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Hair loss drug finasteride can cause debilitating side-effects, men say (www.cbc.ca)

submitted 4 days ago by [email protected] to c/[email protected]

8 comments fedilink hide all child comments

Finasteride — or Propecia, its most popular brand name — was invented by Merck. The pharmaceutical company insists that it's rare for men on the medication to experience side-effects, and has long maintained they vanish once the medication is stopped.

But 25 people interviewed by CBC/Radio Canada during a six-month investigation of finasteride's side-effects tell a different story. They say the drug caused sexual, psychological and physical side-effects for them that have lasted months if not years after they ceased taking the drug.

The men interviewed by CBC/Radio-Canada said their symptoms are debilitating: loss of libido, erectile dysfunction, infertility, cognitive and physical issues, anxiety, insomnia, depression and, in many cases, suicidal ideation.

"It's a complete chemical castration where you have no chemical reaction to anything sexual, anything in life," said Michael, a British Columbia man who says his symptoms have lasted more than 15 years.

"It's important to remember that the majority of patients will not experience permanent symptoms with this type of medication," he said. "The problem is that we don't know which men could develop these symptoms or why."

(emphasis mine)

Since its launch, Propecia's product monograph has mentioned the risk of side-effects such as decreased libido, erectile dysfunction and ejaculation disorder, but states that "the incidence of each of the above side-effects decreased to ≤0.3 per cent by the fifth year of treatment."

In these internal exchanges, however, a Merck scientist calls this safety data "misleading." He points out that to achieve such a low number, his colleagues had excluded all men who had left the studies because of sexual side-effects.

While the company has long claimed that side-effects disappear when users stop the drug, other internal emails suggest some of the clinical trial participants did have persistent adverse effects after cessation.

"Nothing has been reported about these men who developed these persistent side-effects. So we don't know if they ever recovered or not," said Irwig.

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[–] [email protected] 8 points 4 days ago

These side effects were always known; the drug blocks testosterone metabolism so of course there is a possibility that it will block more than you want it to. The drug's other use at a higher dose is to shrink your prostate.

[–] [email protected] 7 points 4 days ago (1 children)

The problem is the medical establishment doesn't really care about men's health; hair loss in men is treated as cosmetic despite the psychological consequences. The best we get are two repurposed drugs (this and minoxidil) that they happened to notice caused hair growth as a side effect.

[–] [email protected] 4 points 4 days ago* (last edited 4 days ago) (2 children)

Psychological consequences? I don't think hair loss is the cause there.

Edit: if you think your looks are insufficient, that you can only be attractive by fitting some mold, that you're somehow lesser without all that hair, that's some incel bullshit that's wormed its way into your psyche. But don't feel too bad about it. Even Patrick Stewart tried a bunch of fixes when he was losing his hair in his teens.

Edit 2: if it's causing psychological issues to the point it's interfering with your life, of course seek help. I screwed up on being dismissive about people that do struggle with this.

[–] [email protected] 10 points 4 days ago (1 children)

That is incredibly dismissive to the real dysphoria, depression, and anxiety that men can feel when they experience hair loss. It's awesome that you either aren't bald yet or weathered the storm well, but dismissing other's experiences is a real dick move.

[–] [email protected] 6 points 4 days ago

Hey, thanks for the pushback. Got me to look up some things and try to square this with how I typically think of things like gender affirming care (all for it).

https://pmc.ncbi.nlm.nih.gov/articles/PMC8719979/

It's kinda interesting that this talks about cognitive behavioral and pharmaceutical interventions being recommended before cosmetic surgeries and there is a portion of the population that will not be satisfied no matter how well surgeries go. Kinda like how some people with eating disorders will never see themselves as thin enough regardless of weight. But that's pretty different approach than what I know of gender affirming care, for instance.

Anyway, again, thanks. There's definitely some nuance I was missing out on.

[–] [email protected] 4 points 4 days ago (1 children)

Would you say the same to a woman who lost her hair?

[–] [email protected] 2 points 4 days ago

I don't think adhering to a beauty standard is the price anybody should pay for the right to exist in society. I don't think my grandmother's hair loss made her any less of a woman. That being said, I don't make the rules of society or decide how others feel. If it's to the point where it's interfering with somebody's life, they should seek help.

[–] [email protected] 7 points 4 days ago* (last edited 4 days ago)

I feel like this should have been a reason to not give the drug approval in the first place. It's not worth it for those side effects even if they're rare. We aren't talking about a disease that can kill you, this is hair loss, something you can live with.