Author: Dr. William Rassman

I read a post you made about someone asking you about propecia and penis shrinkage… I know the internet isnt the most reliable place for facts but i did a little reading and if DHT is responsible for male sex characteristics and propecia inhibits the conversion of testosterone to DHT then how could it not have such effects? Also why would this be considered improbable?

I am going to think this out logically with a little help from reference sites, such as Wikipedia.

The side effects of Propecia (finasteride) deal with the DHT effects that are either hormonal or cyclical on a body part. Penis size is based upon two factors:

1. The anatomical parts of the penis (cultural, diet, genetics)
2. The degree in which the penis is in its flaccid state

The corpus cavernosum is the portion of the penis that gets engorged with blood when it is erect and makes it harder. A man’s penis varies in size based upon his environment and his activities. For example, when exposed to cold the penis shrinks as the blood supply leaves the corpus cavernosum, which deflates the penis, shrinking the penis to its smallest size. See Wikipedia again for a penis anatomy lesson.

The most common cause of a small penis that was larger at one time is probably weight gain, where the peroneal fat surrounds the penis, making it hide in the fat. In severe obesity, the penis may not be visible. I would also suppose that if a man did not have a sex drive and his penis was constantly very flaccid, it might appear that the penis was smaller than the person’s normal penis when it is in a partial state of excitement. You did not post your age, but assuming that you are over 21, your penis size should be relatively constant. None of the patients I have treated with Propecia have complained that their penis is shrinking on the drug. That alone tells me a great deal, because my patients have generally been very direct with me on issues of sexual function while they are on Propecia. I probe their sexuality looking for sexual side effects in case they are shy in telling me about it.

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I have been using Rogaine foam for about 4 months. My hair loss has stopped and I believe I have experienced more fullness and some growth. However, the top of my head (the area with the most loss) “tingles” off and on throughout the day.

Please advise.

You are probably developing irritation from the drug. This is a known side effect of minoxidil.

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Dear Doctor
I have been using proscar tablets(5mg) instead of propecia, quartering the 5mg tablet & taking 1/4 tablet a day. This has worked 4 many years but now it has lost it’s effectiveness & I am shedding hair rapidly.

I have found many articles on the net were doctors suggest that patients increase the dose to 2.5 mg to stop shedding & the risk of side efects will rise only slightly. What do u think ?

Please respond,I am really depressed. Avodart is not available in Australia & regain liquid burnt my scalp & the foam isn’t available in Australia either.
Thanks in Advance.

Taking finasteride 1mg is adequate for the treatment of hair loss. Taking double dose or 2.5mg or 5mg does not mean it will be more effective. Unfortunately finasteride is NOT a complete solution for hair loss. Your genetic fate will eventually catch up to you. Finasteride will at least postpone or prevent further hair loss, as it has its limits. I do not see a problem doubling the dose, provided that you do not develop any side effects.

I sympathize that hair loss is devastating to many people, but if you are that depressed you should see someone professionally about it.

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Hi Dr. Rassman, I sent you an email where I included a link to the Luce LDS 100 study. I am on propecia for about 2 weeks now and I have started my Luce treatment a week ago. I know you said you don’t reccomend using rogaine and propecia at the same time because you don’t know which is the one thats working best for you but I am trying to save my hair asap without it becoming noticeable. My question is since I want to start rogaine which is the best way to apply. I tried the foam which is annoying and get all over my hair and leaves a smell that people notice. The dropper is ok but so much liquid comes out at once and one location. I noticed both the foam and the dropper accentuate the thinning. The dropper is less obvious. Is it possible to get an empty spray bottle and fill it with rogaine 5% extra strength and use it as a spray? Let me know what you reccomend. I want to have a regimen that I can do everyday without it making my hair look like it’s thinning.

It seems that you like to experiment. Go for it and let me know how it works.

Hi Dr,
I have used dutasteride for about 2yrs now, I did think I saw a reduction in shedding shortly after beginning its use but dont know if thats in my head or it was a pattern I wouldve went through if i was on it or not, Here is my question, ive begun to get very conscientious(hope thats spelled right) about the supplements or medications & what not that i use, so i am concerned of causing some side effect either short term or down the road from using dutasteride, i take 1 pill a week, and my question is what kind of doctor can i go to to monitor and make sure everything is fine and there are no side effects or anything at all that would be unhealthy from using the dutasteride?

Thanks

For a general assessment the side effects, you can see your primary care doctors. If you want to get on board with a Master Plan, your hair loss or gain progress should be followed by an experienced hair specialist. Periodical microscopic examination of your scalp for miniaturization should be part of the standard diagnosis for any patients who are using medications for treatment of their hair loss. By taking yearly measurements, you will know if the process is under better control.