Author: Dr. William Rassman

Hello Doctor,
I have been prescribed Dr Reddys Finasteride. It is 5 mg but I have been asked to cut it so as to take only 1 mg. I read some reviews about finasteride on the internet and I am scared to try it out. I have read side effects like ED, impotency, low sperm count etc. In many people these effects have found to be irreversible. I dont know what to do. Could you please let me know whether I should take this pill? I have been also prescribed Elon’s Biotin tablet.

I really appreciate your contribution in this field. I look forward to your reply.

Finasteride is a prescription medication, so you should be talking to your prescribing physician about this. Not sure why you were prescribed biotin unless you were deficient. The Dr Reddy’s 5mg finasteride is a generic version of Proscar, and since there isn’t a generic version of Propecia available in US pharmacies, cutting the 5mg pill into 4 pieces is a good way to save money.

I’ve written extensively about finasteride’s side effects so I won’t rehash it all here, but basically there’s a less than 2% chance for sexual side effects and no evidence that shows the side effects permanent. In fact, should you have any side effects and decide to stop taking finasteride, those sides should be gone within days. Some people might argue that, but I prefer to get my information from actual peer-reviewed studies rather than guys posting anonymously on message boards.

I’ve written before about forum outrage here, here, and here. You can read more about Propecia’s effect on sperm here.

Hello,

I’ve been on finasteride for three years now with some moderate success. The medication didn’t give me any regrowth, but after three years the miniaturized area is only slightly thinner than baseline, so clearly I have responded to the treatment to some extent. The problem is that I have elevated estriol levels (I am a male, by the way), and my doctor believes it’s a side effect from finasteride and wants me to quit taking the medication. However, I am reluctant to do so. Have you seen high estradiol levels in your patients who are on finasteride? This is not listed anywhere as a side effect.

I do not order standard or special laboratory tests for my patients who use finasteride 1mg a day for hair loss, because there is no utility in ordering these tests. There are many variations in test values and there is no use in finding out a test result unless you know:

1. Why you are ordering the test
2. What you expect to learn from the test
3. How you will interpret the test result, and
4. What you will do as a consequence of the results

So no, I haven’t seen high estradiol levels in my patients. You should ask your doctor why those tests were ordered.

I am in my late 40s and have receding hair and a slight thin spot at the crown. I’ve been taking Propecia for about 2 years now and while I haven’t noticed any hair growth, my hair seems to stay consistent. I am, however, unhappy with the decreased libido side effect. I would like to stop taking Propecia and try Rogaine or saw palmetto.

Would you advise this and if you would, should I stop the Propecia cold turkey or gradually stop it?

I can’t advise someone that isn’t my patient to start or stop a prescription medication, which is what Propecia is. I can just give general advice. There’s no weaning process when stopping the medication, but please talk to your prescribing physician about the best way to change your dosing. There’s a couple points you might be aware of, but I feel I should highlight for you just in case:

1. Any benefits you’ve seen from Propecia will start to disappear within months of stopping it, so if you want to try to maintain the consistency you’ve seen you might wish to ask your doctor about taking a lower dosage (some Propecia is better than none) to see if that helps with the side effects.

2. It’s also possible that the drug itself isn’t the cause of your lower libido and there’s another issue coincidentally going on. Stress, anxiety, and age can also be reasons for a lower libido. People seem quick to point the finger at medication first, but in reality people that don’t take medications still have these same issues every day.

Propecia is entirely elective medication for a cosmetic issue (you’re not going to suffer health risks by stopping it), so ultimately it’s up to you whether you want to take it or not.

Hi Dr.
I have enjoyed reading your blog. Throughout my life I have had thin hair but it has never bothered me. If I could keep it at the density that it has been I would be happy. Male Pattern Baldness does run in my family (especially my moms side) and a lot of my cousins have already decided to shave their heads. I have been lucky so far and am at an older age than they were when they started to thin. I thought I had dodged the bullet but I received a shorter than usual haircut this summer and noticed my hair looked a little thinner than usual.

I was into a dermatologist within a week and onto finasteride which helped me mentally more than anything. I still have a full head of hair and the only person to notice it looking thinner so far is me. As time goes on I wonder if it is really appropriate for me to be taking finasteride. Do you have an opinion on this? I have an appointment with a reputable hair restoration surgeon in a month. I made this appointment mostly to have someone tell me if I am really thinning and to make some kind of a “master plan” if I am. Surgery is nowhere in the plans for now.

My main concern is that I could possibly damage my hair by taking finasteride if infact it isn’t necessary. Any information you have on this would be greatly appreciated. Thanks again for your very informative blog.

Taking finasteride will not damage your hair, but you should not be taking finasteride if you do not have androgenic alopecia. There’s no reason to take unnecessary medication, and your doctor will be able to tell you if Propecia is helping. Perhaps your haircut didn’t reveal anything new, but it’d been so long since you’ve had it cut that short that you forgot what your short hair was like? I don’t know…

Really what you need is a good diagnosis, and after you have that, then you can discuss the treatment options and your ‘realistic’ ultimate goal with your doctor to see if Propecia will help.