Propecia is a common hair loss medication containing the drug finasteride, but it’s success may come with a price. Merck, the pharmaceutical company which developed finasteride, has been accused of downplaying some scary side effects. The company has also claimed these negative effects would be reversed after ceasing to use the medication, something that’s turned out not to be the case for everyone.
What Merck Didn’t Want You to Know
In 2015, researchers published a study revealing that using finasteride triples the risk of becoming impotent, even if on low doses. Finasteride also increases the likelihood of needing prescriptions for sexual-performance medications by almost fivefold. Some of Propecia’s side effects include erectile dysfunction, ejaculation disorders, swelling of the hands and feet, skin rashes and dizziness. But it can also affect the user’s mental state, causing depression and suicidal thoughts.
Merck has been the target of some 1,400 lawsuits—some of which were presented in court during the fall of 2016. A New York judge selected the most outstanding of those cases to represent the larger group. According to the World Health Organization, another 69 men have committed suicide as a consequence of using the drug. So it seems this medication could not only render you impotent but also make you want to end your life. While it’s true that these side-effects don’t happen to the majority of users—are the risks worth it?
Propecia Side Effects—the Study
Scientists aren’t completely sure how Propecia side effects arise but they have something to do with the enzyme type II 5-alpha reductase. This enzyme converts testosterone into its most active form, dihydrotestosterone (DHT).
DHT is a strong contributing factor to male pattern baldness and also can lead to enlargement of the prostate. Finasteride works by diminishing DHT levels in the body. At first the drug was only used as a treatment for prostate cancer until it was discovered that it also had a positive effect on patients’ hair growth, Propecia was developed and marketed specifically for that purpose.
However, some men experience severe side effects. In a 2015 study of 4900 men taking finasteride, 577 of them reported persistent sexual dysfunction. Thirty-nine experienced suicidal tendencies.
According to new research, mental changes while taking Propecia are a result of the decrease in the production of DHT, which disrupts the production of other hormones in the brain. According to New York neuroendocrinologist Alan Jacobs, the drug can lead to hormones like cortisol and progesterone turning into “neurosteroids” which have important behavioral purposes. This could lead the brain to exacerbate sexual problems and cause the user to become depressed or suicidal.
As early as 2012, patients began reporting serious side effects from Propecia. That lead Merck to finally start including on the label that “in some cases” the sexual side effects “continued after discontinuation of treatment.” The company also added depression as a potential side effect on the label. Interestingly, by this time, Propecia labels had already been changed in Sweden and some other European countries. Patients there started reporting persistent side effects as early as 2008. But for U.S. male patients, Merck waited until the FDA had received 421 reports of sexual dysfunction before they updated their labels.
What’s in store for Merck and Propecia use as a result of these lawsuits is yet to be seen. Ted Laszlo, one of the attorneys representing the plaintiffs, thinks the possibility that Propecia will be discontinued is low. The plaintiffs are only seeking monetary damages and he believes their case is strong.
“Merck introduced a drug that they knew could cause sexual dysfunction in users, and they soon learned that in some users the symptoms did not resolve,” he says in an interview in Vice. “With that knowledge, they continued to market the drug for years saying that if you stopped using it, the symptoms would go away. They hid their knowledge.”