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Important Side Effects of Propecia
The drug Finasteride first gained FDA approval in FDA as Proscar, a 5mg dose of Finsateride used to treat prostate enlargement. Once clinical studies found its effectiveness at treating hair loss, the 1mg dose was approved in 1997 as Propecia. As the first effective medical treatment for male pattern hair loss, Propecia has become the first step for many in the battle of baldness. Still, you should consider the side effects of Propecia before you speak to your doctor and begin this regiment.
Sexual Side Effects
A fair amount of men on Propecia experience some type of sexual side effect. Impotence occurs in between 1 to 18.5% of men and other side effects include: abnormal ejaculation (7.2%), decreased ejaculatory volume (1-2.8%), erectile dysfunction (1.3%), ejaculation disorder (1.2%), abnormal sexual function (2.5%), testicular pain and gynecomastia in around 2% of men. Gynecomastia is the medical term for the development of abnormally large breast tissue in men. The product insert for Propecia states that most men who discontinue the drug will see these side effects subside, as will most men who continue treatment. Still, there are many causes of men who continue to experience side effects like erectile dysfunction even after discontinuing use of the drug.
In 2008, a study was conducted by the Swedish Medical Products organization to determine if finasteride is safe to use and if it results in irreversible sexual dysfunction like diminished libido or erectile dysfunction. The agency now lists an irreversible difficulty in obtaining an erection as a possible side effect of finasteride drugs like Propecia. Other governments have also added warnings to the drug, including Italy and the United Kingdom. In 2012, the FDA approved a new label for the drug in the United States to include possible side effects such as: persistent libido disorders, orgasm disorders, decreased libido and ejaculation disorders.
Prostate Cancer Risk
Propecia will reduce the levels of prostate-specific antigen (PSA) in your blood after one year of use. PSA is a protein that’s produced by the prostate and the PSA blood test remains the most common way to look for signs of prostate cancer or prostate issues in men. Men with prostate cancer usually produce elevated levels of PSA, which is an indication of more cancer cells in your body. You should always inform your doctor that you take Propecia before a PSA test because the drug will interfere with its ability to screen for prostate cancer.
The FDA also added a warning to Finsateride stating that it produces an increased risk of high-grade prostate cancer. There still isn’t enough evidence to prove this, although existing research shows that the drug can temporarily reduce the growth and spread of benign prostate tumors while making it difficult to detect prostate cancer early. This risk is of most concern to patients who take the drug for benign prostatic hyperplasia (BPH), not hair loss.
Depression and Anxiety
Clinical studies have linked finasteride use to inducing depression and anxiety in both men and women. A dose of 1 mg a day — the dose of the drug in Propecia — was enough to induce moderate to severe depression in 83% of the patients, including every female patient in the study. A study of the same dose involving only men found that the drug increased HADS and BDI depression scores a great deal, which means the drug should be used with caution by patients already at risk or depression. Propecia now carries a warning for depression on the package label.
Male Breast Cancer
The warning label for finasteride was revised to include the risk for male breast cancer after an agency in the UK determined in 2009 that the higher risk for this form of cancer from use of the drug can’t be ruled out. While clinical trials with a 5mg dose produced male breast cancer rates that weren’t significantly higher, more research must be done to determine the exact risk, especially with the dose found in Propecia.