November 12 2007, 3:35 pm PT | Posted in: Drugs
Dr.,
I have been on propecia for a around 2 years now. Recently I have developed Peyronie’s disease, which is utterly demoralizing and far worse than any hair issue I could imagine. Immediately I began searching for possible links between DHT deficiency and structural abnormalities that can dispose a person to penile fibrosis. I didn’t have to search long or hard:
Effect of androgen deprivation on penile ultrastructure
Recent insights into androgen action on the anatomical and physiological substrate of penile erection (human study)
^^^ more proof that androgens are necessary for proper sexual function in menThe Effects of Transdermal Dihydrotestosterone in the Aging Male: A Prospective, Randomized, Double Blind Study (human study)
^^^ take away DHT, you lose sexual function/libido — restore it, you recover functionDihydrotestosterone is the active androgen in the maintenance of nitric oxide-mediated penile erection in the rat
^^^ DHT is necessary for NOS production so you can get an erectionMy penis is hardly functional and I am quite upset that nobody showed me these studies before I took the drug. I acknowledge that it is not definite propecia is the cause. But does this research not certainly point in that direction? I feel betrayed by the FDA. This is not on any warning label, and I must live with this for the rest of my life.
Thank you
p.s. I am 20 years old
I am sorry for the problem that you are going through. As a physician all I can do is to follow the evidence based medication before convincing myself to prescribe a medication and that is pretty much true about every medication. As of yet, there is no evidence to show any ’stastical’ association between finasteride use and Peyronie’s disease. The data that you found during your search points out different aspects of the effects of male hormone on sex function. Based on all available literature, there is really no evidence that can associate Peyronie’s disease to the use of DHT blockers.
The sexual side effect of finasteride is well documented and the question for us is whether we should include this type of disclaimer for all patients considering the use of finasteride. I personally spend a long time explaining the potential side effects of the medication to my patients, as well as discussing the commonly known and published potential complications. I make sure that patients can make an informed decision before starting the medication. I also offer methods for my patients to minimize or treat side effects should they occur. I appreciate your symptoms and belief that there is a connection in your case. I will send this blog posting to Merck, maker of Propecia, for any comments that they may have and will post a follow-up if/when I receive a response.
For more on Peyronie’s disease, see University of Virgina - Urology.
Paid advertisements (not an endorsement):
Related Entries
- Propecia and Liver Disease
- Celiac Disease and Hair Loss
- Mixed Connective Tissue Disease and Hair Loss
- Lyme Disease and Hair Loss?
- Gastrointestinal Problems from Propecia?
Balding Forum
The same thing happened to me, but I was only on Propecia for three weeks. While my penis is not horribly damaged, there is fibrotic tissue under the surface which causes pain and a moderate bend.
It is a humiliating and emasculating disease, and like this poster I am way out of the normal age range for the disease - only 23 - and am convinced that it was the Propecia that caused it. Years from now the ’statistical evidence’ will overwhelmingly support this ‘rare’ side effect as truth.
There is support for men with Peyronie’s at http://www.peyroniesforum.net/ - where you can read about the latest medical and homeopathic treatments for this unfortunate disease.
First of all, these kinds of sexual side effects are not well documented. Merck tells you that it’s very rare to have side effects, and that they go away after discontinuation. In fact, it even encourages users to CONTINUE use if they have side effects, b/c they should just go away eventually. The posts that I read on the internet seem rational, and I’m starting to believe more and more that my condition is not a coincidence.
I have had the same problem sort of. I was on Propecia for about 2.5 years from age 18-21. After about 2 years I decided to go off it for a few weeks, and then back on to “shock” my system. I wish I hadn’t because everything seemed to be going well. About a month later I noticed that my erections were weaker and my penis seemed to be slightly bent. For several months my erections continued to get weaker and the bend more prominent (although the bend doesn’t look like it should cause this much trouble. i’ve seen worse on pics on the internet). I went to a doctor and he told me it’d probably always been this way, which, while I can understand why he might think that, is almost offensive. Obviously I’d know if my penis had been bent my whole life. I can still get erections, just not as good and the feeling is not as good. After 5 months off, it’s not clear if I’ve gotten any better. The sad part is, that now that I see new hair loss I’m almost considering going back on the drug.