Month: November 2012

Dr. Rassman &/or Dr. Pak,

I am contacting you to seek clarification with regard to something that you have already written about in the past. Here’s the link to the information I’m referring to.

I’ve been on finasteride (1 mg) for over 5 months and have experienced superb results. Unfortunately, I have been experiencing breast discomfort. The mild pain that I experience daily get is not confined to one breast and seems to be centered at the nipple. I remember experiencing this pain back in April, but don’t really remember ever noticing or, at least, worrying about it during the months of June or July. I talked about it with my doctor today and he told me to get off of finasteride (1 mg) for two weeks so that we can see if, in fact, finasteride (1 mg) has anything to do with the breast pain.

I’m 21 years old and have not experienced breast enlargement. Further, I have a stress or anxiety disorder that I’m thinking of dealing with by taking Prozac, which my doctor prescribed today. Also, I have functional scoliosis, which I’ve been dealing with for over two years by seeing an osteopath. Although great progress has been made with regard to my back, I still get pain and must exercise everyday. Aside from my psychological problems and my back (which is flexible and healthy, really), I am relatively healthy. I am very slim and jog regularly.

My doctor did not seem too worried about the discomfort that I experience. He didn’t even look at my breasts. Really, neither am I. I know I’m not going to get breast cancer. I don’t know of anyone on either side of my family that has developed breast cancer (including my female relatives!). This breast pain does not bother me and if it means that I have to deal with it to maintain my hair, then I would most definetly continue taking finasteride (1 mg).

What exactly is causing this discomfort? Could it be stress? Increased estrogen? I had a blood test done back in late April or early May and my doctor did not have to discuss the results with me.

Do you have any patients who have continued to take finasteride (1mg) despite having breast pain? What else do you have to say with regard to this topic?

Thanks so much! Your blog is incredible!

Breast enlargement or gynecomastia is a known (rare) side effect of Propecia (finasteride 1mg). You state you do not have gynecomastia, but have breast pain. Breast pain is a side effect of finasteride on rare occasion.

You also state your doctor did not even conduct an exam or seem concerned. I don’t know what the absolute cause of your pain and breast issues (could be the medication, could be something else), but I do think you should revisit your doctor and express concern about not being examined. Otherwise, find a doctor who is willing to at least examine your chest and conduct a proper history and exam.

Dear Dr Rassman,

I’m writing to ask your opinion on my furthered use of Finasteride. I’m nearly 28 years old, around NW 2. All the men in my family (father’s side) are NW 4a by around age 40. I first noticed hairloss at the temples at age 25, at which time it was quite mild.

After suffering extensively with this emotionally (I am/was a musician), I tried 5% minoxidil for 8 months (no results).

I then consulted a dermatologist for a Finasteride prescription (5mg quartered), which I have been taking for just over three months. I have noticed a slightly increased libido and markedly increased shedding which has gotten progressively more extreme to the point where I am increasingly rapidly losing my hairline and density behind it. I am losing hair all over my head and my crown is very itchy/red/inflamed, none of which I had before starting with Finasteride. None of the men in my family suffer from crown loss.

I simply wanted to add myself to the small list of men who feel strongly that the drug is making their hairloss much, much worse and ask whether I should wait it out the suggested year or cut my losses now. My dermatologist suggested stopping the drug.

You’ve written about finasteride shedding several times and I understand your opinion is that it is something of a myth. The statistical data shows that 89% do well with the drug over a 5 year period. Nonetheless, I have seen several anecdotal accounts from men that compare with my situation (age/NW) where they claim their hairloss sped up rapidly and never returned and am unsure what to take from this.

Thanks and best regards.

Your history is atypical. Increased libido is an occasional side effect that I have seen in my patients.

With regard to your shedding, it generally stops at about 3 months, but you need to go back to your prescribing doctor and have him examine you. I hope that he did a bulk analysis of your hair to see if you are actually losing hair bulk. Applying good science tells much about what these observations mean.