Mon 11 Jul 2011
Most physicians and hair loss experts tend to agree that sexual side effects (including erectile dysfunction and a decreased libido or sex drive) are temporary, and will dissipate after stopping the medication. Merck Pharmaceuticals, the makers of Propecia, feels the same, and claim that only 2-3% of users suffer sexual side effects and these reverse after stopping Propecia use.
However, some patients disagree and claim that utilizing Propecia and other finasteride based hair loss treatments can create permanent sexual dysfunction that persists even after stopping treatment. Recently, an article published in the Journal of Sexual Medicine claimed the same, and concluded that using Propecia for hair loss may create persistent sexual dysfunction.
Additionally, around the same time the Sexual Medicine journal article was published, federal health agencies in both the United Kingdom and Sweden announced they were amending the warning labels on finasteride based products to include the possibility of permanent sexual side effects.
In wake of this recent news, an Oklahoma based law firm began organizing a class action lawsuit against Merck Pharmaceuticals (the manufacturer of Propecia), claiming the corporation failed to adequately warn the U.S. public about the possibility of permanent sexual side effects.
In the midst of this controversy, it’s easy to become caught up in the “hype,” or fall prey to information based upon opinions and emotion, not objective fact and medical experience. To help better understand the validity of the class action Propecia lawsuit and whether or not the drug can cause permanent sexual side effects, we asked several hair loss doctors their opinion of the lawsuit, recent studies, and Propecia as a hair loss medication.
Dr. Raymond Konior, a member of our elite Coalition of Independent Hair Restoration Physicians and highly respected hair loss expert, had the following to say regarding the Propecia controversy:
The only information I have reviewed regarding this matter is the Journal of Sexual Medicine article. I strongly object to the conclusions of that article in that no credible scientific methodology appears to have been utilized to substantiate the conclusions that have been reported.
As you know, a statistically significant conclusion requires much more in terms of randomization and blinding than what the author presented. Who is to say that some of his patients would not have developed the problem despite the use of finasteride?
My own clinical experience does not support the existence of permanent sexual dysfunction, although I have encountered many men with short term sexual dysfunctional problems. I can’t recall anyone who continued to have a persistent dysfunction after discontinuing the medication. I have a patient who is a urologist with sub-specialization in male sexual dysfunction. We discussed this topic and he claims that there is a significant number of young men with low baseline testosterone which can be the culprit in some of the cases.
It does not surprise me that the predatory instincts of some law firm have emerged here to capitalize on a potential opportunity to line their pockets. I hope that Merck clarifies their stance here as I am curious as to their position.
Additionally, Dr. William Lindsey, another member of our Coalition of Independent Hair Restoration Physicians and hair loss expert said the following:
I think Propecia is a safe medication. More importantly, urologists treating prostate hypertrophy do and routinely prescribe 5x the Propecia dose as Proscar.
I suspect that many of those permanent sex side effects are in hair loss patients who are gradually suffering from erectile dysfunction (ED) with age, and may attribute the condition to Propecia usage. However, this is simply an educated guess and I have not reviewed my theory with any sort of organized research study.
After completing our own research and analyzing the opinions of these hair loss experts, it’s difficult to jump to the conclusion that Propecia usage is equated with permanent sexual side effects or that this recent controversy is worthy of a class action lawsuit against the Pharmaceutical company.
Furthermore, based on a personal review of the information and the testimonials of hair loss experts, it’s difficult to agree with the conclusions of the Sexual Medicine study or ignore the potential ulterior motives of the law firm organizing the class action lawsuit.
Although we pride ourselves on being patient advocates and take all hair loss medication side effect complaints seriously, it’s always advantageous to rely on objective, evidence-based studies and medical experience when forging an opinion on a matter as important as reevaluating a proven medication and analyzing a lawsuit filed against the makers of the treatment. Until further, peer-reviewed, accepted evidence is presented (which we will always evaluate and respect, despite the outcomes of the conclusion) it is probably best to thoroughly discuss potential side effects and concerns with a personal physician or hair loss expert before beginning a Propecia regimen.
However, based on current evidence and the experience of respected hair restoration experts, the conclusions of the Sexual Medicine study, actions of the European health agencies, and Oklahoma law firm simply do not appear objective and proof enough to conclusively link Propecia usage with permanent sexual side effects. Having said that, we will continue following this issue closely and alter our opinion accordingly if new evidence presents itself.
Blake Bloxham – formerly “Future_HT_Doc”
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