Author: Dr. William Rassman

Dr. Rassman,

I’ll try to keep this as short as possible.

I started Propecia in Summer 2007 as it was prescribed to me after a dermatologist visit in which the doctor diagnosed me with MPB. I took the 1MG 1x daily up until December 2007. I discontinued the drug because of the cost as well as a couple of close friends’ stories of libido loss and worries about impotence.

As I’ve now learned is common upon stopping the pill, I began losing my hair again and it has now become visible and very depressing. I want to get back on Propecia to help curb the hair loss as well as try any other supplements that may help the battle. However, I’m worried sick about some of the stories I have heard/read about concerning long-term use of Propecia and sexual/Prostate problems that are irreversible. How do you feel about these stories? There are multiple websites dedicated to getting the word out about permanent semen reduction, watery semen, ED, depression, etc. Is there evidence to back these stories up that you know of besides the hearsay? What is your professional opinion on these stories and the fact that the drug has only been out 10 years so no long term studies have been conducted?

Also, if I do begin the Propecia again, is Nizoral a good supplement to combine into a regimen? I have heard good things about Zinc supplements as well. Any recommendations?

Thanks so much for your time and help,
It is much appreciated

Nizoral is a good shampoo, but it won’t do anything to regrow your hair. I’ve addressed the side effects questions many, many times before on the blog — the most vocal are the ones with complaints. There are hundreds of thousands of men that use the drug that don’t spend all day on forums discussing it in a positive or negative way. Also, the complaints are unsubstantiated — I could say that Propecia grew a 6th finger on my left hand and made my skin turn silver, and how are you going to disprove that? The FDA published that the side effects occur in less than 2% of men.

You already have experience with the drug and if you did not develop side effects in the 5+ months you took it, it is doubtful that you see them when/if you restart Propecia. We are in total control of our decisions, but unwise choices may lead you further down the course of more and more hair loss.

(Note: The above image is Photoshopped, and it was not caused by Propecia. I hoped I wouldn’t have to point that out, but I don’t want any emails about it.)

Paid advertisements (not an endorsement):

I am a 42 year old male and my hairline began to recede about 3 years ago, primarily on the sides. In addition, the hair in the sideburn area began to thin as well.

To combat this I decided to go to a medical hair treatment consultant 8 months ago. They suggested hair transplants of about 1000-1400 grafts, but I could first try the Propecia & Rogaine combo. I opted for the latter.

After about a month I noticed a huge difference in hair loss. I went from seeing dozens of hairs on my pillow and on my hands when washing my hair, to just a few here and there. At the 6 month mark I began to notice small peach fuzz hairs along the hairline which had been smooth before. Now I am beginning to get hair where hair did not grow before in the lower temporal and side burn areas. Instead of a horseshoe area it is shaped more like a triangle.

My question to you is, will this peach fuzz hairs become thicker? Also, is the hair that was never there before an anomaly?

It is a known side effect of Rogaine (minoxidil) that it will grow hair on other parts of the body, possibly from systemic absorption. When the drug was first developed it was used as an antihypertensive and the side effects were not detectable in women treated systemically with abnormal hair growth on the face and elsewhere.

I can not answer your question directly, but you may be unusually sensitive to this drug’s side effect (of hair loss). Wait it out or stop it. If it continues to grow hair, make sure it is in the areas you want to or just stop it.

Theoretically, how much finasteride would we have to consume to equal the amount those tuber-eating hermaphrodites ate?

I think that the answer to this question has never been quantified. I would guess that it would be hundreds of times the dose, but I really don’t know. A very interesting question, but one that I just don’t have an answer to.

For those interested, a couple years ago I wrote a post about genital abnormalities in babies exposed to finasteride — Proscar Warning Label and Possible Birth Defects.

I used to be highly sexually active up my entire life up until I started taking the propecia six months ago. I’m ready to throw in the towel with taking the propecia. I wanted to hear your thoughts on it first. I haven’t noticed any difference in hair growth, seems to be exactly the same as it was when I started, but I read in places to give it a year before nixing it. If that’s the case is there anything you recommenend to counteract the propecia and increase the sexual libido to the way it was before, besides viagra. Something to take daily.

Speak with your prescribing doctor. With your doctor’s awareness, you might reduce the dose to 1/2 pill (0.5mg) or even 1/4 pill (0.25mg), as some finasteride is better than none in the fight against hair loss. I would want to know more about your sexual problem before I would throw in the towel, so your doctor may give you more insights. If this does not solve the issue, it becomes a personal choice and if it were me, I would take balding over giving up sex (personal choice).

AskMen.com has an article up about foods that are claimed to increase libido. I’m not going to vouch for the validity of these, but with such gems as, “The Aztecs called the avocado tree ahuacatl or ‘testicle tree.’“, I don’t see how you could possibly go wrong! It might be more to do with how the avocado fruit looks when it grows on the vine, rather than what it does to your genitalia, but my Aztec is a bit rusty and I have to rely on AskMen to steer me in the right direction.