Proof

General Discussion
#1

I’m just playing devil’s advocate, so there is no need to flame me.

I am looking at this forum from an objective point of view.
Clearly many men are reporting this issue.
But it seems like symptoms do vary. Even the bloodwork seems complex and it is debated.
So I understand why it can be hard to convince the doctors.
For example, what if the doctor said some men have ED, and you just happened to take this drug?
Actually it is certainly statistically possible.

Would be great to have a scientific study, but of course who would pay for it?
I wonder if there is any way to do a survey or something, even on a low budget. If the data showed that the rate of such problems among men who had taken this drug was higher than the control group, that would be compelling.

#2

Your post certainly should not be flamed because you are asking genuine questions and trying to do so in a reasoned way.

I must say there is absolutely no doubt that finasteride does cause problems regarding the male sex steroids and that there is a complete lack of understanding of this fact amongst many doctors.

Finasteride was originally used as a treatment for prostate cancer to chemically castrate men instead of physically castrating.

It is proven to reduce testosterone and dihydrotestosterone- that is absolutely not in question.

Finasteride is proven to cause hypogonadism, that is also not in question.

The symptoms seen in hypogonadism are diverse, but then again part of that is because there are wide ranging effects on the body due to hypogondism.

A lack of androgens causes everything from;

Poor memory, difficulty concentrating and cognitive issues, low libido, erectile dysfunction, reduced or missing morning erections, increased visceral fat, reduced muscle mass, reduced bone mass, joint pain muscular aches, excessive sweating, depressed/low mood, irritability, anxiety, nervousness, lack of energy and vitality, general lack in well-being, physical exhaustion, sleep problems, decrease in secondary sexual hair such as beard growth, reduced acne and spots due to lack of sebum production, (NOTE pre puberty it causes eunecoid body development with excessive height, disproportionate arm span and disproportionate lower body development and can cause micropenis).

People who have untreated hypogonadism have one or more of the above- each person differs as to how they are affected and the severity is of any symptom is often based on the severity of the lack of androgens.

Hypogonadism at any age through whatever means leads to an increase in the statistical likelihood of developing or doing the following if not treated;

Osteoporosis
Type 2 diabetes (one in three men have hypogonadism)
Strokes
Cardio Vascular Disease
Obesity
Alzheimer’s
Depression
Suicide

So the cause and effect of finasteride is not in doubt at a certain dosage when it comes to hypogonadism.

All the above said and done that is talking about finasteride not Propecia or Proscar.

The association is not so clear cut when dealing with these medications and these doses of finasteride.

Drinking high amounts of alcohol causes an individual to become inebriated, but that does not mean that having a sip of beer makes an individual inebriated. Also water is toxic to the human body in sufficient quantities, but that does not mean water is harmful per sey.

The question should not be is finasteride harmful, as that is abundantly obvious to those doctors who are not idiots, the question should be;

Is Propecia and Proscar harmful?

And

Is finasteride harmful at these levels?

I suspect that part of the problem is that many men with lower androgen status maybe more prone to the effects of low dosage finasteride. I think statistically there will be found to be an absolute cause and effect problem at these levels.

Of course that is only my conjecture.

None of what I have posted relates in any way to the theories that finasteride may cause other endocrine problems- which it may well do (I can’t comment as I have seen no proof either way).

#3

While that’s certainly a possibility, I’d estimate and am betting that 98% of the men who took Propecia for hairloss and who are in the 19-30 year range never had any issues with getting an erection prior to taking the drug.

Of course, I can personally attest to this when I took it at 25. Within 3 days of taking it, I was no longer able to achieve an erection as quickly or easily as I had been my whole life prior.

I am most certainly not a man that had ED or libido problems before taking this drug, and since such side effects are listed by Merck, it is obvious such dysfunction can happen to a small percentage of perfectly functional men as a result of Finasteride use. To claim otherwise is to ignore the facts.

Regarding studies, they are out there. For example, Merck did such a study and submitted it to the FDA prior to Propecia approval. Review the following and note the notes and conclusions of the FDA reviewer.

fda.gov/cder/foi/nda/97/0207 … ia_toc.htm

#4

I think mews post says it all. ED just doesn’t happen in previously healthy 20 something y.o.'s without a serious detectable medical problem.

Plus can somebody answer this question for me. Wouldn’t “normal” physiological ED come on a little at a time progressively getting worse (outside of a circulatory problem). For me this came on suddenly like someone turned off a light switch.

#5

I think Hypo’s post says it all when it comes to why there should have been more warnings on the Propecia literature and commercials. Had I read the facts in Hypo’s post before taking this I know it would have scared me enough to not even try this. Plus knowing this I think the lower doseage study is even more relevent. (see this is big in general)

#6

Just to add Mew’s point which is a very good one;

Typical erectile dysfunction involves reduced ability to obtain and maintain an erection and often has some psychological component.

When erectile dysfunction is due to an underlying hormonal cause there is usually a lack of nocturnal erection and a lack of morning erections.

Or to put it another way;

Because these erections occur under the influence of hormones without the possibility of a psychological influence, a lack thereof often indicates an underlying hormonal imbalance and factor in the dysfunction.

I would be willing to wager that the typical erectile dysfunction found by those who have taken propecia and proscar has resulted in a lack of or reduction in morning erections.

#7

Hypo, if you browse through fda.gov/cder/foi/nda/97/2078 … _STATR.PDF

… The FDA notes that there was a statistically significant difference in favor of the placebo group compared to the Finasteride group when it came to Morning erections. This is all from Merck’s own study data.

So yes, what you wrote is correct.

#8

Men who have lower levels of androgens are more prone to the effects of medications that lower androgen status. The number and severity of adverse side effects reported are likely to be statistically higher in such men.

With this in mind;

Merck’s controlled studies have involved too few subjects to be statistically telling (as far as I am aware- perhaps someone can point me to a large scale study?) in terms of the statistical significance/likelihood of adverse effects and reactions to this medication.

The study numbers may have given an entirely false or at least unrepresentative statistical likelihood of adverse effects and have given a false impression of safety.

The number of men with low normal androgen status is significant; conversely the number of men with low normal androgen status that is likely to have been represented in a study of such small numbers is likely to have been low.

#9

Hypo makes a good point. Personally I think if all drug trials are performed with such small samples it is quite pathetic.