Author: Dr. William Rassman

Okay, so let’s face it, hair loss sucks, hair loss does make a man less attractive by a noticiable amount. There’s no avoiding it. Propecia is an effective medication at stopping hair loss and regrowing hair. Is it really safe though? I have my doubts. One could say that anti propecia blogs are full of men who had problems in the first place and that most normal men wouldn’t be on these blogs in the first place. But the other day, I stumbled upon this article written by none other then Men’s Health magazine. Here is the link.

The full article is not available online but the first page does a good job of describing what the article will talk about. Now Men’s Health is no subtle underground publication it is read by millions of men. I’m no doctor but when you block DHT by using Finasteride which also happens to alter how your endocrine system functions, things probably won’t go well, hormones are emotional regulators and DHT is a powerful male androgen. Obviously hair loss is slighty devestating at worse and dissapointing at best but is it worth sucking out the life of an increasing number of men just for hair? Men want hair to appear as if they are full of life and virility so isn’t it ironic that propecia kills that motivation for many men?

The basis for the article in Men’s Health seems to be the tale of a guy with side effects from Propecia. Then it references a study that says sexual side effects occurred in men 45 to 78 years old when taking 5mg of finasteride (to treat their prostate problems). That is 5 times the dose for treating hair loss, and the prostate problems themselves can lead to libido issues without any medication involved. The article fails to mention that.

The rest of the article is a story about a man named “Charles K”. There isn’t much science here, but rather, a story about an unknown man.

Dear Dr. Rassman,

I am a 31 year old male who has been on Propecia for 5 years. After getting bloodwork done, it was discovered that while my Total Testosterone was high, the percentage of Free Testosterone was proportionately low.

Then, I discovered an article from an Egyptian medical journal entitled “Effect of Oral Finasteride on Serum Androgen Levels and Androgenic Alopecia in Adult men”, which found that all men in the experimental group experienced a decline in free testosterone after taking Propecia relative to no change for those taking a placebo. Were you aware of this? Does this not add to the growing body of literature showing how dangerous Propecia really is?

The main point of why Propecia (finasteride 1mg) works is because it changes DHT hormone levels. DHT is the result of testosterone catabolism (it is a byproduct of testosterone metabolism). So to say Propecia affects testosterone in some way is valid, but I cannot say what this really means. The study you refer to included only 30 men and it does not go on to state what the implication is or what the significance is of the findings.

For those interested, the study can be found here (PDF file).

These are the type of articles that can cause confusion and add fuel to the never-ending debate on Propecia depending on how you parse the information presented. Anyone can quote articles and infer what they want, but the real meaning or significance is unclear. At least this is interesting reading. Let the debates begin… or rather, continue!

Doctor,
Took Dr. Lees 5% non PG formula for years. After FDA shutdown switched to Minoxidilmax non PG form. After ran out of that tried Rogaine Foam and had a terrible shed in within 10 days. I know you don’t see much shedding in your practice, but why would I have such a dramatic shed switching from one 5% formula to another? Could it be the other formulas weren’t the real formulas? People swore by Dr. Lee so its possible Minoxidilmax wasn’t the proper formula. i just can’t handle PG. Even the women’s 2% form have PG.

I’ve read doctors who say stay the course during a shed, but if minoxidil is causing dramatic frontal shedding and the general wisdom is it doesn’t regrow hair in front, Seems like a losing prop to keep going. Would it shed hair that it doesn’t regrow?

Have to try something soon before I’m off minox too long.. Already on Propecia..

Thanks..

I would not know what is going on with your hair loss. It could be a problem with the formula, or maybe there’s another ingredient in there that you’re having an allergic reaction to, or it could be that the Dr. Lee product you used was stronger than 5%. Without an examination and follow up it is just a guessing game.

Typically it is my understanding Rogaine Foam is better absorbed than other formulations and does not contain the propylene glycol, so to have an opposite reaction is strange.

I’ve read back 30 pages, but could not find a former instance of my question. Apologies if it is a chronic repeat.

I’ve been taking Propecia for one year, and recently accepted a lower-paying job. As such, I am interested in switching to the quartered 5mg generic Proscar method. I would like to know that the doctor is willing to prescribe the 5mg prior to scheduling an appointment – is there a way to politely obtain this information?

Thank you in advance for your response.

I can’t tell if your question is about another clinic or doctor at NHI. If it’s elsewhere, just call the doctor and ask. Most patients we treat with finasteride at NHI are prescribed the 5mg dose to save costs, and they are instructed to take 1/4 pill a day.