Proscar, the brand name of the medication finasteride, is classified as a 5-alpha reductase enzyme inhibitor medication. 5-alpha reductase is an enzyme that is necessary to convert the male hormone testosterone into dihydrotestosterone or DHT, the most potent male androgen, which is necessary for sexual development. Increased levels of DHT are associated with enlarged prostate and hair loss. Proscar is often prescribed to treat benign prostatic hyperplasia or BHP, the most common cause of an enlarged prostate and male baldness. Although effective in reducing prostate size and enhancing the growth of new hair, this medication also has several side effects.
Decreased Libido
The level of male androgens, especially testosterone, in the body plays a role in sexual desire. Research published in "The Journal of Cutaneous and Aesthetic Surgery" reveals that taking 5 mg/day of finasteride causes a 68 to 93 percent decrease in the level of circulating dihydrotestosterone. Because this medication interferes with the conversion of testosterone into dihydrotestosterone, the level of testosterone actually increases by 15 to 25 percent, according to this same study. Although testosterone levels rise, the dramatic drop in dihydrotestosterone, which is more potent that testosterone, can cause a decrease in libido.
Impotence
Impotence, or erectile dysfunction, is the inability to obtain and maintain an erection.
Obtaining an erection is dependent on the structure and function of the cells in the penis. However, the levels of male hormones, such as testosterone, do play a role in erectile function. Although studies, such as the one published in a 2009 issue of "The Journal of Cutaneous and Aesthetic Surgery," find that even those who suffer from low levels of hormones can maintain erectile function; normal levels of hormones are required for some men, especially as they age.
Erectile dysfunction leading to impotence is a sexual side effect reported by men who take Proscar. The research published by "The Journal of Cutaneous and Aesthetic Surgery" reports that 0.8 to 33 percent of men taking finasteride reported erectile dysfunction.
Ejaculatory Dysfunction
Another sexual side effect reported by those taking Proscar is ejaculatory dysfunction. Ejaculatory dysfunction causes a decreased volume of ejaculate. The doctors at the Mayo Clinic indicate that the decrease in the amount of semen caused by the medication should not affect sexual performance or fertility.
Breast Enlargement
Breast enlargement, also known as gynecomastia, is a side effect that occurs more often with a dose of 5 mg/day of proscar. A 2009 study published in the "Indian Journal of Dermatology" reported two such cases of breast enlargement due to taking the medication finasteride. This study confirmed that the breast tissue increased without the presence of any abnormal mass. In most cases the breast tissue will return to normal once the medication is stopped.
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