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Comment by bigtones | Hacker News Reader

It was solved a long time ago - just start taking 1mg of Propecia once a day as soon as you start to see the start of hair loss. Propecia will allow you to keep the hair you already have, well into your seventies - just ask Trump. There are even generics so it won't cost that much.

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Propecia caused some pretty serious hormonal changes in my friend which persisted after stopping. Its apparently a known problem but still not labeled correctly. You can find many support groups across the internet with sufferers.

Over the course of a few years taking Propecia, in my late 20s, I completely lost my sex drive.

When I started taking the drug, my doctor warned me of possible side effects. I figured I could just quit if that happened, and things would go back to normal. Eventually, they updated the labeling to say that side effects can persist indefinitely.

I’ve talked to men who have been on it for years without experiencing side effects. I cannot say for certain Propecia is the root cause to my symptoms, there’s really no way to know for sure, but I experienced a radical shift while on it. Taking a powerful but poorly-understood drug that rewires your sex hormones isn’t a decision to take lightly.

I've read that it's only a problem if men ignore the side-effects and continue taking the drug. Is this not true?

It's hard to separate from men who don't take the drug but have erectile dysfunction.

But it is a problem that propeciahelp.com trolls scourge the internet and preach how destructive propecia is.

I’m not trolling, I just saw the drug mentioned here and decided to talk about my experience. I was a healthy guy in my twenties, and my sex drive went from high to non-existent while I was on the drug. Like I said, I can’t be sure Propecia was to blame, but personally I believe there was a connection.

Anyway, if you take Propecia and don’t get side effects, that’s great! Nobody said all men will get side effects and nobody’s questioning your virility.

Oh apologies, I didn't direct that at you or anyone here. It's an known problem on several hair loss forums because male pattern baldness is a sensitive issue = trolling feeding ground. Mix this with self-image issues, depression, and even mental illness (some of the chronic trolls have this one), and you end up with one very vulnerable community. Yes, there are studies on this behavior in hair-loss forums.

I think it's like half of young males experience a period of erectile dysfunction in their life, it's certainly common. (go ask any urologist). With the 3% reported side effects on finesteride, I've read there are 0.7% of cases which are not resolved in itself with therapy (most studies don't get this far). If you can believe this, then there are at least 4 people here have claimed this happened to them. Where are the 12 people that were resolved? Is there even one?

Unless persons are skipping that second part in vivo, it could be fewer than 0.7% of users cannot be resolved on their own. Millions of people take the drug, and you don't find them near this topic for a reason. Not improbable, but where are those missing 2.3%?

I ended up deleting a few studies but it's mostly psychiatric issues, with some hormonal and testosterone problems. You can't convince people like that though but it's unfortunately true. The endocrine issues happen everywhere just like ED, that's why they test your bloodwork in advanced during your routine physical. You did say you are a healthy guy though.

I'm not the nicest guy, but I honestly don't mean to direct this at you. It's just a frequent topic, with an incredible amount of misinformation, and many anecdotes with common and often destructive themes.

I think it's one of the stranger phenomenon of the internet.

Nobody said all men will get side effects and nobody’s questioning your virility.

The problem is people implying that you may lose sex drive or the ability to get an erection for an indefinite period of time, essentially out of the blue. Hence why I asked if the ED and sex drive problems persist if one immediately stops the drug when the effects are first experienced.

I'm not sure how long after discovering the new issues my friend waited before stopping. He was only on it for less than a year, maybe even a half year, to put some constraints.

Well it's cutting by 60% the most powerful androgenic hormone in your body - of course there's going to be negative side effects. When it comes to hormones, any change has consequences. It's analogous to women's birth control.

Question: Are homeopathy forums the best place to go for homeopathy support?

Edit: That means yes.

In some men, propecia/finasteride caused erectile dysfunction. So I will never take this drug.

That's the nature of finasteride, it lowers DHT which is one of the most impactful hormones on libido. Unfortunately, it does not return to it's original levels after cessation either.

Dr. Justin Saya who is one of the best men's endo docs out there and has treated 10k+ cases of ED has suggested finasteride is a common cause of permanently lost libido and ED.

It works and can even allow you to regrow hair. However, your sex drive will take a nose dive. When you stop, things go back to normal, including the hair loss.

> When you stop, things go back to normal

Not always. Constant loss of sex drive has been reported to occur even after stopping the treatment, and it's part of the drug label these days.

It does have some nasty side effects though..

No, this is absolutely false. Provide me a valid study.

Any one of the persons here claiming finesteride has these side effects, I need a study supporting this.

Here you go. It's in the label of the drugs these days.

https://www.aafp.org/news/health-of-the-public/20120418finas...

Worth noting that this article does explicitly denounce the existence of a causal link being supported by science.

You would need to do explicit clinical trials to look exactly at that kind of adverse events to prove the link. Nobody is going to do that.

The FDA also uses black-box warnings for antidepressants. It's an association closely tied to a high risk population.

Downvote all you want, but this is a classic case of a nocebo.

"the group informed about the sexual adverse effects of finasteride reported increased incidence of ED, when compared to the group without information"

Ironically, all the fear mongering has made the issue worse.

"To date, there is no evidence-based data substantiating the link between finasteride and persistent sexual side effects in the numerous double blinded, placebo controlled studies using finasteride 1 mg for hairloss."

https://en.wikipedia.org/wiki/Nocebo https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3481923/

This is the UK NHS take on it: http://www.nhs.uk/news/medication/hair-loss-drugs-linked-wit...

Personal experience: no major side effects

DHT is not the most important (androgen) hormone after puberty

That's an odd statement. What is the most important hormone?

Testosterone

https://en.wikipedia.org/wiki/Dihydrotestosterone#Biological...

(though there is some margin for discussion, see the last paragraph of that section)

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