Those who have participated in Dr. Irwig’s study should know by now his study was published this morning in the Journal of Sexual Medicine. Any thoughts on the article and what can be done from here on out?
I am glad that he ensured that all subjects were otherwise in good health before PFS had onset. This pre-empts many potential defenses and counter-arguments that the condition was caused by an existing and confounding source other than finasteride.
Here is the press release for the article -
Cool,
is the actual study available?
The abstract is available in the Early Review section on the Journal of Sexual Medicine (JSM) website, see:
http://onlinelibrary.wiley.com/doi/10.1111/j.1743-6109.2011.02255.x/abstract
The full article is available online for registered members of JSM (check the “Get PDF” and “View Full Article (HTML)” links on the web page linked to above). The full article will likely also be published in a later issue of a JSM.
Wow.
I think there has been some major progress made lately:
The article by Dr Traish et al was published in the March issue of JSM (see http://onlinelibrary.wiley.com/doi/10.1111/j.1743-6109.2010.02157.x/abstract). This was the first medical article confirming persistent side effects caused by finasteride (Propecia). It also recognizes that the medical authorities in several European countries has issued a warning in the prescription information stating that the sexual side effects in some cases are persistent even after discontinuing the medication.
The article by Dr Irwig will soon be published in the JSM. It is the first study where persistent side effects have been studied in a larger population. I.e. the study confirms that persistent side effects are not only experienced in rare cases, but among a large number of patients.
The media has started picking up the story, and we’ve seen several articles mentioning the findings of the studies in 1) and 2). I would urge everyone to contact the media in your own country and inform them of these articles, and what we’ve all been through. It’s important to spread the word and awareness, and it’s a story that’s likely to be picked up by the media so don’t hesitate to contact them.
There are several more studies on the way. Hopefully this will lead to a better understanding of what mechanisms cause the persistent side effects, and in the end if we’re lucky also a cure or atleast a way to improve our situation.
Finally, after all these years, it feels like things are moving in the right direction. A couple of years ago we were pretty much isolated and ignored, and had a hard time getting doctors to recognize how terribly devastating these persistent side effects have been to our lives. Now I feel like there’s a light at the end of the tunnel.
I know, hardly ground breaking but it’s necessary to begin from the bottom up.
Due to this reality however, i don’t get too “excited” about any of this. All I’m going to read is stuff i already know for a fact through personal experience. It needs said from credible sources in the medical community so i guess this is a start albeit a small step.
The most important aspect of the study is that it provides concrete evidence that PFS syndrome is real and no longer internet hearsay. Some doctors may have been familiar with 1 or 2 reported cases which they could easily disregard but the 71 reported instances makes PFS a bit more substantial.
I am a little disappointed that only 100 of us signed up for the study (about a 6% response) but I am appreciative that Irwig’s work has essentially created some credibility.
For those of you who do not have full access to the article, it basically elaborates upon descriptive statistics defining the patients he interviewed.
It still seems far from damning tbh. It doesn’t mention the real bad side effects like testicle atrophy, penile arophy, PAIN, deep depression or anything like that.
Rather importantly, as it acknowledges, there’s no note of hormone levels or hypogonadism.
We’re still a long way away. That said, it’s a matter of resources and i am eternally grateful for Dr Irwig’s continued interest and dedication to this whole thing as is shown but his follow-up study which is clearly upping the ante. THANK YOU DR IRWIG
livescience.com/13314-male-baldness-drug-finasteride-sexual-dysfunction.html
Wonder where the 20% number comes from . . . . possible misquote.
ABC News! (A major U.S. network, for our international forum members)
Thorough story - looks like they are airing the story on the nightly news.
abcnews.go.com/Health/MensHealth/baldness-drug-sexual-effects/story?id=13152993&page=1
What the author meant to represent was that 20% of the patients interviewed in the study had suffered more than 6 years.
In the paper Dr.Irwig states “…this study does not prove that finasteride caused persistent sexual side effects…”
[Size=4]Yes it does![/size]
If you have 71 men with no previous problems telling you that finasteride has induced in them persistent sexual dysfunction - that is proof! What other conclusion can you possibly draw?!? What other proof do you need?!? In trying to be conservative I think he has drawn the wrong conclusion there. I wish he had stuck his neck out a bit.
Even Traish’s study stated 5aR inhibitors “clearly” cause erectile dysfunction - and that was just a review of the literature.
I agree with Oscar. The conclusion is a little weak and tentative. If one was concerned about drawing a stronger conclusion without “evidence” all that had to be done was use the various studies on here as cross-reference (the effects of 5-ar inhibitors) to add a little leverage to the conclusion that has been case studied with 71 people!
Oscar, the study has what is called “inherent bias” in that those profiled stated at the outset that finasteride caused them persistent problems. Irwig did the right thing.
