Category: Drugs

I took finasteride for about a year and a half with no sexual side effects. I went off the medication due to all the lastest bad news of people having issues even after stopping the drug. SInce I have lost TONS of hair. I want to go back on and am wondering since I was on it for so long with no side effects does that mean I most likely never will going back on it?
Thank you!

If you didn’t have side effects before, I wouldn’t expect they would appear upon restarting the medication, but I can’t know that for sure. I do believe that much of the panicking posts online are from people that have concluded on their own that Propecia is the cause for most of their problems (real or imagined) and there’s likely nothing that will convince them otherwise. The wave of recent press about permanent side effects comes from a study based on interviews with 54 people, but the headlines are more interesting than the content.

As adults, we all have to make grown up decisions that may impact our health. From smoking cigarettes to overeating to putting ourselves in debt… these are decisions we make.

I can not help you with your decision of whether to take the medication other than to say that my son takes it and neither he nor I worry about everything that is panicking the folks on the internet. This is an elective prescription medication, so you’ll need to talk to your doctor more about your concerns and hopefully that will help you decide what you want to do next.

Hi doc

I’ve been taking propecia now for 2 months and starting to see good results,

But I’ve read that people shed hair before you see results? I’ve shed no hair what so ever. Is that good or bad?

Thanks for your help and advise this site has been very helpful

Shedding isn’t that common after starting Propecia, so what you’re seeing is not a rare occurrence. Stick to your plan and congratulations on your early success!

Dear Dr., I am Male to Female Transsexual who’s been on (finasteride 5 mg, Spironolactone 100 mg, Estradiol and Progesterone) for 14 months now. I am 30 y/o, my body is responding well but my hair isn’t. I get some tiny hairs on my hairline but I loose them, I go through phases of shedding. Recently, I started to read a lot about Avodart but I am debating with my Dr. on the dose.

The 0.5 mg is not intended for Hair loss but higher doses are more effective. Is 1.0 mg better or shall I go with the 2.5 mg? Or is the 0.5 mg effective in my case since my T levels are low? I mentioned my case because my case is unlike any other cases, my body Chemistry is a woman’s but I did not have the Testosterone factory removed yet so I am pretty confused.

Please, I really need your kind advice. My Dr. is unfamiliar with Avodart and for financial issues, I cannot see anyone else. Thanks so much and kindly accept my gratitude.

I’ve answered a related question years ago — Transgender Male-to-Female Taking Dutasteride.

As you aren’t my patient, I am unable to give you specific dosing advice on how to use the various drugs which have an anti-androgen effect. This treatment for balding may not work at all if you triggered the hair loss when you had androgens working in your system. Avodart (dutasteride) may not reverse the hair loss, particularly since you’re looking to regrow the hairline, but it may slow down the loss process, possibly more than finasteride.

I have treated male-to-female transsexuals with hair transplants and provided that the balding pattern is not too advanced, the results are pretty good. I have not treated MTF patients with Avodart, though.

First off, great job on the blog Dr. Rassman. It’s probably the most valuable information regarding hair loss on the internet.

I noticed the first “signs” of MPB when i was 22 (26 now). I thought the corners of my hairline started to recede. That coupled with my brother and father being bald I freaked out and decided to see a doctor. I sought the help of a reputed NYC area specialist (I’m not going to mention his name) and upon a hair miniaturization test and the divulging of my family history he advised I go on Propecia. He assured me though that the minituarization was only slightly present just in the front of the hairline.

I got on Propecia right away and 4 years later my hair looks exactly the same short of a little more recession in the hairline but I would say that I am STILL not 100% at the mature hairline point that you describe so thoroughly on this blog.

Because my brother was pretty much bald (full NW5) by the time he was 22 and my father also a full NW5 by age 26 is it somewhat safe to assume that I may have dodged the bullet since I am 26 and not even a full NW2 yet? If it makes any difference I also physically take after my mother and in her family baldness is not common.

It is also very much possible that Propecia may be responsible for me keeping all my hair but I would want to know if there is any way to find out for sure. I would not want to take a drug I don’t really need for all my life especially with all the recent commotion about this product.

Thank you.

Thank you for sharing your story. I guess the way to find out for sure if Propecia was responsible, you’d have to stop taking the medication and see if your hair falls out. Not exactly ideal, and not something I’d recommend.

There’s also the HairDX Finasteride Response test, but it won’t tell you if Propecia is the reason you still have hair on your head. It should tell you if you’re responding to finasteride, though.

Hi,

I must be at an early norwood 3, in my mid 20’s and have started propecia, (its been a little over a month), has two questions;

1) Have there ever been cases where a complete reversal of baldness has taken place with use of propecia ALONE.

2) Could you explain the post finasteride syndrome (extremely scared of reports on the internet) and was wondering how often it is seen in patients (not just the sexual side effects, but also all the others described by some patients such as brain fog, memory loss, stumbling on words etc etc)

I have done a lot of reading and decided to take the pill anyways, so far no known side effects, except for a slight pressure in my prostate which went away within a week.

I have seen some dramatic results with Propecia, but I would not say a complete reversal.

I do not know the exact issues that are referred to as this post-finasteride syndrome. I realize there are anecdotal stories from people on the Internet who claim Propecia ruined their lives forever, but in the 15 or so years that I’ve been prescribing this medication, I have not seen anyone with permanent and lasting effects after they stop taking it.

