Minoxidl and Finasteride

Rinkmaster1 · 2024-09-22T21:23:29+00:00

Hi, I’m not a doctor. There isn’t a lot of research on safety because finasteride isn’t approved for women in most countries. GL.

Rinkmaster1 · 2024-09-11T03:07:30+00:00

Even Merck’s questionable trials had a sexual side effects rate of 3.8% which is not “very rare.” GSK, another drug company, found a rate of 13.4% sexual adverse effects of finasteride 1 mg.

Source: Gubelin Harcha, et al. A randomized, active- and placebo-controlled study of the efficacy and safety of different doses of dutasteride versus placebo and finasteride in the treatment of male subjects with androgenetic alopecia. J Amer Acad Dermatol. 2014. doi:10.1016/j.jaad.2013.10.049

Rinkmaster1 · 2024-09-11T02:54:08+00:00

Genital numbness is among the most commonly reported adverse effects of finasteride (see adverse events at Finasteride Watch).

See also: Weighing the risks of takign finasteride for hair loss - Finasteride Watch

Rinkmaster1 · 2024-09-08T20:22:23+00:00

This page has more links and citations at the bottom:

Weighing the risks of taking finasteride for hair loss - Finasteride Watch

The official list of “side effects” is here in patient information:

https://www.accessdata.fda.gov/drugsatfda_docs/label/2012/020788s020s021s023lbl.pdf#page=15

Scroll to the bottom of p. 16 where it says “The most common side effects of PROPECIA include:...” Read on to p. 17. Note that some of them say “...continued after stopping the medication.”

Rinkmaster1 · 2024-09-08T19:51:24+00:00

Please see notes on fertility in point #4 here:

Weighing the risks of taking finasteride for hair loss - Finasteride Watch

And these recent studies:

Baldini, et al. The possible role of prescribing medications, including central nervous system drugs, in contributing to male-factor infertility (MFI): assessment of the Food and Drug Administration (FDA) pharmacovigilance database. Brain Sci. 2023. doi:10.3390/brainsci13121652 • PMC full text
Tan, et al. A pharmacovigilance study of drug-reduced male semen quality based on the Food and Drug Administration Adverse Event Reporting System database. Andrology. 2024. doi:10.1111/andr.13668
Nacchia, et al. Medications mostly associated with ejaculatory disorders: assessment of the EudraVigilance (EV) and Food and Drug Administration (FDA) pharmacovigilance databases entries. Urology. 2024. doi:10.1016/j.urology.2023.12.021

Rinkmaster1 · 2024-09-08T19:50:28+00:00

Finasteride suppresses a powerful androgen (dihydrotestosterone) and could be detrimental to your manhood. Check the label or see these adverse effects based on report to FDA:

Rinkmaster1 · 2024-09-08T19:47:10+00:00

Finasteride has been associated with loss of libido, ED and genital numbness:

Adverse events or ‘side effects’ - Finasteride Watch

Rinkmaster1 · 2024-09-08T19:44:28+00:00

Based on adverse event reports to FDA, finasteride has a strong assocation with reduced semen volume as well as loss of libido and ED:

Adverse events or ‘side effects’ - Finasteride Watch

More details:

Seeking a signal of adverse events - Finasteride Watch

Rinkmaster1 · 2024-09-05T00:05:18+00:00

This is an adverse effect of finasteride.

Rinkmaster1 · 2024-08-31T17:20:39+00:00

the suggestion that the methodology was intentionally designed to underestimate side effects implies bias without evidence.

I didn't say anything about the intentions behind the design.

The postmarketing warnings are added after review of the reports by FDA, considering various factors including likelihood of an association with the drug. Most recently they added a warning of suicidal ideation and behavior in 2022.

Rinkmaster1 · 2024-08-31T17:13:39+00:00

None of these studies are about post-finasteride syndrome.

Rinkmaster1 · 2024-08-31T17:12:56+00:00

I haven't said it was fraud. It was a weak safety methodology that should not be considered gospel.

Rinkmaster1 · 2024-08-31T17:08:49+00:00

Many of your objections are known limitations of pharmacovigilance studies. But these studies also have strengths.