To prove it, you need to find about 40 guys who are about to take the drug for the first time, measure their T, FSH, SHBG, Adiol-G and 5a/5b metabolite ratios from 24 hour urine, then measure them quarterly over one year. We as a group already know some of those men will be permanently suppressed/altered.
Yeah but inherent bias means you can’t really make any conclusions as to %'s of victims.
It shouldn’t outrule you concluding that the people that were involved in the case study were sexually deciminated and that all of them had one thing in common - finasteride. I know there is a difficult there with the lack of bloods in this particular study but one can definately afford to be a little more enterprising than that conclusion.
Our Lawyer: “M’Lord as evidence I present Dr Irwig’s 2011 study”
Merck’s Lawyer: “That study says it isnt proof of anything.”
Our Lawyer: “Oh yeah…”
Judge: “Do you have any evidence without ‘inherent’ bias?”
Our Lawyer: “Er…No…Thats probably going to be impossible…”
Judge: “Not Guilty!”
Kazman, why do you think 1 in 5 finasteride patients will experience a permanent suppression of hormone levels? Everything I have seen so far led me to think the persistence of propecia side effects will occur in a very minute sub-population of those treated with finasteride. I think a controlled study in the tens of thousands would be required to present tangible evidence of the connection between finasteride and PFS.
Oscar, I was disappointed too when I read that line in his study. However, I think he could have been barraged with objections had he made a stronger claim which may have discredited his entire study.
Please get educated on the legal system. There is something called causation which is very difficult to prove. In all of the accutane cases, ALL OF THEM, including single case losses for $25 million, the drug company never had to admit that their drug caused the problem, just that it was associated with the problem.
THIS IS NOT GOING TO BE AN EASY BATTLE. GET YOUR MEDICAL RECORDS AND STORY IN ORDER.
from the abc news story:
This is a key statement. Irwig describes the typical treatment response doctors give for reporting these side effects.
From the ABC News article:
There is some chance Traish was misquoted here. Half of ~ 25% means roughly one out of 8 on the high end, think I might have typo’ed the original post, meant between 1 to 5, out of 40 new finasteride users. Anecdotal reports from hair loss sites indicate 1 out of 4 suffering simple ED while taking fin is pretty reasonable, possibly even low.
Look at the “bounce” effect, where things return to normal for a few weeks, followed by the crash - how many men get fooled by this and then attribute the problem to some other possible medical connection? Think they’d run into a typical doctor that will think to test all the hormones I listed? How many of them walked out with a script for Viagra, can then still sort of function, but get no joy and not much of an orgasm from sex? They get put on anti-depressents. Only the smart, determined ones, and those with the funds to do so, will drill down to root cause.
My family doctor, after I went back to him a second time in the months after quiting fin, complaining of no libido, and only being able to get a partial erection at 5 AM with lots of effort, finally tested T and free T. Unfortunately he had no clue how to interpret the results (and neither did I, T was “just into” the very bottom of the “normal range”), so we spent years chasing a heart condition that never existed - after stress tests, dye injected stress tests/full body and heart scans, cardiologists, folic acid (to reduce a homocystine level that was considered high back then because it was new, but would not be a concern today) this that and the other thing guess what, my circulatory system was fine, in fact quite clear for my age. At the time all these workups made sense to me, as ED could be a sign of circulatory issues and I was not that old at the time.
Then I finally got diagnosed with secondary hypogonadism, after two docs missed the bloodwork signs overlaid on symptoms. And then conventional treatments only helped in breif windows . . .
It’s a funny side story, but I still check in with one of these earlier docs. Last year he told me M–rk’s drug reps stopped pushing Proscar and Propecia about 4 or 5 years ago - no more free samples, no more mention of it during discussions. He thought it odd as the patents had not run out yet.
Most past propecia users aren’t going to add it up until they see this thing on the evening news, or some television ad asking them to call the 800 number. Too bad its coming out in the middle of the busiest newsdays in months between Japan and Libya. Who knows, maybe M–rk arranged it that way . . . .
The other thing I’ve seen is men taking propecia, for one or three or as much as seven years, insisting their drive, capability, etc. is fine, then succumbing to PFS. As long as M–rk continues to dole out the drug they are simply continuing to build an ever larger pool of plaintiffs - they are hoping the profits that are made will exceed any sort of settlement that might have to be eventually paid. Here in my scientific opinion: they are going to be sadly mistaken.
Look at Cowboybob here, he never added up past finasteride use with his asymptotically approaching zero Adiol-G level:
forum.mesomorphosis.com/mens-health-forum/please-interpret-these-testosterone-134280367.html
How many other Cowboybobs are there out there, bet many thousands more, that never heard of propeciahelp.com. How many men are too shy or embarassed, even in the Viagra age, to talk to their doctor about having no libido, or difficulty concentrating? I certainly was.
Once the lawsuits really start rolling, more ex finasteride users will get these things tested. Then we will see . . . using a tenth, or a quarter of everyone that ever took fin.