Category: Drugs

Hi Doctor,

I have been on Finasteride now for about a month and a half. I have been experiencing some pain in my testicles and pubic region. There is also a small lump on my left inguinal ligament. I wonder if this pain may be due to the Finasteride. Do patients ever complain of swelling is this area. Has this drug ever been known to increase the risk for an inguinal hernia? Thank you very much for your time. This site has been most helpful!

The list of known side effects include swelling of the hands or feet, but not pubic region. I do not know how any drug can cause an inguinal hernia. Please see your physician for an examination.

I just saw a mention of a site called GoodRX that allows you to price check local stores. I ran finasteride through their search and found the prices charged by my local Costco, Kmart, and Target stores, among others. Might be something your readers would be interested in.

Thanks for the information!

It seems there are a wide range of markups for generic finasteride 5mg. $9 for 30 pills seem to be the lowest. If you cut those pills into four pieces, that is basically four months of hair loss treatment for 9 bucks. Doing the math, that’s $27 a year. Not too shabby. You just need your doctor to prescribe the higher dosage to you with instructions to cut the pill.

You say that 0.25mg is about 50% effective as 1mg. Any idea why this would be when studies seem to show that even 0.1mg seems to reduce almost as much DHT as 1mg?

If 0.25mg would only reduce DHT levels by half the amount of the 1mg then I’d be quite inclined to try it just to have some benefit to my hair. I have reasons for not wanting to reduce the DHT in my body as low as 1mg would.

Thanks.

I don’t know which study you’re referring to that says 0.1mg is as effective as 1mg, but I am sure the 0.1mg finasteride dose should have some benefit. The recommended standard dose for treating hair loss is 1mg, and I’m sure this wasn’t chosen arbitrarily. Good luck with splitting the small pill into 10 pieces.

Dr. Rassman, you alluded to a simple cure for gynecomastia. For those of us who are plagued by this condition, & are financially tight, would you please share what this cure is, & will the continuance of Propecia or Avodart nullify the surgical benefits? Thanks so much for a great Forum!!!

There are different surgeries that can successfully treat gynecomastia from a cosmetic point of view (removal of breast tissue or liposuction). The drugs Propecia or Avodart will not reverse or cure this problem and in very rare situations can produce it. I don’t know that these medications would nullify the surgery completely or at all.

Dr. Rassman,

I am a patient of your who last saw you a few years ago regarding hair loss prevention. We decided the best course of action for me is to take Propecia and use Rogaine. I have since been taking Propecia and using Rogaine daily and so far, am pleased with the results and think that my hair loss isn’t progressing. I wanted to get your opinion because I have recently read articles which discussed sexual dysfunction as a result from taking Propecia. Even more recently, the FDA issued a warning with regard to this issue. Do you know anything about this and can you provide any insight? Also, would you recommend continuing usage? Any advice would be greatly appreciated.

Thanks in advance

You should be aware of these alerts, which is why we post about them here; however, the risks are very low and sexual side effects are rare (2%). If you have not had them, it should not be a problem… and if you are young and considering having children, you should see your doctor and get a sperm count to be sure that this problem is not impacting you.

As I’ve said before, one of my sons is taking Propecia, and it is working very well. I have not advised him to stop it when he recently asked me about it.

This is a purely hypothetical question. Would a man taking female birth control pills have any effect on male pattern baldness? What would be the effects on DHT, Testosterone, and hair health. Thanks!

The following post is by UK-based physician Dr. Bessam Farjo:

Written by: Dr Bessam Farjo United Kingdom

Female birth control or contraceptive pills are most often a combination of synthetic forms of the female hormones, estrogen and progesterone. With regards to effect on men’s hair you may get a decrease in facial and body hair in terms of thickness and growth, although male-pattern baldness may improve somewhat or at least stabilises in a similar vein to finasteride for example. We see this effect most commonly in our practice when dealing with male to female transgender patients who use similar hormones to achieve their transformation.

However, these medications may cause a number of adverse effects in men similar to those seen with the use of other female hormones. You may experience changes in the appearance and function sex organs. Risks may include erectile dysfunction, decreased libido and lowered sperm count. Some men may also develop gynecomastia (man boobs). There may be a negative effect of general body muscle mass. In addition, the bones may develop osteoporosis (brittleness). There are other potential general health side effects of course making this an unreasonable approach to control male pattern baldness.

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Learn more about the author of this article, Dr. Bessam Farjo, on his BaldingBlog profile or at his website.

Hi, I have a couple of questions about finasteride, if you have any answers they’d be very appreciated:

– Does finasteride shrink the prostate even in men with a normal prostate (no BPH)? Are there any studies available for this?

– I have read that although finasteride is said to increase testosterone, it actually decreases free/bio-available testosterone which is more important than total testosterone for muscle strength/libido etc (see here). This worries me because as much as I want to save my hair, I am also an athlete and want to be at my peak. Could you comment on this?

– Along the same lines, do you have many patients that are sportsmen using propecia without side effects or reduction in their performance (particularly those in more ‘physical’ sports)? Apart from the ‘free testosterone’ theory, I have heard that DHT plays a role in strength/aggression etc.

Many Thanks for taking the time to read. I find it so frustrating that there isn’t more information on the subject and when I do find something I can’t be sure to trust whether it is a study which should be considered valid or not.

I don’t know if finasteride shrinks a normal prostate, though since it is used to treat enlarged prostate it can be inferred that there is the possibility of some effect. I don’t have any studies to refer to off the top of my head, but there have been many studies done relating to finasteride and BPH… so if someone has links to studies that this reader is requesting, please feel free to share.

From a practical point of view, I do not know if taking finasteride will negatively impact your overall physical strength. I would doubt that you would see an impact from reducing your DHT, but everyone is different and this opinion is not universal across the board. I don’t recall any of my more athletic patients mention their athletic performance being limited after taking the medication.

On the flip side of the coin, finasteride/Propecia was once banned in professional sports by the World Anti-Doping Agency due to a similar idea that it may enhance performance or mask steroid use. It does not and it is not banned in professional sports anymore.

I’ve started balding a year ago (when I was 19), since then my crown has become very thin, but now i’m also slowly losing hair in front and top, what kind of Norwood class did I start with because I can’t find any that starts with the vertex while having full hair in front, but slowly thinning on top and front too.

Also, would you advice propecia to a 20 year old?

If you were taking Propecia (finasteride), the hair loss you are experiencing will be slowed, stopped, or reversed (particularly in the crown). The Norwood scale is to define the final stage of balding, not the interim steps you are experiencing. It’s not unusual to have the loss start in the crown.

Get a good doctor who will work with you to build a Master Plan for your short and long term hair loss problem.