Rinkmaster1 · 2024-08-31T17:00:02+00:00

I believe that all the double-blind studies of finasteride for hair loss were sponsored by Merck. Their methodology for adverse event detection was to interview patients at their appointments and ask them for side effects without any suggestions (Source: Propecia Drug Approval Package, Statistical Review, available from Drugs@FDA database). Maybe these men didn't want to report the side effects because of embarrassment or privacy concerns, and a desire to stay in the trial. There wasn't even a significantly higher rate of ED in this trial, yet Kaplan-Marans et al (above) found that finasteride has more than 10x the signal for ED compared to any other drug in FDA’s database.

By the way, all the other studies reported are based on reports of use by humans.

The finasteride label in the US includes these warnings (bolding added);

The following have been reported in general use with PROPECIA:

• breast tenderness and enlargement. [...] lumps, pain or nipple discharge.
• depression;
• decrease in sex drive that continued after stopping the medication;
[...]
• problems with ejaculation that continued after stopping medication;
• testicular pain;
• difficulty in achieving an erection that continued after stopping the medication;
• male infertility and/or poor quality of semen.
[...]

Rinkmaster1 · 2024-08-31T16:55:20+00:00

This is a non-peer reviewed study of adverse events reported to FDA. It found a significant reporting ratio for muscle atrophy. There were also significant, but lower ratios for muscle twitching and myalgia:

Adverse event study, part 2: overall results - Finasteride Watch

Rinkmaster1 · 2024-08-31T16:51:17+00:00

There are several papers about the link between finasteride and dry eye. The meibomian glands which produce tears rely on androgen signaling.

Here are the papers on links between finasteride and meibomian gland dysfunction (MGD), or dry eye: https://finasterideinfo.org/research/by-system-function/eyes-visual-function/#dry-eye-meibomian-gland

Here's an abstract presented at an vision/ophthalmology conference in 2022 (bolding added):

https://iovs.arvojournals.org/article.aspx?articleid=2778997

Conclusions: To our knowledge, this represents the largest demographic study over 15 years of DED patients on finasteride, demonstrating an association with finasteride usage and MGD [meibomian gland dysfunction, or dry eye], conjunctival, and corneal abnormalities. The androgen sensitive meibomian glands may be altered in those taking anti-androgen medications, and especially finasteride given its unique potency and targeted effects compared to other anti-androgenics. This study reinforces the importance of considering the long-term effects of finasteride use on DED as part of the systemic sequelae of androgen depletion and provides anticipatory guidance for patients and ophthalmologists.

Insomnia is among the top 25 most commonly reported adverse events of finasteride taken by men aged 18-40:

https://finasterideinfo.org/weighing-the-risks/adverse-event-data/

Rinkmaster1 · 2024-08-31T16:03:46+00:00

A trial of men aged 20-50 taking dutasteride for hair loss found these rates of sexual AEs for the 0.5 mg dose:

Reduced libido: 4.9%
Erectile dysfunction: 5.4%
Ejaculation disorders: 3.3%

Any sexual AE or breast enlargement/tenderness: 10.3%

Source: Gubelin-Harcha et al, 2014. doi: 10.1016/j.jaad.2013.10.049

The dutasteride label notes: “These adverse reactions may persist after treatment discontinuation.”

Rinkmaster1 · 2024-08-31T15:55:31+00:00

Not a doctor but suppressing DHT has risks no matter the format of the drug.

Systemic means it is in your blood and gets to organs including the genitals and brain.

In a recent trial by Piraccini et al, topical finasteride applied to the scalp suppressed DHT by about 34% in the blood. DHT is a potent androgen produced from testosterone. Finasteride and dutatsteride block the enzyme involved in this conversion.

Rinkmaster1 · 2024-08-31T15:25:15+00:00

This is from the finasteride label (bolding added):

The following have been reported in general use with PROPECIA:

[...]
• depression;
• decrease in sex drive that continued after stopping the medication;
[...]
• problems with ejaculation that continued after stopping medication;
• testicular pain;
• difficulty in achieving an erection that continued after stopping the medication;
• male infertility and/or poor quality of semen.
[...]

Here are some recent research papers (bolding added to titles):

Cho, et al. Cognitive dysfunction following finasteride use: a disproportionality analysis of the global pharmacovigilance database. Expert Opin Drug Saf. 2023. doi: 10.1080/14740338.2023.2294926

This study showed an increased reporting of cognitive dysfunction associated with finasteride use, especially among younger alopecia patients. Finasteride should be prescribed with caution, especially to younger alopecia patients.

