Gynecomastia and Finasteride – Hair Loss Information by Dr. William Rassman

Hi, Is there any conclusive evidence that the regular use of Finasteride (Propecia) for hair loss can result in Gynocomastia as a side-effect?

The Physician’s Desk Reference does not list this drug as a possible cause of Gynocomastia, but I have heard mixed stories from individuals.

Results of any known conclusive studies in this regard would be appreciated.

Gynecomastia is a known side effect from the use of Propecia. I do not understand the mechanism of action for it, but when it does happen, most men usually find it as a reason to stop using Propecia. Fortunately, I believe that the incidence is well below 1 in 300 men. I don’t know of any studies off the top of my head, but if any blog readers happen to have a link to any studies posted online, please feel free to post the link in the comments.

Propecia and Minoxidil Combo Questions – Hair Loss Information by Dr. William Rassman

I am a 26 year old male who is experiencing early signs of balding on the crown and around the vertex. I have been to a trichologist who suggests that I use a combination of propecia and minoxidil to try to stabilse and hopefully regrow some hair. My question is; if I stop using one of these hair loss treatments would my hair loss accelerate quicker than if I never took them? Would you recommend a combination of the two drugs? Does stopping one have more of an effect that the other? And finally, what can I expect from this sort of treatment and if it is successful how long can I maintain my hair at its current stage? Many thanks

For a 26 year old, I do not recommend the use of both Propecia (finasteride) and minoxidil for the following reasons:

  1. Propecia goes to the root of the problem (assuming genetic hair loss is present).
  2. Minoxidil confuses the situation and does build dependence if there are benefits from it.
  3. If you stop taking minoxidil and there is dependence, you only know by stopping it (bad way to find out).
  4. In most young men, minoxidil is of little help.
  5. I recommend minoxidil only after Propecia fails to work to meet the expectations of the patient. The incremental value of minoxidil will be seen 8 months after starting it, so at the least you will know if it is working.

If you stop minoxidil or Propecia, you will not lose more hair that you would have normally lost without having taken it in the first place. Lastly, I can not tell you what will happen to you from an email inquiry like this.

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Propecia and Testicular Pain, Follow-Up – Hair Loss Information by Dr. William Rassman

I saw the post today mentioning the testicular pain when on Propecia. I’ve been on Propecia almost 5 months now. I did have intense testicular pain after about a week or two on the drug. But right when I was about the quit, the pain went away and I haven’t noticed it since. Hope this helps.

I generally tell patients not to overreact to things. This is a good example where a little patience solved the problem. Thanks for sharing it with us.

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So Where’s the Generic Propecia? – Hair Loss Information by Dr. William Rassman

Dr,
Any word on generic propecia getting to the market yet? I know some company has the patent and that you would keep an eye on it, but I havent heard anything.

  • Propecia is a brand name for finasteride 1mg tablet. Propecia (finasteride 1mg) is still under patent protection and is not available in generic formulation.
  • Proscar is a brand name for finasteride 5mg tablet. Proscar (finasteride 5mg) is now available in generic (less expensive) formulation.

There has been some confusion on websites that Propecia (finasteride 1mg) will be available in generic formulation, but it is my understanding that it is not the case. I know it has been pointed out here that 1mg finasteride was listed on the US FDA website, but it being listed as approved for sale is different from it being on sale (which in my understanding would be in violation of Merck’s patent rights). This applies to countries where US patent laws and treaties exist.

Since Propecia and Proscar are both the same medication in different strengths (1mg vs. 5mg), some patients prefer to save money and take generic Proscar (finasteride 5mg) and use a pill cutter and divide it into 1/4ths (which makes about 1.25mg). When a pill cutter is used, it often is not exact and there is a tendency for the pill to break apart so that you have to estimate what is about 1mg. I personally do not think that there is a difference if you are slightly above or below the recommended dose.

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Women and Propecia – Hair Loss Information by Dr. William Rassman

I am 49 year old female with very thinning hair, primarily in the crown. Can women of non-childbearing years take Propecia? Have any studies been done on its effectiveness in women?

There are women who take Propecia (finasteride) and it has worked for them. That being said, it has not been well studied in women and it is not recommended for women, because the long term effects on female cancer risks (ovarian, uterine, breast) are just not well known.

There’s a good overview written earlier this month about female hair loss options — Treatments Available for Female Hair Loss

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Taking Propecia Before the Sun Rises – Hair Loss Information – Balding Blog

SunriseHey doc, I need this question answered ASAP, if you wouldn’t mind. As you may know, Ramadan has begun and many Muslims will be getting up in the middle of the night to eat and drink, for eating and drinking aren’t permitted until the sun sets.

So if I take Propecia before the sun rises, like around 4 AM or so, would it have the same effect as taking it later on in the day? Thanks

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You can take Propecia (finasteride) at any time. Just take it about once every 24 hours (day). I generally recommend taking it when you wake up in the morning, when your testosterone is highest and if that is 4am, it will work as well at that time.

