An Article published in the British Medical Journal in September 2016, based upon “two populations of men free of risk factors for erectile dysfunction and other sexual dysfunction or its treatment: men aged 40 or more with benign prostatic hyperplasia who received a prescription for a 5-alpha reductase inhibitor (finasteride or dutasteride) or alpha blocker, or both, and men aged 18-59 with alopecia”, suggests : “The incidence rate of erectile dysfunction was lowest among users of 5-alpha reductase inhibitors only (15.3 per 1000 person years, 95% confidence interval 14.3 to 16.5), and similar among users of 5-alpha reductase inhibitors+alpha blockers (19.2 per 1000 person years, 17.4 to 21.1) and alpha blockers only (20.1 per 1000 person years, 19.6 to 20.7). Compared with users of alpha blockers only, the adjusted incidence rate ratios for users of 5-? reductase inhibitors only and 5-alpha reductase inhibitors+alpha blockers were 0.92 (95% confidence interval 0.85 to 0.99) and 1.09 (0.99 to 1.21), respectively.” Of further note: “cases of erectile dysfunction were more likely than matched controls to be overweight or obese (as measured by body mass index) or to have a diagnosis of non-erectile dysfunction sexual dysfunction, hypertension, diabetes, hyperlipidemia, depression, orchitis, or alcohol misuse before the index date.” Of course, this study was done in an older population that is prone to Erectile Dysfunction

https://www.bmj.com/content/354/bmj.i4823#:~:text=The%20risk%20of%20erectile%20dysfunction%20increased%20with%20increasing%20number%20of,odds%20ratios%20were%20statistically%20significant

Comment: The risks of ED rises with age, so the groups tested were clearly at a higher risk of ED than younger men. The statistics reported by this article suggest that in this higher-risk population, the risk of ED was 1.3%, less than was reported in the original Merck study or in the Propecia ED risk factors brochures. I am wondering why so many younger men are reporting ED, considering the above statistics?

These photos were sent to me by Dr. Richard Burgmeier in Arizona who had a patient with Alopecia Totalis that failed to respond to treatment for many years. Dr. Burgmeier said:

“The patient is sixteen years of age and had the problem since the age of twelve. She has seen different doctors and has tried multiple treatments with no improvement. She started the Laser (LLLT) in November 2005 and at the same time started Joe Soaza’s protocol which included L-Tyrosine 3 pills in morning 2 at night and minoxidil 5% twice a day after showering. Since November 2005 she has been getting treatments with the Laser for 20 minutes twice a week. The patient is very excited with this treatment. This is the best treatment she has tried. It is the only treatment that has stimulated hair growth over her entire scalp. The patient stated “This is the most hair I have had in 2 years.” She has had problems with eczema over her scalp that has completely resolved since her treatments started.

We currently have 10 other patients that have been using the Laser Hair Care System 20 minutes twice a week for the past 6-8 weeks. So far every one of these patients have been very happy with results. These other patients have only been treated with the laser.”

It is clear to me that the results in a very short time frame were beyond what Dr. Burgmeier had expected. Like our last blog entry for the laser therapy, Laser Treatment (LLLT) for Hair Loss (with Photos), there were multiple therapies used, but clearly the results were spectacular for the early treatment of this combined therapy. Dr. Burgmeier feels that the laser treatment has great value based upon his experience with it. If this patient continues with this type of gain, we all hope that much more of her hair will return. A bald female at 16 needs all the help and luck she can get. The relationship with the laser and the cause of its benefit is not clear from a scientific basis. I would have liked to see the treatments added with one therapy and then a second therapy separated over time so that their incremental value would be more directly evident. Then we might know which treatment actually produced the benefit you see here. Is there hope for this young girl? Frankly, I am a perpetual optimist, so I hope for her sake that she will continue with the growth, covering a wider and wider area. I will get follow-up pictures on her in the next few months and post them here. What I would hopefully see is that these small islands of hair will grow larger and then merge together to appear like a full head of hair (ideal result, of course). Click the photos below to enlarge.

My idea is to use topical once every other day and and oral every other day as well, like

Monday : topical

Tuesday : 2.5mg oral

Wednesday : topical

and so on…

I’m using topical min since 1.5 years now and would like to add oral min to increase effectiveness. It’s also getting really tiring to apply the topical everyday. Topical min was really good for me but I feel like it lost its efficiency. I’m also on 1mg finasteride for 2 months.

This makes no sense to me. If you are on the oral minoxidil, stay on it and forget the topical. You don’t want to overdose this medication because of heart side effects.

1- $60 a month is robbery. Morr F is $13 or so.: ANSWER: The FDA is a real problem for this company so that put the following disclaimer on the site: “Information, statements and products on this listing have not been evaluated by the FDA as it is not a prescription medicine and are not intended to diagnose, mitigate, treat, cure, or prevent any disease or health condition.”

The dose in More F is 25 less of a dose than the therapeutic dose required at a minimum and still there is no evidence that this finasteride in the More F solution is effective.

2- Can I dissolve my pills or crush them and then use them on my scalp: ANSWER: No you can’t because it will not get through the skin to where it needs to be

Do hairs like this stand a change with medication? Is a HT even a viable option to increase density?

Am I a good hair transplant candidate?

Yes, you may be an excellent candidate for a hair transplant because you have a persistent juvenile hairline which doesn’t need to suck up grafts and the grafts can be distributed to more easily cover the balding area on top and in the crown.

I am 39 years old. I have not taken any medication for my hair loss.

I have written about this before on Reddit. Medical treatment is important, but at 39, it is unlikely that you will get a good response to it. It is worth trying anyway. I am concerned about the pattern of balding you are showing. I want to ascertain that this is genetic, not a form of autoimmune disease, as your pattern is not classic for genetic balding. Good doctors routinely perform trichoscopy to rule out diseases of the recipient and donor areas. I would look at the nature of the hair and the skin in and around the balding area. If I am concerned, then I would biopsy the areas of concern because autoimmune diseases of the scalp kill hair transplants. Assuming you have no autoimmune scalp disease, I would establish your lifetime donor supply of grafts, including (1) donor density and (2) hair shaft thickness of the donor’s hairs. This will tell the surgeon what you will look like after the hair transplant, which should be shared with you. Not all grafts are equal; for example, coarse hair has 10 times the value of very fine hair (cosmetic-wise). Hair transplant science is well-established today.

[If you have any questions, you can reach me at williamrassman33@gmail.com]