Author: Dr. William Rassman

Dr. Rassman, Are there any alternatives for someone who has developed side effects from propecia. I began to develop gynocomastia from it after three months and I am no win the process of looking for something else to slow down hair loss.

Also, thanks for having this blog!! You rock!

Gynecomastia (painful nodules that appear in the male breast) is a rare complication/side effect from Propecia. I believe that even Avodart has the same side effect. My heart goes out to you. Get a good Master Plan, which may be critical to defining what your future hair loss has in store for you. Minoxidil may help as well, but it usually does not stop the hair loss in the young man.

Hello Folks,
I have been using finasteride 2MG daily and found no issues related to Sex drive. However what I find interesting is that the hair shedding has increased to a very high extent i.e more before using drug. Is this normal? i found that this is due to movement of hairs from telogen to anagen phase. Should I stop the drug? Increase the dose?
Thanks

I have no patients that have complained of shedding from Propecia, yet I have been asked about it in emails via this blog a few times. I probably have more patients on Propecia than any doctor in California, so I find it interesting to hear about the shedding problem that is reported to me here. My best advice is to continue to take the drug. What you might be seeing is some accelerated hair loss in its normal cycle, which hopefully will be addressed as the drug kicks in.

Dear Dr. Rassman,
I have used Propecia for many years now but continue to lose my hair and just in the last few days I discontinued its use in favor of Avodart. My main concern is if I should continue with Propecia since it has proven effective for hairloss alongside Avodart use or will Avodart alone do the same job? In other words, I know Propecia works. Am I risking hairloss by discontinuing its use?
Thank you.

If you switched, you can abandon Propecia. I doubt that stopping Propecia will negatively impact you while you are on Avodart.

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I’m a 25 year old male with hair loss problems. I started to take Propecia about a year ago and then found out about Avodart. I started taking this drug about 3 months ago. Very recently, I found out that my girlfriend is pregnant. I want to know if through my sperm can my baby have birth defects?

I’m very scared of having a child so early in my life and finding out that it comes out with birth defects.

Please Advise!!!

The issues of safety and effectiveness have not been fully explored in the youth like you with Avodart. Without that information in a research controlled, FDA approved study, there is no way to tell the answer to your question. Unfortunately, the manufacturer has not elected to sell into the hair market, despite the good blocking effect that Avodart has on the targeted enzyme. The FDA has certified this drug for prostate disease and I suspect based upon this, the drug should have no impact on the egg fertilized by the sperm of a man taking the drug, or when having unprotected sex during pregnancy.

Avodart (Dutasteride) blocks an enzyme called 5-alpha-reductase, which is necessary to change testosterone to another hormone that causes the prostate to grow. The effects of dutasteride have a prolonged half life, measured in weeks or months (which means it hangs around the body for quite a while).

Women who are or who may become pregnant should not take dutasteride or even touch dutasteride capsules, because it can cause changes in the genitals (sex organs) of male fetuses and this drug should not be exposed to children. It is not clearly defined if enough of the drug (or for that matter any of it) can cross into the woman through intercourse from a man who is taking it and it is even more of a stretch to think that it can be built up in enough quantities to reach the pregnant female and then the unborn fetus. With that said, every source I’ve read tells the doctor and patient not to use it in women who may become pregnant or who are nursing. Much of this may just be ‘protective’ language for the drug company, but I can not say for certain.

In any event, I do not prescribe Avodart for these very reasons. A cross over from Avodart to Propecia information may reflect on the same issues, except for the long half life of Avodart. For information on Propecia and pregnancy, please read:

• Propecia and Pregnancy, is it safe? on HairLossTalk.com
• Propecia and Pregnancy – Part 2 on HairLossTalk.com