I wanted to share some important information that on one hand helps to dispel some of the possible scaremongering out there. I went to go through some of the possible headlines and the research studies and unpick. Exactly. What's been said how their search studies have been carried out and what could be the potential causes of concern with these research studies. I also want to highlight that, well, one in 20 men who take Finasteride, there are going to be some long term and potentially permanent side effects research into the long-term side effects of Finasteride is still ongoing.

A 2014 review in the Korean journal of urology found at least four previous studies that reported persistent or irreversible sexual side effects. The author said that the studies reported negative emotional toll and reduced quality of life for the men affected. They stated that the argument that the benefits of these drugs outweigh the risks is slowly eroding in the face of new emerging scientific evidence from preclinical and clinical studies.
The authors wrote men who suffered term sexual dysfunction after taking Propecia have filed lawsuits against Merck that accused the company of failing to warn users of the risk just in the U S 5 million men were prescribed Finasteride in 2007 that's figure doubles to over 10 million men by 2016. Finasteride is an extremely commonly prescribed medication in the U S between 2007 and 2017. Over 76 million men were prescribed Finasteride just in the U S alone. If 5% of men are affected by adverse side effects, that makes 3.81 million men over the course of 10 years, experiencing some degree of side effects out of this.
It's unclear how many people will experience long-term side effects. Once they stop taking the drug for this video, I'll be looking at the potential for sexual side effects, including loss of libido, impotence, ejaculatory  disorders, depression, and thoughts of suicide in people who had previously not to experienced these it's vital to ASCO haircare doctor about the rate of side effects that their patients experience after being prescribed Finasteride.
And towards the end of the video, I share some interesting information on dosage of Finasteride and how this could potentially help to reduce these side effects. So please do watch all the way through.
So let's get into finasteride as a prescription only for tablets taken orally, and it was approved by the FDA in 1992 for the treatment of enlarged prostates. Finasteride is the generic form of the drug Propecia while per patient is the more well-known and recognized name.
They do the same thing and provide the same overall benefits per patient is the most often prescribed medication for male pattern Baldness Finasteride helps to shrink enlarged prostates and in doing so helps to reduce the risk of acute urinary retention or the need for surgical procedures. When testing Finasteride researchers discovered that one of the interesting accidental side effects was that balding men began to regrow their hair.
And so it was six years later that Finasteride came onto the market as a drug that can reverse hair loss. Finasteride is often described as a DHT blocker, but it doesn't actually block DHT. It blocks the enzyme five alpha reductase.
This enzyme is responsible for converting testosterone to DHT. So let's have a really quick recap on what DHT actually is also, don't forget to pick up your free e-book everything you need to know about blocking DHT from eight radio X The Beck includes a recipe for a homemade scalp experience and the best foods and drinks that help to block DHT and regrow your hair. The link is in the description below.
DHT stands for dihydrotestosterone. It's a hormone produced in the skin liver and testes. DHT is present in both men and women, but DHT related hair loss, otherwise known as Andro genic, alopecia, or pattern baldness affects much more men than women. By the age of 35, two thirds of American men will experience some degree of appreciable hair loss. When flowing around your bloodstream, DHT attaches itself to genetically susceptible hair follicles and shrinks them.

