Dermatology Journal is not a reputable source. And it certainly does not summzrize all existing data on finasteride and side effectgs. It's that simple.

 

[Valiant]

I agree when you post in the side effects section those who respond are likely those who had/have side effects. finasteride can and does cause side effects in some men. Most who take it don't get side effects. It also works to stop hairloss and for regrowth. I did not believe the stories of crazy side effects either. I took it for years with no issues. When I quit, my body did not adjust and my hormones crashed. Several doctors all agreed on that causal relationship between quitting and crashing. Then, many of the crazy sides happened to me. Having off the charts low t will make many parts of you feel like sh*t. I am still trying to recover. finasteride sides exist, and when you choose to take it you have to accept the fact that most don't get them but some do. The author of the article even says that the evidence of side effects cannot be ignored. He suggests phasing dosage in. And consider that the author is a hair transplant surgeon who probably prescribes finasteride to every male transplant patient to maximize results. Bottom line is to make the decision with full knowledge of the upsides and downsides. Based upon what happened to me, I can't recommend starting it but if you do, there is no reason not to phase it in.

 

[Wuffer]

Most who take it don't get side effects. It also works to stop hairloss and for regrowth. I did not believe the stories of crazy side effects either. I took it for years with no issues. When I quit, my body did not adjust and my hormones crashed. Several doctors all agreed on that causal relationship between quitting and crashing. Then, many of the crazy sides happened to me. Having off the charts low t will make many parts of you feel like sh*t. I am still trying to recover. finasteride sides exist, and when you choose to take it you have to accept the fact that most don't get them but some do. Bottom line is to make the decision with full knowledge of the upsides and downsides. Based upon what happened to me, I can't recommend starting it but if you do, there is no reason not to phase it in.

I found your post very refreshing. I really appreciate that in spite of your negative experience on the drug, you are still able to remain objective and realize that this outcome is rare.

I personally think finasteride can cause some terrible outcomes in some situations, in spite of lacking medical evidence. I think the nocebo effect accounts for many cases that we see online, but probably not all of them. Taking finasteride is a risk that you very well might regret, albeit small. But for all the negative stories we hear online, we need to remember there are a million other positive stories that we aren't hearing about.

What did your hormones look like before and after finasteride? Have your doctors started you on any hormonal replacement therapies after noticing low T levels?

 

[Quantum Cat]

You may be unaware that there have been an abundance of studies done on the drug since 1997, including this excellent recent one: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3481923/ which reviews and summarizes all existing data on finasteride and side effects.

that's an excellent read and a balanced unbiased summary of the situation - everyone considering taking Finasteride should read that study IMO. Once again the dubious Irwig studies are called into doubt.



this part was interesting:

In addition, the author also feels that in patients who are apprehensive about the side effects, it is worthwhile considering administration of lower daily doses or staggered pulse doses of the drug, to enhance patient compliance. As discussed earlier, there is sound rationale for such regimens. Plasma half life of finasteride is 6-8 hours and tissue binding is 4-5 days.[5] Doses of 0.2 mg are adequate to suppress both scalp skin and serum DHT levels. While 0.2 mg caused 55% DHT suppression, 5 mg per day achieved 69% DHT suppression. Efficacy has been demonstrated for all end points for finasteride at doses of 0.2 mg/day or higher, with 1 and 5 mg demonstrating similar efficacy that was superior to lower doses.[8,9,19] The drug may be therefore initially administered at 0.5 mg daily or one tablet alternate days, to gain confidence of the patient and the 1 mg/day dosage may be restored once patient is comfortable about the drug. The value of such a regimen was shown in a preliminary study.[20] However, further large, long term studies are needed to establish the value of such regimens.

implying that 5mg actually suppresses more DHT than 1mg, so I wonder if taking higher doses than 1mg could be more effective after all?



the issue that slightly worries me is the part about the decrease in sperm quality that was observed in some men

 

[swingline747]

http://www.transgendercare.com/medical/resources/tmf_program/tmf_program_5.asp[FONT=Verdana, Arial, Helvetica, sans-serif]


