Category: Drugs

Hi Dr Rassman, I heard [editor’s note: TV and radio host] Dr Drew Pinsky in CA say that marijuana decreases testosterone. My question to you can the decrease in testosterone prevent the production of dht & therefore prevent mpb?

There is nothing that prevents male pattern baldness. Even drugs such as finasteride only slows down or improves MPB. You cannot cheat your genetic fate.

Decreased testosterone can also lead to low sex drive and energy levels and it might even produce long term wasting disease of your muscles. There are numerous other medications and methods to decrease testosterone, but I doubt the side effects are worth it. The most extreme case is castration to stop virtually all testosterone production.

In short, marijuana does not prevent MPB. Just look at all the bald hippies from the 1960s and 1970s.

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Hey Doc, great site, very informative.

I know you’re not into guessing and speculation, and the question is not as simple as it sounds at face value, but if you HAD to give an estimate as to the percentage difference in efficacy when it comes to taking propecia in the morning (9:30am) as opposed to in the evening (7:30pm), what relative percentages would you assign to each? Let’s say that all other lifestyle factors are equal and the timing of dose is the only variable here. I work a regular 9-5 day, Mon-Fri.

Would you expect taking it at 9:30 am would be x% more effective than 7:30pm?

Again, just an educated guess on your part (since I value your experienced opinion). And by the way, what time do you take it?

Thanks a lot, and congrats on the awesome site! I’ve been reading almost daily since last spring

Morning vs evening use of Propecia should not make a huge difference. It just makes sense to me to take it upon awakening in the morning when the testosterone levels are highest.

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Dear Dr. Rassman.

What current info do you have on the possibility of finasteride reducing sperm count? Are there any scientific studies out there on this subject? I will be planning on starting a family in the next year or two and fear such side effects will greatly harm my chances of conception.

You have stated that finasteride in a dose of 0.5mg is around 70-80% as effective as 1mg. Can you give an answer as to how effective you think a 0.25mg dose would be in comparison to 1mg? After only 5 days of taking a quartered proscar pill, I’m experiencing some side effects such as increased libido and problems in maintaining an erection. I have no problems getting an erection (due to the increase of libido), just maintaining it.

I’ve heard that taking zinc in high doses can significantly lower DHT levels. Can you shed more light on this subject?

Warmest Regards

Finasteride (Propecia) may cause a decrease in volume of semen, but there is no evidence that the medication causes low sperm count in men. In animal studies, mature rats treated with very high doses of finasteride (488 times the usual human exposure) for up to 12 weeks did not demonstrate any adverse effect on fertility or ejaculate volume. However, when treatment was continued for 24 to 30 weeks, fertility rate decreased significantly in those animals. Diminished fertility was entirely reversible within 6 weeks of discontinuation of the medication in all animals.

The above mentioned study was performed with very high doses of finasteride. The occurrence of decreased fertility should be much less if any in usual doses in human. If you are still concerned about fertility, stop finasteride and the potential adverse effect of the medication should be eliminated in days.

About the effect of lower doses of finasteride, there is not enough evidence on lower doses to absolutely confirm value. We suspect the lower doses may still have a good effect based on animal studies. I can not give you an exact number for this until it is proven by scientific studies on humans. There is no evidence that fertility is impacted by finasteride so this woman on the right could have been your wife.

Regarding the last part of your question; treatment with zinc has been studied in 37 patients with infertility. Administration of zinc has increased DHT with no effect on testosterone or fertility. The mechanism of this effect is not clear. And we don’t have any evidences that zinc supplement can increase hair growth in people who are not zinc deficient.

I’m an 18 year old male and was recently told by my dermatologist that I am starting to bald. My dermatologist told me that I should just take Rogaine, since I was able to catch the balding early. However, the thinning is happening in spots just behind the hairline, and I know that Rogaine has not been proven to work in that spot. Should I go back and ask for Propecia?

If your only concern is hair loss at the hairline and the immediate area behind it, you should be aware that most of the studies, which documented positive effects of Propecia, were done on crown and vertex area. This is also true about Rogaine. With that said, Propecia is the best medical treatment for genetic balding, but you need a diagnosis by mapping out your scalp for miniaturization to determine if this is indeed genetic balding or just the maturation of your frontal hairline. One reason I usually recommend finasteride (Propecia) to my male patients, because of its ease of use (one pill a day rather than applying Rogaine solution to the bald area twice a day).

In the office yesterday, I saw a young man who was started on Propecia a year ago. He responded well in the frontal area, reducing the miniaturization from 70% to 30% and he had more hair in the frontal area from picture comparisons we had of him and his own assessment. What this means is that just because the official line is that Propecia may not work in the frontal area, clearly we all respond differently. He was smiling (certainly not complaining) about all of that new hair in the frontal area.

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Hi

I saw an infomercial today on the product ScalpMed and have read your comments about it. It says that the active ingredient is minoxidil 5%, the same as Rogaine. If the active ingredient is the same then what makes it different than Rogaine or any other product that contains minoxidil? Shouldn’t the results be the same too?

Thanks

Yes, if the concentration of the minoxidil is the same. As for the results being the same, I would suspect that to be the case.

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Dr. I came in for a consultation at your LA office in mid August. I saw Dr. Pak, and had my hair mapped for miniturization. The follow up e-mail said I was “very early Class 3, possible Class 4A balding pattern.” I was actively losing hair and it was suggested to wait on a surgical procedure, I agreed. I had already been taking propecia with no results. It was recomended I continue for possible results. About mid september I noticed a large decrease in the amount of hairs on my hands in the shower. Unfortunitely for me a friend pointed out I was kinda growing a chest. I had not noticed this. Here is the thing. I drank very heavely for about four years, I know alcohol abuse can cause this. My question is, is it more likely the propecia or the past alcohol abuse that is causeing this, and what do you suggest I do. I don’t drink heavely anymore I had stopped before this was pointed out to me. It’s noticable enough that I’m self concious about it, and if there is no other option except surgical removal I may have to consider it. On that note, can you recomend a good surgeon to see for a consultation. It’s causeing me some greif in the work place, I’m a Marine so I’m sure you can imagine the comments. I lost 15 pounds since I stopped drinking so that helped, but not enough, I fear the rest may be breast tissue. I would have called your office with these questions however I am deployed to Iraq until April. Thank you very much for your time!!

First, I would try stopping Propecia to see if your problem resolves in 2-4 weeks. That will show if the cause is Propecia. You should see your Army surgeon (it is kept private) who will be skilled in assessing the breast enlargement. Any good general surgeon back home can take care of this for you if it does not get better with stopping the Propecia.

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Hi. i been using rogaine four months now. i had a hair transplant a year ago and i have shedding in the areas that were transplanted from rogaine and get irritation from it only when wearing a hat. Could it be my hat causing the the shedding at four month. And will transplanted hair grow back even if it been a year ?

It is difficult to know what is truly going on.

1. Rogaine can cause irritation. If it is causing irritation, it should probably be stopped. I doubt that the irritation is causing hair loss unless you are scratching it.
2. Wearing a hat can cause irritation. If it is causing irritation, you should stop wearing it. I doubt that the use of a hat is causing hair loss.
3. Hair transplants should not fall out, since they are considered permanent. If hair transplants were to fall out (and never grow back) no one would be doing it. I doubt that the falling hair is the transplanted hair unless you are traumatizing it. It may be the hair that was originally there (native hair). If the transplanted hair falls out for whatever reason, it should grow back.

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