This is called miniaturization. It gradually kills the hair follicle so that hair can no longer grow their Finasteride acts as a specific inhibitor of type two, five alpha reductase treatment with Finasteride may have some effect on type one, five alpha reductase, which is predominantly expressed in sebaceous glands of most regions of skin, including the scalp and the liver lowering the body's levels of DHT may correct hair loss, but problems arise because the sex hormone is also important for maintaining the structural integrity of nerves, smooth muscle connective tissue and signaling pathways in the penis. Finasteride has been around for almost 30 years. Extensive testing has been done on this drug, and it's largely considered safe and effective in treating hair loss. But one in 20 men who take Finasteride, there are going to be some long-term and potentially permanent side effects. The most common of which include impotence loss of interest in sex trouble. Having an orgasm, abnormal ejaculation, swelling in your hands or feet, swelling or tenderness in your breasts, dizziness, weakness, feeling like you might pass out, headache, runny nose or skin rash.
In some men, Finasteride may decrease the amount of semen released during sex. This is a harmless side effect, but tasks continued in some men, even after they've stopped taking Finasteride. This may become more of a concern for you. If you want to start a family, if this happens to you, it's important to tell your doctor immediately, if the side effects get worse or possessed, it's also important to tell your doctor if you experience any of the serious side effects, including nipple discharge, breast tenderness, a lump in the breast, breast, enlargement pain in the testicles, or inability to urinate and allergic reaction, isn't likely, but it does require immediate attention. The symptoms of a serious allergic reaction include itching or swelling, especially in the face throat or rash, trouble breathing and severe dizziness.

The sexual side effects of Propecia may continue after you stop taking it. It's always important to speak to your doctor before you start taking Finasteride for alopecia may also decrease in blood prostate specific antigen or PSA levels and can affect the PSA bloods test. It's extremely important that any pregnant women do not handle the Finasteride tablet studies show that Finasteride can cause birth defects in particular in male fetuses. It can cause a birth defect that affects the development of male genitalia and our stride should also not be handled by any breastfeeding women per patient is available in the strength of one milligram tablets.
The recommended dose is one tablet taken daily, and apparently President Trump has taken for Propecia for many years. In general daily use for three months is necessary before hair growth is observed before using Propecia. Also be mindful to tell your doctor about your medical history, especially of prostate cancer, liver disease infections, and urinary problems. The vast majority of men who do experience side effects notice that the side effects stop.
Once they stop taking the medication. I also feel it's important to reiterate that these side effects are in fact, In this study, in the author's opinion, The most informative trials specifically analyzing the effect of Finasteride and sexual functioning was the prostate cancer prevention trial. This was a randomized double blind placebo controlled study that was able to evaluate sexual dysfunction and any possible confounding variables. In 17,313 participants. Over seven years, they utilized a sexual activity scale ranging from zero to a hundred with higher numbers, demonstrating greater sexual dysfunction. The scale evaluated the ability to have an erection, the degree of sexual satisfaction, any change in sexual performance and frequency of sexual activities. So at whatever level the participants set their own personal level of sexual dysfunction between zero to a hundred for such has found that Finasteride increased this level of dysfunction by around 3.2, 1% at six months of usage. And this decreased to 2.1, 1% after seven years of usage, interestingly research has found that other health factors also lead to a similar level of sexual dysfunction

in participants. These include increased body mass index, diabetes, hypertension, smoking, and declining physical function. Also age worse than sexual dysfunction with an increase of 1.26 points per year.
Interestingly, the mental health score did not significantly affect sexual dysfunction over time. None of the 17,313 participants reported persistent sexual dysfunction.

The authors concluded that the effect of Finasteride on sexual functioning was minimal and that it should not interfere with prescribing practices. However, there have been reports that are very small. Number of men continue to experience side effects after they stopped taking the medication. It's also important to remember that the area of research into the side effects Finasteride is still ongoing. Another one of the questions that we've been asked on Instagram is it, should I worry about all the reports about Finasteride in April, 2012, the FDA issued a warning on the side effects of Finasteride. It stated that sexual side effects could persist even after stopping the medication.
The side effects include decreased sex drive and ejaculation problems. Propecia use has also been associated with several ejaculators disorders, ejaculatory disorders range from premature or rapid accolation relation to delayed ejaculation to complete inability to ejaculate a 2002 review of randomized Finasteride trials found more men who took the drug reported ejaculation disorders than men who took a placebo.