Finasteride (Proscar, Propecia)[/FONT]
[FONT=Verdana, Arial, Helvetica, sans-serif]Another good choice for an anti-androgen is finasteride (Proscar, Propecia), and is able to be used in concert with spironolactone. The primary use of Proscar (finasteride 5 mg) was in the treatment of benign prostatic enlargement, but with its reintroduction as Propecia (finasteride 1 mg), the drug is being largely marketed to promote scalp hair growth. For transgendered women, finasteride when given in the larger dose promotes not only scalp hair growth but acts as an potent anti-androgen as it is highly effective in inhibiting the conversion of testosterone to DHT (dehydrotestosterone) responsible for male sexual characteristics. Finasteride is usually physically well tolerated over long durations, but is expensive. [/FONT]

 

[Tim45678]

I just want to update my original post in this thread. I think I have made a full recovery and my dick feels 'normal' again. So I got the 'post finasteride crash' but not the 'post finasteride syndrome' (long term side effects). The recovery was the same as the recovery when I first noticed side effects while on the drug and stopped, didn't notice much difference in first 3 days then gradually recovered over the next few was was nearly normal after one week.

What this crash means though is that my body was trying to lower my DHT back down to the level it was when I was on the drug, so that means that there is some kind 'memory' that is created in your body when you go on this drug. Maybe because I was on it for only a week my body still remembered what my normal levels are suppose to be and realised that they were too low after the crash and raised them back up again. So if I was on the drug for longer then the 'memory' might have become more ingrained and it would be harder to recover.

Timeline: 12th -20th Nov: Took 1.25mg per day

20th Nov: Noticed ball ache and numb dick, hated the way it made my dick feel so quit immediately

21st - 23rd: Ball ache was gone but not much difference in numb dick

24th - 27th: Dick gradually became normal

28th Nov - 6th Dec: 100% normal again like before I took the drug.

7th Dec : Crashed noticed ball ache for this day and numb dick took about a week to recover again like it did before when I quit the drug.

15th Dec: Seem to be 100% normal again. Now just hope it stays that way and I don't get another crash even though I am no longer on the drug since 20th of Nov.


Now if I didn't recover then the first thing I would have tried is some natural testosterone boosting herbs like tribulus. There are some stories in the 'recoveries' section propeciahelp of users that took stuff like that and they attribute it to their recovery. Maybe if we take something to boost the hormones back up then that will create a new high hormone level 'memory' over the low hormone level memory that finasteride created. Look for the threads by 'cdnuts' and 'hopingformore' for more info on that.

After this, I currently strongly recommend not to use this drug for cosmetic purposes. However if nothing will stop you from taking it then I will make a suggestion and that is to just get 1mg tablets not 5mg tablets, and just use .5mg every 2 days or .25mg every day or something like that. I got bad sides after 1 week so I think that 1mg is too high to start off with. So if you do this get sides on .25mg a day that you don't like, then there is not much point in going to 1mg per day, also the same thing if the .25mg per day keeps your hair then no point in risking sides by going higher. I think the 1mg per day is just a round number they came up with which would be easier to market. But like I said I don't recommend taking it for hairloss, especially if yours isn't that bad and you haven't yet tried topical solutions which may keep what you have. Use it as a last resort only if you think you have high dht eg lots of shedding and you accept the risks of permanent side effects, as I do believe the post finasteride syndrome is real.

Also I may already have naturally low DHT levels because I am a norwood 1 with thick hair all over my head except for a bit of thinning on my front hairline and temples where there is some miniaturisation and hair staying longer in the resting phase. I never get hair sheds and my hair doesn't fall out easily and I never really notice any hair coming out (I do keep my hair short). Also my dad doesn't really have male pattern baldness but my uncles on my mothers side definitely have it. The thought of just taking a tablet to prevent further loss sounded good but after trying it, it is definitely not for me, because I hate the way it made my dick feel. I am hoping that topical solutions like Nizoral, minoxidil and possibly spironolactone and azalaic acid cream will keep what I have in my temples.


