Propecia/Finasteride -
Side Effects and Effects on the Prostate
What are the Side Effects
of Finasteride or Propecia?
Based on the standard
dose of Propecia (Commercial name for finasteride sold
at 1 mg daily dosage), the side effects are rare. If
they occur, they are not permanent.
Sexual dysfunction in
the form of decreased libido, erectile dysfunction or
decreased volume of semen have been reported in a study
of men taking Propecia, affecting around 2 to 4 percent
of the men. The side effect normally appear within months
of taking the medication, and reversed within a few
weeks in all men who discontinued the therapy. A study published in 2010 shows that 1 in 80 of those men has also experienced erectile dysfunction. It involved the analysis of a dozen studies on the drug involving nearly 4,000 men. [1] Another study suggests a higher rate of occurences.[2]
In August 2011, Health Canada updated the labelling to say that Male breast cancer has been reported in a small number of patients worldwide with both the 1 mg and 5 mg formulations of finasteride. Most of the reports have been in association with the 5mg formulation.[3]
Based on the result of
this study, if you experience negative side effects,
you should consider stopping the Propecia therapy until
the side effects disappear, and then restarting on a
lower dose. Quit if this side effect reappear even after
the lower dose. Consider
an alternative therapy such as the low level laser therapy,
that has no known side effect.
Gynecomasia amongst men
(breast tenderness or breast enlargement) is a side
effect that may happen although very rare. This is the
effect of inhibiting the male hormone DHT. This occurred
in 0.4 percent of men on finesteride of 1 mg per day.
Linked to this is the possibility of breast cancer.
The results for this side effect is statistically insignificant
when compared to the control group that it can be considered
not a great concern.
Other side effects are
also not statistically significant. The mentioned ones
are rash, itching, hives, swelling of the lips and face,
and testicular pain.
There no reported interaction
between finesteride and other drugs.
Finestaride / Propecia
effect on Prostate
Prostate cancer is screened
by examining the prostate specific antigen (PSA) levels.
Finasteride causes PSA blood levels to decrease by about
50 percent in healthy men. Therefore your doctor should
be informed that you are taking finesteride if your
PSA level is being tested.
In a study conducted
in 2003 on men taking a daily dosage of 5 mg finasteride
for 7 years, there was a reduction of 25 percent in
incidences of prostate cancer when comparted with men
on placebo. This is a positive side benefit of taking
a high dosage of finesteride but it should be weighed
against the real possibility of sexual dysfunction as
reported above.
Proper dosage of finasteride
/ Propecia
The recommended daily
dosage of finasteride is 1 mg a day for treating hair
loss, promoted under the common name of Propecia. Lower
doses will have positive effect at diminished levels.
There is little evidence that higher dosage will increase
the effect on stopping or reversing hair loss.
At the higher dosage
of 5 mg, finasteride is marketed as Proscar. This is
cheaper than 5 doses of finesteride at 1 mg each.
The efficacy of finasteride
is not affected by food, so it can be taken at any time
of the day; although is has been said that morning is
the best time when the level of testerone is usually
highest for most men.
Finasteride (Propecia)
combining with Minoxidil (Rogaine)
When finasteride is combined
with minoxidil,
theoretically there should be an increased effect on
stopping or reversing hair loss. The reason is that
they work differently. Finesteride promotes hair growth
by blocking the impact of DHT, while minoxidil stmulates
the hair folicle directly. Based on results, finesteride
have a greater positive effect on hair growth.
Reference
1. Mella J M, Perret M C, Manzotti M, Catalano H N, Gordon Guyatt G. "Efficacy and Safety of Finasteride Therapy for Androgenetic Alopecia - A systematic Review". Arch Dermatol. 2010;146(10):1141-1150.
2. Hassani J, Zitzmann M, Hansen ML, "Adverse Side Effects of 5α-Reductase Inhibitors Therapy: Persistent Diminished Libido and Erectile Dysfunction and Depression in a Subset of Patients", J Sex Med., 2010 Dec 22.
3. Health Canada, "Finasteride (Propecis: Potential rare risk of breast cancer in men", Health Canada website: Information Update, accessed August 4, 2011.
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