This is a long shot here guys as we still don’t understand the mechanism of propecia-induced sexual dysfunction, but I recently remembered reading something back when I was on Fluoxotine and quickly drew some parallels.
SSRI discontinuation syndrome has several symptoms in common with those reported by many here:
Decreased or absent libido
Impotence
Difficulty initiating or maintaining an erection or becoming aroused
Muted, delayed or absent orgasm (anorgasmia)
Reduced or no experience of pleasure during orgasm (ejaculatory anhedonia)
Premature ejaculation
Weakened penile, vaginal or clitoral sensitivity
Genital anesthesia
Loss or decreased response to sexual stimuli
Reduced semen volume
And the others:
Sleep disturbances
Weight gain
Lethargy and fatigue
Like finasteride, the long-term effects of SSRIs are not well researched (it is a billion dollar industry after all) but there are groups like ours all over the internet for SSRI discontinuation syndrome. Anyhow, for patients who require antidepressants yet suffer intolerable sexual side-effects, Bupropion (Wellbutrin) is often prescribed as an alternative. But not only is it prescribed as an alternative to SSRIs, it is sometimes prescribed off-label to treat sexual dysfunction.
From Wikipedia:
In a mixed-gender double-blind study, 63% of subjects on a 12-week course of bupropion rated their condition as improved or much improved, versus 3% of subjects on placebo. Two studies, one of which was placebo-controlled, demonstrated the efficacy of bupropion for women with hypoactive sexual desire disorder, resulting in significant improvement of arousal, orgasm and overall satisfaction. Bupropion also showed promise as a treatment for sexual dysfunction caused by chemotherapy for breast cancer and for orgasmic dysfunction.
So as I said, it’s a long shot, but if it can reverse sexual dysfunction in SSRI and chemotherapy patients, it could help with Propecia related symptoms too. I’m not suggesting anyone should take it because I’m clearly not a medical expert, but just say you were considering taking anti-depressants, I’d definitely give Wellbutrin a shot.