I will also add that 5 days before I got the post finasteride crash, I was using 2% Nizoral shampoo everyday. On the first day I left it on overnight like a cream and on the day before the crash, I used it extra long because I left it on while I cleaned the shower and it was the day after I noticed the same side effects I had started to notice on the last day I took finasteride. I also have a crew cut so it is very easy for the shampoo to get in contact with my scalp. I started using it because it is suppose to be good for hairloss but also for dandruff which I noticed is worse while I have been on minoxidil. So I just wanted to add this because it is possible that the ketoconazole in the Nizoral shampoo become systematic and started binding to my androgen receptors. http://www.ncbi.nlm.nih.gov/pubmed/1526623/ (this study is obviously about the oral form but if the topical form goes systematic it may have the same effect). I have done some research in forum threads and many people think that not enough will be absorbed to create systematic sides so I just want to balance that. I may recreate this as an experiment later on when I am sure the finasteride side effects aren't going to come back again.

 

[Valiant]

I did not have a bad experience when I was first taking Propecia. My problem started after I quit. I spoke to several physicians who all independently told me that the cessation of Propecia caused my hormonal problems. I could go into the explanation in more detail but it would probably be pretty lengthy. (I'm happy to do it in a separate thread if you want to know more detail about it.) Prior to quitting, my testosterone was 439. After I quit, my testosterone dropped by nearly half. It was in the 220s two months after I quit. Having test that low really screws you up bad. I ultimately had to use Clomid to restore my HPTA. Unfortunately, I'm still dealing with it. I had blood work done several times over the last six months and each time I had a problem with either high estrogen or high SHBG or both.

 

[michalek]

Thank you so much for your replies! I read all of your posts and analysed the research paper about finasteride. It seems that many people crashed after dropping finasteride. Does this mean that you would be okay if you carried on taking it?

I have been on it for three weeks and I haven't experienced any adverse side effects (only slight testicle ache that comes and goes). I am sexually active and I found no problems with erections etc. Do you think that I should carry on taking it ? Any help would be much appreciated !

 

[swingline747]

I did not have a bad experience when I was first taking Propecia. My problem started after I quit. I spoke to several physicians who all independently told me that the cessation of Propecia caused my hormonal problems. I could go into the explanation in more detail but it would probably be pretty lengthy. (I'm happy to do it in a separate thread if you want to know more detail about it.) Prior to quitting, my testosterone was 439. After I quit, my testosterone dropped by nearly half. It was in the 220s two months after I quit. Having test that low really screws you up bad. I ultimately had to use Clomid to restore my HPTA. Unfortunately, I'm still dealing with it. I had blood work done several times over the last six months and each time I had a problem with either high estrogen or high SHBG or both.

Valiant what steps have you taken to readjust your T levels aside clomid?

To me more prescriptions are not always the answer..

http://www.hairlosstalk.com/interac...ter-Propecia?p=1152417&viewfull=1#post1152417

Just some of the stuff I have done to get back to normal.

I understand many guys have issues after quitting, but why did you quit? What sides do you have now?

I have said that my side effects were totally equivalent to steroid use overdosing.

 

[michalek]

Guys ! Do you think that after 3 weeks it would be okay if I changed my dose from 1mg to 0.25mg? or is it too late? I think that 0.25 may be enough to keep my hair without experiencing side effects.

 

[Wuffer]

This isn't true. A Harvard Affiliated research institution is studying the problem. If Harvard recognized Post Finasteride Syndrome, so does the rest of the medical community. Post Finasteride Syndrome is well recognized, especially here in Europe.

"Post Finasteride Syndrome" is a proposed medical condition. People refer to it, and researchers may be studying it, but it's not a recognized medical diagnosis by any major health organization that I'm aware of. There are no published papers on pubmed that use the term "post finasteride syndrome". This doesn't mean that it's not real, but just because someone decided to name a set of symptoms, doesn't automatically make it a recognized medical condition (see: "Adrenal Fatigue" as another example of this).

Recognized medical conditions need to have defined diagnosis criteria, as well as a standard set of symptoms. Last I looked, PFS (according to propeciahelp) has over 50 reported symptoms, none of which are considered standard.

This simply isn't true. The Proscar controlled clinical trials had men suffering from long term Finasteride side effects. That's why they warned about it.

I may not have seen this, but which clinical trials are you referring to? If by "That's why they warned about it" you are referring to the FDA, their press release stated that the warnings were added to the Proscar/Propecia product insert due to post-marketing reports, not due to any particular studies. In fact, the FDA also stated that they could not causally associate the symptoms to any data that was available on the drug.