The research article in BMC urology looked at five double blind placebo controlled trials, lasting 12 months. The authors calculated the relative risk for a Jack culation disorders was three points, 6% for men taking Finasteride ejaculate disorders associated with Propecia also include retrograde ejaculation. When semen goes backwards into the bladder rather than forwards out of the penis ejaculation failure decreases in semen volume.

The FDA warning was based on around a hundred reports that the FDA received over 20 years. This is also not proof that Finasteride was to blame since a variety of medical conditions, including body mass index and diabetes or prescription drugs could explain the sexual symptoms that the men reported while taking Finasteride irreversible sexual side effects from Finasteride are relatively rare.

Since millions of men have taken these medications during the time period surveyed 2017, a Northwestern medicine study found that out of 11,909 men who took Finasteride Audi task, 1.4% developed persistent erectile dysfunction. That continued for an average of about 1,350 days after stopping treatment. According to the study, there seems to be a correlation between how long you're taking the drug for, and the likelihood of experiencing persistent erectile dysfunction, young men who had more than 205 days of exposure to the drug had nearly five times higher risks of persistent erectile dysfunction than men with shorter exposure. In other well-conducted research trials, sexual side effects occurred in about 4% to 6% of men.
And these effects were usually reversible, but there still have been some attention grabbing headlines, which have really put people off taking Finasteride
In some men. This story is based on two new sources. The first is a U S TV interview with this person, Kevin Malley. He claimed his genitals shrunk after taking Finasteride.

The second more verifiable source is a study that found that Finasteride could cause persistent loss of libido and erectile dysfunction. There are a number of significant issues with both sources, primarily that doesn't seem to be any independent background evidence supporting the claims held by Kevin Malley.
And the second study included only a relatively small sample of men. 54 men were interviewed and 44 were later re-interviewed to see if their symptoms had persisted. All of the people who'd been recruited into the study were experiencing persistent sexual problems, and they were found via a website that was set up by men who claimed that Finasteride had caused them sexual side effects. This might not necessarily reflect the experiences of all men who take Finasteride.
The study also fails to show the proportion of men using Finasteride against the proportion of men who are experiencing side effects. And from those men, how many of those are experiencing permanent side effects So where did the study come from A single author from the George Washington university in the U S conducted this study. And from what I can tell, it's really difficult to see who funded this study. And so it's not clear whether there could be any kind of potential conflict of interest that's what's can be agreed upon is this comment by Dr. Airwick who said that roughly 5% of men who take this medicine will experience sexual side effects. And if those it's hard to tell how many will experience persistent problems, we know that there is a potential problem, but we can't quantify what the exact risk is. I can't tell a man if he has a one in a hundred chance or a one in a thousand chance of developing persistent sexual dysfunction, but it's pretty clear that there's a relationship here.
He says, so how can you avoid the side effects of Finasteride There has been some discussion online that it's not necessary to take one milligram of Propecia per day, Dr. Vikrum J appro cash and Dr. Russell Knutsen point out that Finasteride can stay in the skin for up to 30 days. And they advise to take it three times per week, which is enough to mop up five alpha reductase without causing any permanent or long-term side effects.

If you do experience side effects, it's likely that your doctor will lower your dosage or stop you from taking Finasteride altogether. So before I close off, I just want to highlight again that the side effects of Finasteride are relatively low. So around 5% of men will experience short term side effects, but they'll gently ease once you stop taking Finasteride. It's important to remember that Finasteride can stay in the body for up to 30 days. So each tablet stays in the skin and the scalp for around 30 days, and you build up a level of Finasteride in the body. So if, for example, you've been taking Finasteride for three months and then start to develop side effects. It could take another three months for the Finasteride to really drain out of your system. It may take much longer or less time, but it's really important to speak to your doctor. Once you start to experience the side effects of Finasteride.
According to a 1992 report in the New England journal of medicine research has found a higher incidence of impotence ejaculate carry disorders and decreased libido in Finasteride users. When compared with men who took a placebo, this study was published just four months after the FDA approved Finasteride under the brand name PRASCA to treat enlarged prostates.

