Category: Drugs

Hello Doctor ,

I have been taking propecia for 6 years with a great success , but i am close to 30 years now , and i was wondering if i could stop it now. Don’t you think that with our Testo levels decreasing over age (about 2% per year after 30) , the DHT levels will decrease too, so that we could stop the propecia by getting older ?

Good thought, but taking Propecia is not directly related to testosterone levels. Propecia affects DHT levels, and even DHT levels do not tell the full story. For example, even with high testosterone levels, you can have NO hair loss. Conversely even with low testosterone levels you can have massive hair loss.

The root of the problem (pardon the pun) for hair loss in men is genetic, not DHT. As such, there is no definitive cure. But if Propecia is working well for you to this point and you have no problems, why stop it? In reality, you should never stop taking it, as long as you wish to retain your hair.

Paid advertisements (not an endorsement):

Dr. Rassman other than stating that sal palmentto has not been proven to block DHT. Do you have a professional opinion to the clams of many who have benefited from taking Sal Palmentto?I have been taking Propecia for years and stopped hair loss. However I must cease buying Propecia due to economics and have been looking for a clear honest opinion.
Thank you

Saw palmetto may help stop hair loss, and you’re welcome to try it, but it is not certain that it does what people on the internet claim. In my professional opinion, it has not been proven to be effective.

We all know that generic drugs cost less than the name brand, but there is no generic 1mg finasteride available legally in the US at this time due to patent laws. So ask your doctor for a prescription of the 5mg generic finasteride and let him/her know that you’ll cut it into 4 pieces (making it nearly the same as Propecia). This will be a significant savings for you. The cost of the 5mg generic finasteride at Costco is $5/month, which is possibly cheaper than saw palmetto and with more certainty that it will work.

Snippet from the interview:

I love my hair – my barber, Paul, has given me a 50s style with a bit of a quiff. I take Propecia pills for my hair, because I started losing it four years ago. It’s a horrible thing – it’s emasculating and you just feel you aren’t sexy any more. The pills worked and my hair grew back, but I am sure they’ll stop working.

Read the rest at — What I see in the mirror: Will Young

I honestly had no idea who he is, but apparently he’s quite popular across the pond. Wikipedia says he won the first Pop Idol show, which is the precursor to American Idol. Look, I have a tough enough time staying current with all of the US celebrities!

At any rate, I’m sure someone will find this interesting, at least for the fact that a celebrity is going public about taking his hair loss medication and seeing results.

It occurred to me that there is no reason that the finasteride clock has to be based on a 24-hour clock. I work for JPL and we use an elongated day in order to plan rover activities on Mars. This means that the days are longer than 24 hours.

I have developed a titre-method that maintains an average daily dose of 1mg of finasteride using quartered proscar pills. Take 1.25 mg every 30 hours as such:

Sunday: 6am 1.25mg
Monday: 12pm 1.25mg
Tuesday: 6pm 1.25mg
Thursday: 12am 1.25mg
Friday: 6am 1.25mg
Saturday: 12pm 1.25mg
Sunday: 6pm 1.25mg
Tuesday: 12am 1.25mg
Wednesday: 6am 1.25mg
Thursday: 12pm 1.25mg
Friday: 6pm 1.25mg
Sunday 12am 1.25mg

But why go through all the trouble? Why hasn’t anyone developed a transdermal patch or implanted finasteride device to main a constant titre? Is this hard to do?

I commend you on your scientific reasoning and approach, but I must point out one flaw: human beings are not computers and can be somewhat lazy in nature. We have a hard time keeping to a set schedule no matter how simple it may look on paper. Can you remember to brush your teeth exactly at a certain time? Maybe it would be a different story on Mars, but it’s hard enough to get someone to take one pill just once a day. Compliance is the issue at hand. One more thing which may be a bit more important — the half life of finasteride is about 4 hours. To maintain a constant level, the presence of the drug will deteriorate on a minute by minute basis so you might need to actually take 0.125 mg per hour or 0.00209 mg per minute. Try that for a compliance model.

A transdermal finasteride patch is a good idea, but there needs to be money, clinical trials, special drug formulations, and pharmacokinetics to make that work. Who will be willing to put up that research and investment when the cost of Propecia itself (in a simple pill) is cost prohibitive for many men?

Dr, please respond to this email I am in desperate need of help. Im a 21 year old with a rapidly receding hairline. I was prescribed propecia and and took it for 2 weeks. I know it seems impossible but after a week on it I almost completely lost my ability to get an erection, both during sex and masturbation. When I finally get one it is extremely weak and doesnt last long. This has never in my life been a problem before. I’ve been off the medication for 3 weeks and the problem has not resolved itself. What can I do?

I can understand the desperation, but I highly suggest you go back to your prescribing doctor to help manage the problem. Sexual side effects occur rarely (1 to 2 percent), and many men can manage the process with their doctors including reducing the dose, or by stopping it to study what happens when the drug is withdrawn. Many times this side effect will go away over a month or so. If your libido is there, then drugs like Viagra may help while you try to work through the problem with your doctor.

I realize the Internet is filled with strange side effect stories. The strength of some of the most prolific campaigns to predict loss of libido or erectile dysfunction can become highly suggestive for the young reader of these bulletin boards.

what do you prefer in MPHL (male pattern hair loss) in topical solution? Please also tell me the percentage that you recommend for its treatment? And also for how long its therapy has to be taken.

Thanks. Waiting for your reply.

For a topical solution I recommend 5% minoxidil, which should be used twice a day. However, Propecia (finasteride) is the best treatment if you are actively balding, but that is a daily oral pill. If you wish to maintain the benefits from the treatment, you must stay on the medication forever (this goes for Propecia or minoxidil).