Category: Drugs

My husband has taken Propecia for hair loss for 8 years and I am concerned about his sperm count because we want to get pregnant. How long does it take to leave the body? Is there a danger to the fetus? Does it cause fertility problems? I am very concerned and wish he never took this drug.

In general, men can continue to take Propecia while trying to conceive. This is safe and there should not be a danger to the fetus. However, in my practice I generally advise men to stop taking Propecia for the two week mid-cycle so that there can be no question as to the safety issue and to put the patient’s mind at ease. Propecia is out of the blood stream within 24 hours and out of the tissue in a few days.

The most important part to this is to talk with your doctor and discuss these concerns with them.

Doc,

Thanks for the great blog.

I started taking Propecia about 7 months ago at age 21 and have had great results. I’ve had some regrowth even at my hairline.

Is early success any indication of future effectiveness/longevity? I’m trying to gauge how much time I can expect Propecia to hold off baldness. Have you found any sort of correlation with your patients?

Thank you.

It appears that people who had a good response to finasteride early do get better long term results. Like I’ve said before, I’ve had patients on this medication for over a decade with continued great results. I won’t be able to know what kind of time frame of success you’ll have, though.

If you’ve had regrowth at the hairline, that is fairly rare, but exciting!

Dr. Rassman,

It seems there are a lot of young men frequenting your site, myself included, that are concerned about hair loss.

My questions is how much recession from a juvenile hair line must occur before hair loss can be diagnosed and a treatment can be issued.

Would a responsible doctor issue finasteride to maintain a Norwood 1 hairline?

Finasteride does not usually bring back frontal hairlines and I do not prescribe it to men who are not balding. Norwood 1 or 2 patterns are not considered balding.

Hi Drs. Rassman and Pak:

I take 2.5mgs of Xanax once per day, in the morning, prescribed by my psychiatrist for anxiety and panic attacks. Is there any drug interaction between Xanax and Propecia? Also, would the sexual side effects risk be increased by taking Xanax? I have no side effects with Xanax, by the way.

Propecia (finasteride) does not interact with Xanax (alprazolam).

In general, I do not know of ANY drug that has a truly bad interaction with Propecia. Interactions can be found here, but there’s nothing all that common and nothing I can see that is alarming. As always, ask your prescribing doctor and be sure to inform your doctor about what medications you are on.

Dear Dr Rassman, thanks again for the great blog and thoughtful responses.

Afraid I have yet another propecia related inquiry! I noticed in a recent post you informed another reader that there have been cases of your patients on propecia developing lumps in the breast region and that your are now working with another Dr to treat this side effect.

While I’m aware these are not necessarily related to their propecia course I was wondering if you could give an approximate indication of what percent of your patients have suffered this side effect?

Many many thanks again

I believe what you are referring to is gynecomastia (enlargement of breast tissue). They are not necessarily “lumps”. I believe the reported incidence is about 1 in 300 to 1 in 700 or so. In my clinical practice I think the incidence is lower.

I have been on propecia about 6 years. Over the past 5 months I have probably missed 7-10 days a month. The past month I have noticed alot of shedding and am concerned I am experiencing catch up hairloss. Have I missed enough days that this could be the case? If this is the case, will I recede the point of never having started propecia or to the point of when I first began treatment. If the former is the case, should I quit treatment and accept my fate? Thanks.

I wouldn’t worry about missing a few days of the medication. It generally takes weeks or months of consistently not taking Propecia for catch-up hair loss to be evident. There is tissue fixation at least for a week, if not more. Talk with you doctor regarding your medication and clinical decisions.

The top of my hair looks like it’s thinning when it’s wet or when you apply gel (can see the scalp). Currently I’m 24, and when I looked back to pictures from 8 years ago, it seems that I had the same thing. I went to a dermatologist who mentioned mild miniaturization and pushed propecia.

My question is it possible my hair has always been like this, and there is no hair loss or miniaturization at all? He did not want to look at any pictures from my young age. I recently took notice because I have friends losing hair and became fixated on it. When my hair is dry you cannot see my scalp.

Propecia is an elective medication you take for treating androgenic alopecia. If you do not believe you need it, do not take it. If you do not want to take it, do not take it. If you think your doctor is wrong, then get a second opinion. I’m curious to know why you saw a doctor for thinning hair when you didn’t think your were losing hair.

Some hair styles can cause your hair to look thinner. Direct light can also do that. Perhaps your hair gel is sticking your hair together and causing more scalp to show through, giving the illusion of thinning. I really have no way to know.