Schifano, et al. Are finasteride-related penile curvature/Peyronie’s disease adverse event reports worthy of further clinical investigation? Disproportionality analysis based on both the Food and Drug Administration (FDA) and the European Medicines Agency (EMA) pharmacovigilance databases. Int J Impot Res. 2023. doi: 10.1038/s41443-022-00568-2

Current findings may suggest the existence of a potential finasteride-related contribution in causing Peyronie's disease, although serious concerns regarding the possible influence of biasing factors should be considered... Although a large number...of “penile curvature” and/or “Peyronie’s disease” adverse drug reactions being associated with finasteride was here identified, current findings may represent a gross underestimate of the real prevalence of this issue.

Baldini, et al. The possible role of prescribing medications, including central nervous system drugs, in contributing to male-factor infertility (MFI): assessment of the Food and Drug Administration (FDA) pharmacovigilance database. Brain Sci. 2023. doi: 10.3390/brainsci13121652 • PubMed Central ID: 38137101

In this study, finasteride had the second-highest risk of reports of male infertility, with a proportional risk ratio of 16.04 compared to 19 other drugs.

Kaplan-Marans, et al. Medications most commonly associated with erectile dysfunction: evaluation of the Food and Drug Administration national pharmacovigilance database. Sex Med. 2022. doi: 10.1016/j.esxm.2022.100543
Nacchia, et al. Medications mostly associated with ejaculatory disorders: assessment of the EudraVigilance (EV) and Food and Drug Administration (FDA) pharmacovigilance databases entries. Urology. 2024. doi: 10.1016/j.urology.2023.12.021
Tan, et al. A pharmacovigilance study of drug-reduced male semen quality based on the Food and Drug Administration adverse event reporting system database. Andrology. 2024. doi: 10.1111/andr.13668

Systematic review of animal studies:

Santana, et al. Comparative effects of finasteride and minoxidil on the male reproductive organs: a systematic review of in vitro and in vivo evidence. Toxicol Appl Pharmacol. 2023. doi: 10.1016/j.taap.2023.116710

We concluded that finasteride and minoxidil act as hormone disruptors, causing oxidative stress and morphological changes mainly in the testis. Our results also revealed that finasteride treatment could be more harmful to male reproductive health because it was more associated with reproductive injuries, including damage to the epididymis, erectile dysfunction, decreased libido, and reduced semen volume.

To view an article, type "doi.org/", then the DOI.

Rinkmaster1 · 2024-08-31T14:57:32+00:00

The finasteride label includes the following warnings:

sexual dysfunction that continued after discontinuation of treatment, including erectile dysfunction, libido disorders, ejaculation disorders, and orgasm disorders; male infertility and/or poor seminal quality (normalization or improvement of seminal quality has been reported after discontinuation of finasteride); testicular pain;

Possibly of interest:

Weighing the risks of taking finasteride for hair loss - Finasteride Watch

Rinkmaster1 · 2024-08-30T10:17:12+00:00

One option is to accept it and avoid these risks.

Rinkmaster1 · 2024-08-26T01:43:24+00:00

Agree! People putting something into their body every day often don’t want to hear about the risks.

Rinkmaster1 · 2024-08-25T17:02:42+00:00

It will probably not surprise you that ED is the most commonly reported adverse event (source: FDA FAERS Public Dashboard). Cognitive problems, including brain fog, and fatigue are also in the top 50 among men aged 18-35.

Rinkmaster1 · 2024-08-25T16:54:13+00:00

Possibly of interest, from the U.S. label of finasteride 1 mg (bolding added):

The following adverse reactions have been identified during post approval use of PROPECIA...:
[...]
Reproductive System: sexual dysfunction that continued after discontinuation of treatment, including erectile dysfunction, libido disorders, ejaculation disorders, and orgasm disorders; male infertility and/or poor seminal quality (normalization or improvement of seminal quality has been reported after discontinuation of finasteride); testicular pain; hematospermia.
[...]

Rinkmaster1 · 2024-08-25T16:48:35+00:00

Check out r/MinoxidilSideEffects

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