The Indian Online Dermatology Journal is not a reputable source. And it certainly does not summzrize all existing data on finasteride and side effectgs. It's that simple.

This argument could be made for primary research studies, but this is an assessment of existing research, and sources are provided for all data that was gathered. I posted this because it's accessible to the average reader, but I suppose if one is inclined to check the facts oneself, they could check the sources. Was there anything in particular you disagreed with in this study?

 

[dutchdude]

"Post Finasteride Syndrome" is a proposed medical condition. People refer to it, and researchers may be studying it, but it's not a recognized medical diagnosis by any major health organization that I'm aware of.

Yes, the Internaional Society of Sexual Medicine recognises the term and I believe they are having a conference on it.

There are no published papers on pubmed that use the term "post finasteride syndrome".

There is one that uses that term, pubished by the Journal of Sexual Medicine. It was very recent so I'm not sure if it's on pubmed yet.

This doesn't mean that it's not real, but just because someone decided to name a set of symptoms, doesn't automatically make it a recognized medical condition (see: "Adrenal Fatigue" as another example of this).

No, Andrenal Fatigue is alternative health vernacular, PFS is a real condition being researched using the most up-to-date scientific instruments.

I may not have seen this, but which clinical trials are you referring to?

Apparently, you didn't read it. I already stated which clinical trials--Proscar.

If by "That's why they warned about it" you are referring to the FDA, their press release stated that the warnings were added to the Proscar/Propecia product insert due to post-marketing reports, not due to any particular studies.

No. When I said "that's why they [Merck] warned about it," I meant Merck warned about Proscar side effects that did not always resolve in Proscar's original warning label. Read it.

edit:I never mentioned the FDA, please don't tell me what I'm "referring" to. I consider it putting words in my mouth and that is rude.

In fact, the FDA also stated that they could not causally associate the symptoms to any data that was available on the drug.

Goes to show you how competent the FDA is now, doesn't it?

This argument could be made for primary research studies, but this is an assessment of existing research, and sources are provided for all data that was gathered. I posted this because it's accessible to the average reader, but I suppose if one is inclined to check the facts oneself, they could check the sources. Was there anything in particular you disagreed with in this study?

Yes, it said there was no evidence linking Finasteride to persistent sexual dysfunction. See above.

Also, it's not even a meta-analysis. It's just an opinion piece. Some opinions I agree with but it's still nothing but the author's opinions.

eta: exlamation marks in a purported research paper is ludicrous.

 

[Wuffer]

Yes, the Internaional Society of Sexual Medicine recognises the term and I believe they are having a conference on it.

I wouldn't consider the ISSM a major health organization. But I should have been more specific, I more meant mainstream medicine doesn't recognize this as a condition.

No, Andrenal Fatigue is alternative health vernacular, PFS is a real condition being researched using the most up-to-date scientific instruments.

I've seen alternative health proponents argue that Adrenal Fatigue is a real condition as well. PFS is a phenomenon that's being researched. Like I said, there is no diagnosis criteria, no standard presentation of symptoms, no known or documented tests. Next to nothing is known about it. Research is great; hopefully that will change, but right now it's a medical phenomenon.

Apparently, you didn't read it. I already stated which clinical trials--Proscar.

"Clinical trials --Proscar" doesn't tell me anything. Can you provide a PMID number for it? There have been dozens of clinical trials done on Proscar. Are you referring to the FDA trials? You are telling me there's a clinical trial that showed people with PFS-like symptoms; I haven't seen it, so it would be helpful if you provided more information. This is important information for me, as I take finasteride myself.

No. When I said "that's why they [Merck] warned about it," I meant Merck warned about Proscar side effects that did not always resolve in Proscar's original warning label. Read it.

What is an "original warning label"? You need to be more specific, please. Are you talking about the medication package insert, or the medication monograph? I may not have read what you are referring to. If it's available on the internet somewhere, I would appreciate if you provided a link to it. Otherwise, it's difficult to just take your word for it.

edit:I never mentioned the FDA, please don't tell me what I'm "referring" to. I consider it putting words in my mouth and that is rude.

I said: "If by "That's why they warned about it" you are referring to the FDA". How am I telling you what you said when I'm asking a question? Again if you would be a little more specific in your responses, it would help clear up any confusions like this. No offense intended.

