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Experts Link Propecia to Male Sexual Dysfunction


February 27, 2012 — Experts at two medical schools have found links between Propecia and sexual side effects that could be permanent. The hair-loss drug has been linked to persistent erectile dysfunction, clinical depression, breast cancer, and aggressive prostate cancer, prompting hundreds of men to file a Propecia lawsuit against the pharmaceutical company Merck & Co. Although there is growing evidence linking Propecia to severe, life-threatening side effects, millions of men who are taking this drug may be unaware of the possible risks.

Propecia (finasteride) was approved by the U.S. Food and Drug Administration (FDA) in 1997 to treat the symptoms of male patten baldness. It was originally developed in 5-mg doses to treat enlarged prostate (sold under the brand-name Proscar). Doctors noticed that a side effect of Proscar was hair growth, and soon, finasteride was re-branded as Propecia and sold in 1-mg doses to treat male-pattern baldness.

Unfortunately, there is growing evidence that men taking finasteride may suffer severe sexual side effects.

One man leading the research is Dr. Michael Irwig, an assistant professor at George Washington University’s School of Medicine, and the Director for the University’s Center for Andrology. After several men reported that they had developed persistent sexual sexual side effects while taking Propecia, Dr. Irwig began investigating. He found an online support group for men suffering Propecia sexual side effects. Dr. Iwig then recruited 71 men from the website, and interviewed them.

What Dr. Irwig found was that 94% of the men suffered low libido, 92% suffered erectile dysfunction and decreased arousal, and 69% had problems reaching orgasm. They also reported a two-thirds reduction in sexual activity after using Propecia. Dr. Irwig’s research found that Propecia side effects may include erectile dysfunction, impotence, greatly reduced libido, testicular pain, difficulty reaching orgasm, and a condition called gynecomastia (over-growth of male breast tissue). There is no known cure for many of these severe sexual health problems.

Even though many men have reported severe side effects, prior to Dr. Irwig’s study, the topic of persistent sexual health issues related to Propecia had not received much attention. After Dr. Irwig published his study in the Journal of Sexual Medicine, another doctor decided to investigate. Dr. Abdulmaged M. Traish of Boston University School of Medicine led a second study of Propecia sexual side effects. His review found that men who took Propecia suffered erectile dysfunction, reduced ejaculation, and reduced semen volume — symptoms that persisted even after the medication was stopped. The results of the study were published in the Journal of Sexual Medicine.

Evidence from these two experts adds to the growing evidence that Propecia can have devastating sexual side effects. Many are concerned that Merck actually had evidence that Propecia could cause long-lasting sexual side effects, but the company waited to make changes to the safety labeling in the United States. Several years ago, the United Kingdom and Sweden documented persistent sexual problems in men taking Propecia, and required that the labeling be updated to include this information. However, the company has only recently updated the safety labeling in the U.S. to warn of persistent sexual problems.

Even now, the safety labeling may still be inadequate to warn men of the variety of sexual side effects they may develop. Persistent erectile dysfunction is not the only sexual side effect that men have reported. There is also evidence that Propecia has the capacity to persistently change the brain’s chemistry. Propecia makes changes to the enzyme 5-alpha reductase. Dr. Irwig explains that, “finasteride is different because it can actually change the brain’s chemistry. The enzyme 5 alpha reductase is present in many areas of the brain. It is rare for a drug to have the capability to persistently change the brain’s chemistry.”

The problem is complicated by the fact that many doctors may be unaware that they are prescribing a medication that may cause persistent sexual dysfunction. The doctors prescribing the medication (typically dermatologists and general practitioners) may not be communicating with the doctors that treat the symptoms of Propecia side effects (urologists and endocrinologists).

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