Baldness, Prostate Drugs May Cause Persistent Erectile Dysfunction

Erectile dysfunction is a known side effect of <"">Propecia, <"">Proscar, <"">Avodart or <"">Jalyn. But recent research out of Boston University indicates that in some cases, sexual dysfunction linked to these drugs could be irreversible,

Propecia and Proscar (finasteride), Avodart (dutasteride) and Jalyn (dutasteride and tamsulosin) are known as <"">5-alpha reductase inhibitors (5-ARIs). Propecia is used to treat male pattern baldness, while Proscar, Avodart and Jalyn are used to treat enlarged prostate. All of these drugs work by blocking androgen, which is needed for normal male sexual function.

For their study published last March in the Journal of Sexual Medicine, the team from Boston University reviewed the available medical literature for reports of sexual side effects associated with 5-ARIs. About 8 percent of men taking the drugs reported erectile dysfunction (compared with 4 percent taking placebo), and 4.2 percent reported reduced libido (compared to 1. 8 percent in the placebo group). Other men taking the drugs reported reduced ejaculation and semen volume and depression.

In a small number of cases, symptoms persisted even after the medications were stopped, the researchers said.

“Extreme caution should be exercised prior to prescribing 5A-RIs therapy to patients for hair growth or for BPH symptoms,” the authors write. “In some patients, these adverse effects are persistent and may be prolonged and patients do not recover well after discontinuation from drug use.”

Recently, a number of men who claim to have developed erectile dysfunction while using Propecia have filed suit against Merck & Co., the maker of that drug. According to a Propecia erectile dysfunction lawsuit filed this past April in federal court in New Jersey, Merck changed label warnings for the drug in Sweden, Italy and the United Kingdom to include “persistence of erectile dysfunction after discontinuation of treatment” as a possible side effect. These label changes occurred after the Swedish Medical Products Agency began “investigating reports of persistent sexual dysfunction side effects which continue in men despite discontinuing finasteride” in 2006. But Merck revised the U.S. Propecia product monograph in 2010 without including an “updated warning regarding the persistence of sexual dysfunction,” the lawsuit claims.

The plaintiffs say they would not have taken the drug had they been warned of the possible side effects, and charged Merck with negligence, failure to provide adequate warnings and breach of warranty.

“I am just totally against finesteride. I have had so many patients that have come to me where that medication has destroyed their life,” said John Crisler, a physician at a men’s health clinic in Michigan, who is quoted in the complaint. “[T]hey become depressed, weak, important and the problem is when they go off the drug their symptoms remain.”

Sexual dysfunction is not the only side affect associated with 5-ARIs like Propecia. Earlier this summer, the U.S. Food & Drug Administration (FDA) warned that the drugs had been linked to a higher risk of high-grade prostate cancer. Such drugs may also increase the risk that users will develop male breast cancer.

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