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In 1974, the endocrinologist, Julianne L. Imperato-McGinley, heard about a large group of pseudo-hermaphrodites that were found living in a remote mountain village in the Dominican Republic. These pseudo-hermaphrodites had ambiguous genitalia with “labial-like scrotums” and “blind vaginal pouches,” and were thought to be girls at birth by the other villagers. Upon puberty, however, their clitorises enlarged to resemble small (micro) penises, their testes descended, muscles developed, and their voices grew deep. But, their sexual organs remained severely undeveloped. Also noted was that these individuals had very low levels of the most potent male hormone, dihydrotestosterone (“DHT”), unusually small prostate glands, and – full heads of hair.

Imperato-McGinley traced the condition to an inheritable genetic mutation which caused a deficiency in the 5-alpha reductase type-II enzyme. The 5AR enzyme is what converts testosterone into DHT (it also converts several other hormones into neurohormones in the brain). She concluded that DHT is crucial in the development of the male sex organs and that the absence of DHT (via a 5AR deficiency) is what caused the horrific mutations and disfigurements in the villagers.

Despite knowing that a 5AR deficiency led to these horrific birth defects, Merck saw an opportunity in this discovery. Merck knew it could make a fortune off a drug that could prevent both hair loss and prostate enlargement, so Merck started researching ways to artificially create a 5AR deficiency in adult males in order to replicate the full heads of hair and small prostate glands exhibited by the pseudo-hermaphrodites. Merck succeeded – and in 1984 filed for a patent on finasteride (the generic name for Propecia).  

When Merck began selling Propecia as drug to treat male pattern hair loss in 1997, it hired a big New York City advertising firm to launch the drug and branded Propecia as a scientific cure for hair loss. Merck spent millions of dollars promoting the drug and what it could do, but what it didn’t tell men was that Propecia is literally hormone therapy – and it surely didn’t tell men that Propecia was designed to replicate a hormone deficiency that causes pseudo-hermaphroditism.

Not surprisingly, many men that took Propecia are now suffering from serious sexual dysfunction. Men are reporting erectile dysfunction, penile shrinkage/atrophy, penile numbness, painful ejaculation, testicular pain, malformed penises, low levels of testosterone, high levels of estrogen, breast enlargement, decreased libido, memory loss, and problems concentrating. Even worse is that many of these symptoms have persisted long after men stopped taking the drug.

Complaints about permanent erectile dysfunction and total loss of libido from Propecia appeared on the internet a few years after Propecia was put on the market. In 2003, affected men even started an internet Yahoo group where they could share stories and discuss possible solutions to the problems they were experiencing. After an investigation in 2007 by the Swedish Medical Agency, Merck added a warning about persistent sexual side-effects to the Propecia label in various European countries; but this warning was not provided to American consumers until April 11, 2012, when the FDA finally ordered Merck to put such a warning on the label of its $450,000,000/yr. drug.

Now, maybe it was a big shock to Merck that its “miracle” drug could cause these serious sexual, physical, and mental side effects. Or maybe the huge profits were just too tempting for Merck. But regardless, considering the origin of Propecia, it’s pretty obvious that Merck should have known from the start that treating hair loss with hormone therapy was just not a good idea.