These side effects. Weren't given much thought because the men who are participating in the studies already were experiencing enlarged prostates. And so they were more prone to underlying sexual dysfunction. But when Merck introduced Propecia in 1997 to younger men who were much less likely to experience sexual dysfunction, when they began Finasteride, the concern of potential sexual side effects grew
following the early drug trials, both Merck and the FDA assured men that the sexual complications were to resolve once they stopped taking the drug.
But later evidence would on the contrary, the pre-approval trials were not especially reliable. As the information was drawn from a relatively small patient group treated for only six months to one year and follow up procedures were unclear, more recent investigations show that the drugs' sexual side effects can persist after a man stops taking the drug. Although it's unclear out of the 5% of people experiencing side effects, how many people will face permanent side effects at July, 2015 study and pharmacology also found increased risk of suicidal thoughts among men taking the medication in this study.
Research has relied on adverse events reported to the FDA. They looked at reports filed between 1998 and 2013. Researchers looked for men who used low doses of Finasteride and reported both sexual dysfunction and suicidal ideation, 910 reports. They found 577 patients who reported persistent sexual side effects and 39 men who reported suicidal thoughts of the 39 who reported suicidal thoughts, 87.2% also reported sexual dysfunction.
Six of the sexual dysfunction reports included patients' deaths.
There are more than 1,100 lawsuits filed against the United States, accusing Merck of not adequately warning patients of the drug's possible side effects and their duration in this investigation by Reuters because of filing errors in a federal court case, a Reuters reporter was able to view material that lawyers for Merck, the manufacturers of Propecia had intended to keep confidential. They accused Merck of exaggerating the drugs safety record citing internal company communications. These legal briefs filed by plaintiff's lawyers alleged the in revisions to the drugs, original 1997 label, MK understated the number of men who experienced sexual symptoms in clinical trials and how long those symptoms lasted.
Other documents show that Mark knew roughly 20 years ago that sales of the drug would suffer. If the public became aware of propitious possible long-term effects on men's sexual health, a redacted section of one plaintiff's motion reviewed by Reuters sites, correspondence from a Merck executive in which he objected to what he described as misleading information about the incidents of sexual dysfunction in men taking Propecia, that information was placed on the drug's label, despite his comments, the court said, and it's remains there today.
I'm putting a link in the description to it. It's extremely distressing. And it also comes from the perspective of the widow of the person who away after taking Finasteride, who developed suicidal thoughts and depression, if you or anyone, you know, is experiencing post Finasteride syndrome is also a Twitter page. And you can find it using the hashtag me too Propecia. So I've listed some support websites for anyone that you think might find it very useful. There's lots of helpful information and communities of people out there that have been directly affected by the side effects of Finasteride, including the families and friends of people who have been taking Finasteride. I hope you find this video useful. It's quite serious, and it's a little bit different from most of the other videos that we make, which are a little bit less serious in general for, from all of the data out there.

It looks as if the side effects of Finasteride are relatively rare. Around four to 6% of people will experience side effects. Most of these are reversible, but it's a smaller proportion of people who experience permanent or long-term side effects from the data out there. It's very difficult to judge how many of the 5% will go on to experience permanent side effects. So it's really important to bear this in mind when finding out more about Finasteride and speaking to your hair care doctor, important to reiterate that when you speak to hair loss specialists, it's important to ask them about the rate of reported side effects that their patients experience. And then you can start to compare this among the various hair loss specialists that you speak to. I think that's probably a really good rule of thumb going forward. If you're interested in taking Finasteride stopping treatment can lead to a reversal of the head that's grown within the last 12 months, Propecia can also interact with other drugs.

So don't forget to tell your doctor about the medications and supplements that you're using. I hope you find this video useful. Feel free to reach out to us on Instagram. If you have any questions we're at it really works vitamins, and also feel free to check us out.

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