Early 20s, Desperate for Hair Treatment that Works – Hair Loss Information – Balding Blog

I’ve just recently discovered your website but have found it very informative. I am 23 and have a family history, on both my mother and father’s side, of male pattern hairloss. I too have been suffering, and in the last three months my hair loss has accelerated to such a degree that the hair on the front and top of my head is becoming increasingly thin, and my hair line is dramatically rising. I have recently started using Kirkland minoxidil (having used Rogaine whilst at university but then stopping as I couldn’t afford it) but not only is my scalp flaking a lot, but I am also losing a lot of hair on a daily basis. As I’ve only used it for under a month, do you think I should persist with the treatment as I have a years supply?

I have also recently bought dutasteride on the internet, having used propecia for 3 months but with no affect, only spots on my forehead. I realise that it takes longer than three months for the tablets to work but do you think I should see if the Dutasteride works as I am awaiting a two month supply in the post, or go back to propecia? Ultimately my hair loss is getting me down a great deal and being that I am so young and as this treatment is quite expensive, would it be better to save up for a hair transplant, and if so do you have any contacts in the UK that are not only reliable but might also be able to give me some impartial and helpful advise. Thank you so much in advance for your response as you can see my hairloss has left me really sad and I would really appreciate any advise you can give me. Many thanks again

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There are many, many young men in a situation similar to yours. I can’t say for sure what you should or should not do, as you are not my patient — but my general advice would be to give the Propecia more than 3 months (8 months is my minimum trial period) to see any benefits. Especially at your age with early hair loss, Propecia tends to work better than minoxidil. I do not recommend dutasteride, not only because it stays in your system far longer than Propecia, but also because there have not been enough studies (to my satisfaction) that show any long-term effects the drug may have in a younger person, such as yourself. To find a doctor in the UK, I’d suggest looking at the ISHRS site’s physician search. Good luck.

WHY Does Shedding from Hair Loss Medications Occur? – Hair Loss Information by Dr. William Rassman

Hey, Doc. I’ve been taking Avodart for the past 3 months and have been experiencing what can only be described as a “shed”. While I’ve seen other posts and answers here regarding shedding, I’ve never seen you delve into why it actually happens. Can you enlighten? Thanks.

I do not know why it happens. It seems to happen more through the reports on this blog site than I have seen in my own practice. As I do not have experience with Avodart (dutasteride), I can only assume that any ideas I might have will be a common thread to Propecia (finasteride). It has been suggested by some doctors that shedding can be explained, because acceleration of a hair cycle occurs. Hairs in the growth phase are pushed into a telogen phase (which means that it will have some shedding). The suggestion then is that the growth phase comes in stronger. This is the idea of others, so I am just passing what I hear, not what I know as fact.

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Hair Loss InformationPropecia and Hair Count – Hair Loss Information – Balding Blog

This is a reader response to my blog posting from way back in May, 2005 — When Will I Go Bald?

My question to you is the following: Per your last line [note: “There is no doubt that the hair loss will still pick up again (even on the drug) but it will be a slower process.“], even if i take Propecia, and stay on it forever, then at some point I’ll begin losing more hair anyway? Is that what you mean by your last line? Thanks.

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Let’s say that you start off with 100 hairs prior to the Propecia (finasteride). Then with the Propecia you go up to 130 hairs after year one. You also have an identical twin brother (100% exactly the same as you), but he decides not to take Propecia. Now let’s see what happens to the hair count for the two of you…

  Hair Count – You
(with Propecia)
Hair Count – Twin
(without Propecia)
Start 100 100
Year 1 130 98
Year 2 127 95
Year 3 120 89
Year 4 112 85
Year 5 106 82
Year 6 101 78
Year 7 98 74
Year 8 93 70
Year 9 88 68
Year 10 85 64
30 years later 75 62

 

Note that you may be coming closer together. Maybe not. Obviously, this is just an example to illustrate a point, but I hope that makes things a little more clear. Simply, Propecia does not stop hair loss completely or forever, but it does modify the course of the hair loss over time.

Propecia and Testicular Pain – Hair Loss Information – Balding Blog

I have had pain in my testicles after I started Propecia. Is there a relationships?

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There have been occasional reports of testicular pain on Propecia (finasteride). I have had thousands of patients using this medication and this has never crossed my path as a patient complaint, but some other doctors in the community have reported this as a suspected rare side effect. One doctor reported that the pain came on with the drug and disappeared when the drug was stopped, suggesting a relationship. It could have been coincidental. Most causes of testicular pain are caused by athletic stresses and for the young men, it may have something to do with puberty.

I would stop Propecia, wait a month and start it up again. If it happens a second time, then assume that this is a side effect of this drug for you.