Propecia—Sex Drive and Stem Cells

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I’ll never forget the first time I met Propecia the drug. We were culture expanding the stem cells for an otherwise very active and healthy middle-aged guy, and his cells failed to grow well. In fact, we could barely limp them along. Eventually, it turned out to be due to the drug Propecia, which was turning him into a chemical eunuch in exchange for allowing him to keep a few more strands of hair. Now, a new lawsuit is coming that claims that the drug’s maker knew there were serious issues with it years before they informed US consumers.

Propecia the Sex-Drive Robber

The chemical name of this drug is finasteride. It was designed to inhibit an enzyme that converts testosterone into its active form. Given that hair loss can be caused by too much testosterone, the drug can reduce hair loss. The problem seems to be that by blocking this enzyme, it also reduces the conversion of other key hormones involved in the brain and mood. It also tanks normal testosterone levels, turning the patient into a chemical eunuch.

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My First Direct Experience with the Drug

Many years ago, we had a patient who was the epitome of a middle-aged and highly active guy. He was the exact picture of what I would consider optimized stem cell health. However, as we were culture expanding his cells, they weren’t proliferating well; in fact, we were barely able to get them to grow. I knew from experience that medications could impact cells, but he was only on Propecia. Not being in the hair-loss field, I had barely heard of the drug, but when I looked up how it worked, I was dumbfounded. The drug’s purpose was to tank testosterone levels! I thought to myself, what a bizarre way to help a guy keep his hair! He’ll look younger, but he won’t want to do much about it as lower testosterone levels reduce sex drive. Yikes!

I took this patient off the drug, and then we recultured a new batch of cells. Sure enough, his cells grew as expected, and I added another “bad drug” to our ever-expanding drug list. Lesson learned.

The Propecia Lawsuit

It turns out I’m not the only one who thinks that the idea behind Propecia is nuts. There is allegedly a group of men whose sex drive never or only slowly returns even after they stop the drug. Also, some of these men end up with significant depression. This makes sense as animal studies show that Propecia blocks essential brain hormones as well as testosterone activation. This group of men is now suing drug maker Merck.

The upshot? Pharma companies never cease to amaze me. They are the ultimate bull in the china shop of the body. While many physicians on the ground would look at the mechanism of a drug like this and the first thing that would cross our minds would be, “Is this a good idea?” the average pharmaceutical company looks at this concept and just salivates at the size of the market! While I’m no fan of plaintiff’s attorneys, in this case, I’d say let the sharks go after Merck!

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Chris Centeno, MD is a specialist in regenerative medicine and the new field of Interventional Orthopedics. Centeno pioneered orthopedic stem cell procedures in 2005 and is responsible for a large amount of the published research on stem cell use for orthopedic applications. View Profile

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