Difficult choice: bald macho or hairy infertile impotent
Merck will make changes to the warnings indicated on the instructions for two drugs, the active ingredient of which is finasteride. According to a statement made on Thursday, March 12 by a representative of the US Food and Drug Administration (FDA), taking such drugs can lead to undesirable reactions from the reproductive system.
One of the drugs under discussion, propecia, is designed to combat androgenic baldness, while the other, proscar, is for the treatment of prostatic hyperplasia. One dose of propecia contains 1 mg, and one dose of proscar contains 5 mg of finasteride.
Baldness can be associated with endocrine disorders, but hair can also fall out in perfectly healthy people. Heredity plays an important role in this, which determines both the hormonal balance and the sensitivity of hair follicle cells to male hormones.
Finasteride has therefore been used for exactly 30 years, because the cessation of baldness and the restoration of hair growth is ensured by its antiandrogenic effect. Finasteride blocks the work of the enzyme 5-alpha-reductase, which is synthesized both in the "second heart of a man" – the prostate gland, and (well, so nature wanted) in the sebaceous glands and hair follicles. This enzyme converts testosterone circulating in the blood into a more active form – 5-alpha-dihydrotestosterone (DHT). Penetrating into the follicle cells, DHT disrupts protein synthesis and shortens the duration of the hair growth phase. The follicles gradually degrade, and the hair growing from them becomes short and thin and quickly falls out.
In addition to the antiandrogenic effect, taking finasteride can cause a decrease in blood pressure (it was developed as an antihypertensive drug, and hair growth was discovered by accident when taking it), heart pain and tachycardia. All this has been known for a long time, so changes in the instructions are not a sensation like "pills for baldness cause impotence," as it is written in the title of the message, which is retold here – VM.
According to the FDA statement, the new instructions for propecia will contain a warning about possible "libido disorders, as well as problems with erection and orgasm, continuing after discontinuation of the drug." At the same time, a warning will be added to the instructions for proscar about the likelihood of "a decrease in libido that does not stop after the drug is discontinued."
The instructions for the drugs will also contain a description of cases of male infertility and / or deterioration of sperm quality, the symptoms of which disappeared or improved after discontinuation of the drugs.
The representative of the agency noted that undesirable reactions from the reproductive system are manifested in a small number of men taking finasteride drugs. But, despite the fact that taking these drugs rarely leads to the described side effects, the FDA claims that individual cases recorded indicate the existence of a problem.
At the same time, the FDA believes that taking such medicines as prescribed is safe, but recommends that patients and attending physicians take into account new warnings when choosing optimal therapies.
Last year, the instructions for both drugs included a warning about the possible development of erectile dysfunction, which does not recover even after discontinuation of therapy. Experts believe that the latest additions are of exceptional importance, since propecia is often taken by young men aged 20-30 years for the treatment of premature baldness. It is obvious that for this age group, the issue of infertility is of exceptional importance.
More detailed information about finasteride can be found on the FDA website.
Evgenia Ryabtseva, Alexander Chubenko
Portal "Eternal youth" http://vechnayamolodost.ru based on Medical Xpress materials:
Baldness drug may cause sexual side effects: FDA.
13.04.2012