Goes to show you how competent the FDA is now, doesn't it?

Well, they concluded that they can't find evidence of PFS, and I can't find evidence either, so I believe they are very competent in this case, yes.

Yes, it said there was no evidence linking Finasteride to persistent sexual dysfunction. See above. Also, it's not even a meta-analysis. It's just an opinion piece. Some opinions I agree with but it's still nothing but the author's opinions. eta: exlamation marks in a purported research paper is ludicrous.

Okay, so you didn't agree with the conclusion they made, and it has exclamation points in it.

Here's a new meta-analysis from the University of Toronto: http://www.ncbi.nlm.nih.gov/pubmed/23768246

"A systematic review identified all relevant randomized controlled trials of finasteride 1 mg, 5 mg.... not significantly different from placebo in eliciting sexual dysfunction"

Again, I've never seen a placebo-controlled study done on finasteride that noted men experienced unresolved sexual dysfunction, or persistent PFS-like symptoms. You're saying some Proscar "clinical trials" noted that, so I'm very interested in reading what you are referring to.

I'm not arguing that PFS doesn't exist, because I think it does. But the fact that it's never been encountered in randomized trials highlights how rare it is. Whatever is happening to people, I think it's wildly overblown on the internet, and I believe the nocebo effect and/or the (very terrible and real) symptoms of depression/anxiety come into play as well.

 

[dutchdude]

I've seen alternative health proponents argue that Adrenal Fatigue is a real condition as well. PFS is a phenomenon that's being researched. Like I said, there is no diagnosis criteria, no standard presentation of symptoms, no known or documented tests.

Doctors do perform penile nerve function tests, penile ultrasounds, hormonal assays, and nocturnal erection tests. Whether or not these are "standard tests" for the diagnosis of "PFS" I've no idea. But as doctors are becoming more aware of the problem, they are coming up with criteria to determine if one is suffering from finasteride related problems.

"Clinical trials --Proscar" doesn't tell me anything. Can you provide a PMID number for it? There have been dozens of clinical trials done on Proscar. Are you referring to the FDA trials? You are telling me there's a clinical trial that showed people with PFS-like symptoms; I haven't seen it, so it would be helpful if you provided more information. This is important information for me, as I take finasteride myselff

These trials were conducted in the late 80's early 90's. I'm not going to spend any time searching the for the trials. They might be there, they might not be. But the Proscar clinical trials did pick up persistent side effects, otherwise Merck would not have warned patients.

What is an "original warning label"? You need to be more specific, please. Are you talking about the medication package insert, or the medication monograph? I may not have read what you are referring to. If it's available on the internet somewhere, I would appreciate if you provided a link to it. Otherwise, it's difficult to just take your word for it.

http://ebookbrowsee.net/proscar-Doctor-d382231097 There it is, in black in white. Merck warning men finasteride side effects do not always go away as early as the 90's.

Well, they concluded that they can't find evidence of PFS, and I can't find evidence either, so I believe they are very competent in this case, yes.

But Merck did find evidence as early as 1992. I have to conclude the FDA didn't look at the original Proscar label.

Here's a new meta-analysis from the University of Toronto: http://www.ncbi.nlm.nih.gov/pubmed/23768246

"A systematic review identified all relevant randomized controlled trials of finasteride 1 mg, 5 mg.... not significantly different from placebo in eliciting sexual dysfunction"

It has to say "Not [statistically] signifcant" .... at what level. If it doesn't give the p value, then it's worthless. No reputable journal would ever allow an omission of p when determining statistical signifcance. Especially since most studies, including Merck's, found a statistically significant difference (p < .01) between the finsteride group and control group in the sexual dysfunction AE. Sorry, the Journal of Dermatology Treatment is not reputable, if they allow that to be published. The Lancet or NEJM would never allow that.

Again, I've never seen a placebo-controlled study done on finasteride that noted men experienced unresolved sexual dysfunction, or persistent PFS-like symptoms. You're saying some Proscar "clinical trials" noted that, so I'm very interested in reading what you are referring to.

There's certainly been a placebo-controlled study that noted men experienced unresolved sexual dysfunction i nthe Finasteride group. And not all studies screen for long term side effects. No offence, but I think some of this might be over your head.