I have read about it online, I know a select few readers/commenters on this blog are very vocal about it, and we’ve written about the interviews with patients that have resulted in a study that the media went crazy over… yet I still don’t know what is considered “post-finasteride syndrome”, since there are so many random side effects that people apply to this medication.

I do not know how Propecia may cause pressure on the prostate. I do not think I would even how that may feel. Please speak with your doctor on these issues.

Dr. Rassmann,

I am 21 year old male and I recently had surgery to correct an underbite. I started propecia shortly after my surgery. Will the propecia protect against possible shock loss after the surgery? I’m concerned because I saw in earlier posts that in balding men with shock hair loss, the hair does not usually return.

Propecia is taken for treating androgenic alopecia, not for shock loss following underbite correction surgery. Hair loss after general anesthesia or medical issues is not related to androgenic alopecia.

If you were prescribed Propecia to treat your genetic hair loss, it might protect you… but I wouldn’t recommend the medication solely for protecting from a temporary shock loss.

Listen guys, I am sure you get this question a lot, but I’m 18 years old. Within the last year, my hairline has receded noticeable and on the crown of my head there is definitely thinning.

The side-effects of propecia (loss of libido, impotence, etc) turned me off to the product, so I first considered minoxodil (aka rogaine), well upon further research it seems that rogaine has a very rare and similar side-effects such as loss of libido and impotence which is long-lasting affecting the youthful and the more elderly.

Can anyone clear the air on this matter, please if you use/used rogaine explain if those horror stories hold any water. The company does not list it as a possible side-effect, but the amount of scenarios ive read on the internet (i know not very reliable) has implanted an idea that this may somehow be correlated with sexual side-effects.

I appreciate all of the help, I would really like to retain what I have, family does not have a good history with balding, yet speaking with them all, I am very young to have already begun experiencing this, most of them began in their late 20’s early 30’s, so I’m crossing my fingers because i like wearing my hair long.

All medications have side effect potential. Growing old also has a side effect of loss of libido, as well. Thinking about a side effect and growing scared to take a medication due to possible side effect after reading (as you state) “unreliable” information on the Internet, can cause that side effect to manifest itself.

I am sure you will find people who used Rogaine (minoxidil) claiming loss of libido, but it’s not a known side effect in the literature as far as I’m aware. Many of the people on forums that talk about various side effects they get from any medication diagnose themselves and look for the easiest answer to come up with as a source of their problems.

Get a clear diagnosis of your medication condition. Then find a doctor who can go over your treatment goals and come up with a Master Plan. After weighing out your risk and benefits, you can make the ultimate decision if you want to take the medication.

Hey Dr. Rassman,

Have been taking propecia for approximately 4 years and for the past two switched to finasteride due to it being cheaper. Have had fantastic results with my hair (have more hair now at 30 than I did at 24!)

However, I have slowly been developing sexual side effects over the past 2 years which has come to a breaking point recently. It is now difficult for me to get and maintain an erection and my semen is watery/decreased volume. I am currently taking 1.25 mg of fin a day. I am seeing a doctor today to get my hormone levels checked. I have two questions for you:

1. Do you think these side effects may go away if I lower my dosage to 0.5 mg/day and do you even think that is worth doing? I would love to keep my hair but I am worried I am poisoning my body.

2. If I want a hair transplant in the future, will me being off finasteride significantly limit my options?

Thanks

Lowering the dose of finasteride may lower the side effects, as I have seen this in my practice. Always discuss your medication changes with your prescribing doctor.

While it is advantageous to be on finasteride when considering a hair transplant surgery, it is not an absolute factor. Many patients undergo hair transplantation without taking finasteride.

Hi doctor!

I was researching before and after pics for finasteride results when I stumbled on this link from Dr. Bernsteins website.

According to his site these are all patients who took finasteride or minoxidil or both ONLY. No surgical procedures on these patients. And I must say the results are pretty thumping good! I am 22 and recently was prescribed about a month ago for early hairloss. At this point i seem to be heading towards a Norwood 3 with a persistent forelock (as of now) no major recession or erosion of the hairline just many shorter hairs in the front that “appear” The same thickness but just aren’t getting as long as my “long hair”. My coarse dark hair however does look incredibly thin when wet but when dry it’s extremely thick appearing. I get compliments on how much hair I have. So there is no noticeable balding or thinning happening to the outside world yet.

My question is why do you say in many posts that finasteride and minoxidil do not work in the frontal scalp and hairline?

According to these patients almost EVERY person of all age ranges seem to have gotten a good bit of positive results from the medications alone including crown AND frontal regrowth. I only ask because I am hopeful that finasteride will produce similar results for me and if nothing else maintain what I have. I currently have no thinning in crown, that’s actually my thickest area of my hair.

I am 22 and given where I currently stand would you say that finasteride has a good chance of working for me? About what percentage of men see NO RESULTS from finasteride and continue to thin At the same pace? I am worried that I will be one of the patients that see no response from it

Thanks for your time and your informative site!

The photos you saw on Dr. Bernstein’s site are amazing, and I have seen results like this for myself on occasion at my office. But regrowth at the front is rare (probably under 5%) compared to the results that are more common in the top/crown.

The photos show what is possible, but you have to remember that everyone will react differently to medication. Dr. Bernstein was not implying guaranteed results, but just showing some examples of positive growth. Medication might regrow your hairline, but you shouldn’t expect it to.

I have no way to know if finasteride will work for you, but you can have a HairDX finasteride response test done if you’re curious. If anything, I would expect to arrest your hair loss to give you more time with hair. If it regrows, that’s the icing on the cake.