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by Robert MacKay, Monday, 17 June 2013 | Categories: Propecia

The medication for male pattern baldness, Propecia, may help patients reduce their alcohol consumption. This has been stated by a new study found in the journal “Alcoholism: Clinical and Experimental Research”. The active ingredient involved –namely, Finasteride– has been noticed to have this effect in male rodents in past studies but this is the first study that has considered the impact on human alcohol consumption.

The research found that more than half (65%) of men, who have stopped taking finasteride for at least 3 months (because of sexual-related side effects), reported a decrease in alcohol intake. This study is part of a research project that seeks to understand how Finasteride affects the production of neurosteroids and, therefore, how it might alter brain’s processes.

The study (by Professor Michael S. Irwig) can really only be seen as a starting point for further research on the subject. This is because of three main methodological reasons. First of all, the research does not have a control group: useful to compare the results from the experimental group and help understand the extent to which the results are significant. Secondly, evidence seems to be based on reports from patients during interviews, which might be subjective and not as accurate as scientific testing. Thirdly, the sample population was formed by men who have had adverse sexual-related side effects to the drug, hence, the conclusions cannot be applied to men who use Propecia regularly and do not have side effects, nor to men who have never used (and do not need) the hair loss medication. There might also be other external factors that might cause patients to report decreased alcohol consumption.

Although the report is interesting, it really has very little value at this stage as we cannot demonstrate a causal relationship. It should also be pointed out that the participants were clearly social drinkers rather than problem drinkers so the applicability of Finasteride as a potential treatment for alcohol addiction is far from established. Based on my random sample of one (myself), I can exclusively report that Finasteride has had no impact on my alcohol consumption whatsoever.




by Robert MacKay, Thursday, 11 October 2012 | Categories: Propecia

Last year we reported about a poorly conducted study regarding the side effects of Propecia. The same researchers have now published a follow up study, where the interpretation of the results remains questionable.

The study reassessed 54 individuals with a mean age of 31 years that did not present with any other medical conditions. The patients were sent a follow up questionnaire called ASEX via email. In total 81% responded and of those 89% met the definition for sexual dysfunction.  The length of use of the medication, as well as duration of the side effects appeared to be unrelated. However, the majority of individuals in the study had experienced the side effects for 1-2 years. Based on this, the authors concluded that there is a possibility for the side effects to be long lasting or potentially permanent and therefore urged for caution when prescribing Propecia.

To a large extent, the recruitment of participants depended on the same sample they used in the previous study. Yet, this was one of the main flaws of the initial study. By recruiting participants that already exhibited sexual side effects, the authors made it challenging to generalise the findings to all individuals who take Propecia. Although they specified that their sample did not take any other medications or have any other conditions that may have affected the outcome, there was no mention of corroborating this with medical records.

Although we understand the need to research side effects of any medication, we also feel that it is important that more rigorous studies are made before suggesting that the side effects may be permanent. We also agree that caution should be taken when prescribing any medication and as such fail to see the value of the conclusion of this badly constructed study.




by Robert MacKay, Monday, 23 April 2012 | Categories: Propecia

The Food and Drug Administration (FDA) in the USA has now ordered that packets of Propecia be accompanied by health warnings regarding problems with ejaculation, orgasm and libido that are said to occur even after patients stop taking the hair loss treatment.

Propecia already carries a warning on its label regarding a decrease in libido but now the other warnings will also be added to it. Along with sexual side effects, the label warnings will include side effects such as a decrease in semen quality and infertility however these are two side effects that are said to disappear once treatment ceases.

Despite this move, no evidence is available to establish a direct link between Finasteride, the active ingredient in Propecia and Proscar, with these symptoms. The cases investigated have been reported voluntarily and the number of actual reports was very small given the prescribed population, thus making it difficult to draw any reliable conclusions or establish any causal link between the drug and these symptoms.

Drug companies are obliged to advertise such warnings since cases have been reported. However, we assure patients that there is no concrete evidence to prove that Finasteride has these effects on patients and very few of our patients report any side effects whatsoever so Propecia appears to be well tolerated on the whole and we are not aware of any label changes in the UK.




by Robert MacKay, Thursday, 08 March 2012 | Categories: Propecia

The Food and Drug Administration (FDA) is addressing the fact that there is a growing fear surrounding Propecia’s supposed effects on sexual function. Men have been reporting permanent sexual dysfunction having taken the hair loss treatment.

Until investigations have been carried out, both the FDA and the manufacturers, Merck, are staying silent on the topic. The FDA will carry out a review with a view to updating the drug’s safety data if necessary. This might include a warning regarding the potential for certain individuals to experience certain side effects to a more severe degree than others.

This review probably signals a swathe of complaints about the side effects in question however, no formal evidence has been presented as of yet and until there is sufficient support for these complaints, patients should not be alarmed by any reports that they read online.

The Online Clinic has been prescribing Propecia online for around 7 years and we have not had a single patient who has suffered irreversible sexual side effects. We do take the view that the sexual side effects have a higher incidence than the figures from the original clinical trials but the percentage does not quite reach double figures according to our patient follow-up responses.




by Robert MacKay, Wednesday, 23 March 2011 | Categories: Propecia

Merck, the manufacturers of popular hair loss treatment, Propecia (Finasteride) has been faced with a lot of bad press recently. It has always been suspected that Finasteride caused sexual dysfunction in men with side effects including:lower libido; erectile dysfunction; and problems with ejaculation but we were always told that if side effects were to be experienced by a patient, they would soon disappear once treatment ceased.

Researchers at the George Washington University carried out a study on 76 men between the ages of 21 and 46 and found that these men were experiencing problems with sexual dysfunction such as erectile dysfunction (ED) and premature ejaculation from 3 weeks to 10 years after they had stopped taking the drug. The study is published in The Journal of Sexual Medicine.

94% of participants who had taken the drug for a number of days noted that they had low levels of sexual desire, a similar number reported difficulty with sexual arousal and ED and 69% had problems with achieving orgasm. Those who had taken Finasteride for 28 months reported that they had experienced sexual problems for a duration of 40 months on average from when they stopped taking the treatment to the time the reports were made. 20% of men were experiencing side effects 6 years later.

What is interesting is that in order to be considered eligible to participate in this study, men had to have experienced problems with sexual dysfunction for at least three months after they had stopped taking Finasteride. It seems to me that the study’s authors had a pretty clear indication of the outcome they wanted to see before they even began! Furthermore, in order to participate in this study, men had to include the results of two hormone and fertility tests with their application. These tests were to be spaced one month apart. There was no mention of these results and their effect on sexual dysfunction in the report, only the influence of Finasteride. This report is based on a very small and biased sample and quite simply, it is bad science.

The fact remains that Propecia does benefit those suffering from hair loss and it may cause sexual dysfunction in certain patients but as yet there is no reliable evidence to suggest that any side effects are widespread and long lasting.




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