Month: January 2023

Time to say good bye to propecia …

after 3 years on propecia, all this venture end with a gynecomastia surgery ! According to my surgeon the breast gland size was like a lemon…

He also said to me that finasteride drug is also gives to men who want to be a female (transgender…). according to the drug compagny, gynecomastia is a rare side effect… Now i think it is more a common side effect but impossible to really know at least at the beginning of taking this drug… like me….

Anyway this is my own story, i simply want to warning those guys that might thinking of taking this drug…PLEASE READ TWICE THE SIDE EFFECT SECTION, ESPECIALLY THE “RARE SIDE EFFECT SECTION” BEFORE ENROLL TO PROPECIA.

While I’m not entirely familiar with medications transgender patients might take, consider this — most male to female transgender patients do not want male pattern baldness, so finasteride is a good choice to prevent that. Propecia is not a medication to make you transgendered. In other words, transgender people do not take Propecia to make them “more” transgendered.

One of the potential side effects of Propecia is gynecomastia. This side effect is rare (my recollection is 1 in 300 or 500). Most of the time it is reversible, at least in my 14 years of experience… and most men will complain of breast enlargement when it is early, way before their breast turns to the size of a lemon.

In general, for older men (not taking Propecia) the prevalence of gynecomastia is 24-65% (source: eMedicine). But statistics aside, if it happens to YOU it is 100%, right?

Drugs other than Propecia that can cause gynecomastia are:

• Cimetidine (Tagamet), ranitidine (Zantac), to treat heartburn
• Nifedipine (Adalat, Nifedical, Procardia), to treat high blood pressure
• Spironolactone (Aldactone), to treat high blood pressure and heart failure

Hi Dr. Rassman

My doctor refused to give me prescription for proscar telling me that the drug will minimize my prostate and that long term use will cause me permanent libido problems. Now i consider buying the drug from internet. What’s your opinion? Thanks.

Male 24, NW2.

I would see another doctor. Finasteride 1mg will not give you permanent libido problems.

You need to be followed by a doctor and have a doctor’s prescription for taking this medication. More importantly, you need to have a good diagnosis of what you are treating before you start any medication. I do realize you can buy many medications without a doctors prescription over the Internet, but that is not a smart thing to do, nor is it exactly legal.

Hi Doctor. I recently went to my doctor regarding an acne problem I have had for years, and he prescribed me to take propecia for it. He said that acne is caused my the same hormone that causes hairloss. Something called DHT. And that the ingridient in propecia inhibts DHT and thus eliminating acne. What do you thik about this, it seems kind of wierd to me. Please inform me soon because you seem to be an expert on propecia. I wanted to ask him more questions, but he is one of those doctors thats always in a hurry.

He was pretty condfident that propecia treats acne really well

I haven’t heard of Propecia (finasteride) being prescribed for treating acne. Acne is generally caused by bacteria on your skin and certain hormones in conjunctions with a high sebum production. I recently wrote about acne and DHT here.

So while Propecia does inhibit some of these androgens (such as DHT), Propecia is not prescribed for acne as a treatment. I would consider seeking another physician for a second opinion (mine does not count as I am not your doctor) since you are clearly not comfortable with your treatment plan nor your doctor.

Hi Doctor Rassman, I have a question, I know med advice is not given on the internet, but all I need is just an expert opinion from someone like yourself who is an expert in hairloss industry.

I am 28 years old male in perfect health. No drinking or smoking at all. I have been on brand propecia 1mg for 2 years exactly as prescribed by my dermatologist. in the 2 years I have not got the best results, hair looks almost the same as pre treatment with propecia, but doctor said looks like I am slightly below baseline. so he said for me to keep taking propecia 1mg daily because it has slowed the rate down, I have not experienced any side affects at all on propecia.

Since I have not experienced any side affects from finasteride, my dermatologist also wrote me a prescription for avodart 0.5 mg. he told me avodart is a stronger dht blocker and told me to use it ever other day at the 0.5 mg level. He suggested I still take the 1mg finasteride daily, but just use avodart 0.5mg every other day, basically 4 times a week. He told me not to drop finasteride as maybe I might experience a loss of hair that finasteride was hanging on to. I asked if this was safe and he said yes, and not to worry. Basically in your opinion do you have any positive results from patients that use avodart? do you think its better for hairloss?

I really do not know the details about you. I generally think that if Propecia (finasteride) is working, then just keep to it. If your hair looks the same today as when you started Propecia 2 years ago, that sounds like it’s working just fine. Not everyone will see substantial regrowth, and just keeping the hair loss at bay would mean the medication is successful.

Avodart (dutasteride) added to the Propecia routine makes no sense to me, as both medications work in similar ways. I’ve prescribed dutasteride in rare cases for patients that saw results from Propecia dissipate over the years… but in your case, it sounds like the Propecia is working just fine. I have no idea why your doctor would prescribe both drugs to you.

Good afternoon Doctor. To make a long story short just want to say I am a 28 year old male with early hair loss, and my derma gave me an rx for the drug avodart to stop hair loss. He didn’t give finasteride as he said its weak, and avodart is better. he told me about all the side affects of both drugs such as erection problems, gyno, low sperm count with avodart, etc. and basically said its my decision to pick which one, propecia or avodart so I choose the more effective one. I honestly do not care about the side affects, I’m single and I could care less if I have erection problems from avodart. My hair is more important than sex lol.

But anyways my question is that does avodart from clinical experience and studies does it work on hair loss better, or its about the same as propecia? The reason I’m asking is because avodart is more expensive, so if it the same as propecia might as well take the cheaper one. My dermatologist said it blocks type 2 5AR way better than propecia, and that the type 1 blocking ability of it will do nothing for hair loss as type is negligible and not proven to cause hair loss. From your practice, are the patients that take this drug doing better than the ones on propecia?

My first choice for a drug treatment is always finasteride (Propecia) and in the generic form it costs about $3/month. So yes, while Propecia is probably the cheaper option, it is also the only oral drug approved at this time by the FDA for the treating genetic hair loss (the other is topical minoxidil).

There haven’t been a ton of studies comparing the two for treating hair loss, but the one study that stands out in my mind is from late 2006, where 416 men were studied over 24 weeks. The results showed dutasteride was more potent and resulted in a superior hair growth count based on photos. But that is just one study over six months time, published nearly seven years ago.

One does not have to give up their sex life, nor does one have to take crazy risks with this decision. The incidence of sexual side effects from finasteride is 1 to 2%. Avodart (dutasteride) might work better in some men, but the side effect risk is much higher. I would criticize your doctor’s view on these two drug choices, and will point out that you are welcome to get another doctor’s opinion. Some doctors who do not specialize in these areas may not have all the information.