Month: February 2011

Hello,

I just wanted to let you know that Wal-Mart has added Finasteride 5mg to their discounted generics program, they charge only $9 for 30, 5mg tablets. I just thought that your readers might find this information helpful…

Yes, I’m sure many readers are very pleased to learn about this info. Thanks for sharing!

That pricing is on par with what Target charges for generic 5mg finasteride.

I was watching TV last night and saw a commercial for a depression medication called Abilify (aripiprazole). I often treat and see patients on anti-depressant medications and it is a great benefit for them (for treating their depression). What struck me about the TV commercial was the lengthy side effect warnings, including stroke, high fever, muscle rigidity, high blood sugar, higher risk of infection, etc. These side effects are very rare, and many other anti-depressant medications have very similar possible side effects.

Then I turned on my computer to look up the common side effect of a popular erectile dysfunction medication most of you probably heard of: Viagra (sildenafil). Some reported and documented side effects include blindness, heart attack, hearing loss, etc.

Which brings me to the controversy of Propecia (finasteride) and its negative sexual side effects. I acknowledge there are websites devoted to the unreported side effects of Propecia (as well as other medications) and that there are men who are experiencing something. I really cannot say if what they are experiencing is due to Propecia, but for the sake of argument, let’s give them the benefit of doubt. I think we can all agree the chances of getting these side effects are relatively low. From personal experience in treating thousands of patients for over 10+ years I personally have not seen any permanent side effects associated with Propecia, and about 1 to 2% of men do experience negative sexual side effects (which have been all reversible). Again, this is from my personal experience among thousands of patients I have seen.

My point is this: ALL MEDICATIONS HAVE SIDE EFFECTS. You must understand this and discuss the benefits as well as the risks with your doctor and make an educated and informed decision. Millions of people use Viagra knowing that they can go blind or have hearing loss… but the risk of this happening is extremely low! If you believe the extreme side effects associated with Propecia, it is your choice not to take it. To some, sex may be more important than their vision or hearing. And to others, hair is more important than their sexual activities. Of note, I can say that I have prescribed Viagra to men who are taking Propecia and they still have their hair, sight, and hearing.

I tried taking Proscar, cut into quarters, for 3 months and at the three month mark quit as I felt I was experiencing side effects (frequency of erections dropped drastically, morning wood gone, very difficult to maintain an erection, etc.) After quitting, within approximately 2 weeks I felt that sexual functions were back to normal. I had done tons of research prior to taking it, and was very worried about sexual side effects, and cannot rule out the possibility that the side effects were psychological in nature; however, the lack of morning wood I felt to be pretty significant.

I can’t get the idea of trying it one more time for a little longer than 3 months out of my mind. If I were to try it again, would you recommend sticking with 1/4 a pill a day, or do you think I could get by with taking 1/4 a pill every other day or just on Monday, Wednesday, Friday?

It does not sound like your erections have been “tested in the field”. Just the absence of morning erections does not fit the “field test”. The libido issues certainly could’ve been prompted from psyching yourself up about side effects, but it would be impossible for me to say one way or the other. I don’t know how old you are or anything about your medical history, but there’s some info at WebMD that you might find interesting.

In general, you can try a lower daily dose to see if that helps, but you need to discuss this with your prescribing doctor.

Dear Dr. Rassman, Thank you for this wonderful blog. Me and my friends in Dubai are eager to know any reliable international online pharmacy (such as drugstore.com) that can send us Rogaine FOAM to the UAE. We only have generic minoxidil here which causes severe irritation. My heart broke when I came to know Amazon.com and Rogaine.com do not take orders from UAE. These were the two sites I could trust. I’m not sure about minoxidilshop.com. Kindly help us. Thank you very much in advance.

I searched for online pharmacies that ship to Dubai and couldn’t find any that I’d put trust in. I suggest that you might check with doctors who come from the United States and practice hair transplantation in Dubai, as they may be willing to bring in the medication with them. Check out the physician search at ISHRS.org for physicians in the United Arab Emirates.

Or if there are readers in Dubai that know where Rogaine Foam can be purchased, please let us know! Thanks.

Hello doctor William

why don’t doctors ever mention that testosterone by its self can cause hairloss as well. I know its metabolite DHT is more potent at causing hairloss but we all know testosterone on its own can cause hairloss as well.

I mentioned this before, propecia increases testosterone by about roughly 15%. A persons front region/temple/hairline is more sensitive to testosterone and has more testosterone receptors.

Doctors always fail to mention that propecia has a possibility to accelerate hairline thinning. Yes it help the crown but at the expense of the hairline. For example if a person has mild hairloss, then by simply taking propecia it will jump start his hairline thinning.

I enjoy a good conspiracy as much as the next guy, but come on…

Doctors do not mention testosterone causing hair loss, because testosterone does not cause hair loss… except by its conversion to DHT. If the body has testosterone, it automatically has DHT. Genetics cause androgenic alopecia that is precipitated by DHT, and that is why finasteride works. It is not a hormone issue, it is a genetic issue. If you do not have the gene for hair loss, you can have all the testosterone or DHT or whatever hormone you want to blame and you will still have a full head of hair.

Also Propecia does not cause hair loss. It slows down hair loss. I can see why you think this, but your logic is flawed.