Finasteride for hair loss, side effects include impotence or erectile dysfuntion, use for prostate enlargement, 1 mg and 5 mg.
How to reverse the adverse sexual effects with alternative or natural treatments
April 22 2017 by Ray Sahelian, M.D.
The development and introduction in clinical practice of finasteride, the first potent inhibitor of steroid 5-alpha-reductase, has created the possibility to prevent and treat prostate enlargement disorder by manipulating and lowering the androgens levels in the prostate gland.
Finasteride is also an orally administered drug approved for male-patterned baldness manufactured by Merck, Inc. It helps regrow hair in many men. In the United States it is sold as Propecia and other trade names. Topical forms have shown benefit for hair growth in initial studies. The combination of topical minoxidil and finasteride as a hair lotion is more effective than minoxidil alone. This antiandrogen inhibits type II 5-alpha reductase, an enzyme that converts testosterone to a more potent form dihydrotestosterone.
Finasteride side effects, safety, risk, danger
Some finasteride side effects that have been reported include decrease in libido, loss of sensation, impotence or ED, low sperm count, and a decrease in general vitality. These occur gradually and in a subtle manner, and many men do not realize it is occurring and forget how they felt before they started finasteride treatment for hair loss or prostate enlargement. Some men feel that life is not as exciting as it used to be and others may even experience low mood or depression. Another adverse reaction may be an increase in abdominal fat (increase in size of the belly). Many men on these medications have less of an urge to drink alcohol perhaps interfering with the making in the brain of neurosteroids.
Users report that its side effects — inability to orgasm, painful erections, chronic depression, insomnia, brain fog, and suicidal thoughts — can last long after patients stop taking the pill.
Curr Opin Endocrinol Diabetes Obes. 2015. Safety concerns regarding 5α reductase inhibitors for the treatment of androgenetic alopecia. To examine the clinical and basic studies regarding persistent adverse effects associated with 5α reductase inhibitor treatment for androgenetic alopecia. Recent postmarketing reports and a US Food and Drug Administration analysis have documented uncommon persistent sexual and nonsexual side-effects in a subset of younger men who have taken finasteride 1 mg for androgenic alopecia. While the mechanisms of the sexual side-effects in humans is incompletely understood, one study found lower cerebrospinal fluid concentrations of dihydrotestosterone, progesterone, dihydroprogesterone and allopregnanolone, and higher levels of testosterone, 5α-androstane-3α,17β-diol and pregnenolone. Another study found up-regulation of the androgen receptor in the human foreskin with a mean of 5 years after finasteride discontinuation. Studies of erectile dysfunction in finasteride-treated rats showed fewer autophagosomes in smooth muscle on transmission electron microscopy, increased apoptosis, decreased smooth muscle, increased collagen deposition and decreased endothelial nitric oxide synthase. Finally, 5α reductase inhibitors have also been found to alter semen parameters in healthy men. Multiple animal studies provide a biological basis for many of the persistent effects seen in humans such as erectile dysfunction, depression and decreased alcohol consumption. Prescribers of 5α reductase inhibitors should discuss the potential risks with their patients seeking treatment for androgenetic alopecia.
Erectile dysfunction, impotence, loss of libido or sex drive
Some people find that the libido reducing effects from short term use are reversed within several weeks after stopping the medication. Some individuals like to reverse it quicker with the use of certain libido boosting herbal products, for instance Passion Rx or other natural aphrodisiac herbs. In most men who develop persistent sexual side effects longer than 3 months despite the discontinuation of finasteride, the sexual dysfunction continues for many months or years.
Men with the most common form of baldness who take this drug are more likely to experience an increase in hair count, and say they believe their hair is thicker. But some also experience erectile dysfunction or impotence.
Horm Mol Biol Clin Investig. 2015. Finasteride, not tamsulosin, increases severity of erectile dysfunction and decreases testosterone levels in men with benign prostatic hyperplasia.
Am J Mens Health. 2014 . Persistent Sexual, Emotional, and Cognitive Impairment Post-Finasteride: A Survey of Men Reporting Symptoms. Finasteride is a synthetic 5-α reductase inhibitor, which prevents the conversion of testosterone to dihydrotestosterone and has been used for more than 20 years in the treatment of male pattern hair loss. Randomized, controlled trials have associated finasteride with both reversible and persistent adverse effects. In this pilot study, we sought to characterize sexual and nonsexual adverse effects that men reported experiencing at least 3 months after stopping the medication. Based on previous research on persistent side effects of finasteride, we constructed an Internet survey targeting six domains: physical symptoms, sexual libido, ejaculatory disorders, disorders of the penis and testes, cognitive symptoms, and psychological symptoms and was e-mailed to patients who reported experiencing symptoms of side effects of finasteride. Responses from 131 generally healthy men (mean age, 24 years) who had taken finasteride for male pattern hair loss was included in the analysis. The most notable finding was that adverse effects persisted in each of the domains, indicating the possible presence of a "post-finasteride syndrome."
Expert Opin Drug Saf. 2013. Effects of 5-alpha reductase inhibitors on erectile function, sexual desire and ejaculation. Treatment with 5-alpha reductase inhibitors (5ARI) is commonly utilized for the treatment of benign prostatic hyperplasia (BPH). The true prevalence of sexual side effects with 5ARI treatment is currently unknown. Clinical trials with 5ARI report decreased circulating dihydrotestosterone (DHT) associated with diminished sexual desire and/or orgasm. The presence of adverse sexual effects is associated with decreased self-esteem, quality of life and ability to maintain an intimate relationship.
Use of dutasteride (Avodart) and finasteride (Proscar and Propecia) were linked to erectile dysfunction, depression and loss of libido in a review of existing studies. In a small percentage of cases, symptoms persisted even after the medication is stopped. For those men, "it's a life sentence. No sex. No desire. Potential depression," said researcher Abdulmaged M. Traish, a professor of biochemistry and urology at Boston University School of Medicine.. Almost
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