Category: Drugs

Hello, We’re wondering about the difference between Rogaine for men, & Rogaine for women. Also, it would seem that by now something would be developed that you wouldn’t have to use twice a day, also something less sticky…

In today’s world of hi-tech advances (Latisse is one, & what a blessing for men/women who have had surgery), that something would come along that grows hair much easier.Just wondering…
Thank you

Rogaine is a brand name for a topical formulation of a generic drug named minoxidil meant for topical application to the scalp (for hair growth). It comes in 5% strength for men and 2.5% strength for women and is available without a doctor’s prescription (over the counter). I’ve written about the ingredient differences before here.

Some formulations are very sticky, as you imply, and others are not. It all depends on the preparation of how it is mixed and packaged. The brand name Rogaine also comes in a foam and it is not sticky at all, but I believe it is slightly more expensive. In summary, there is consumer choice available to each of you and some experimenting with what is available maybe a good idea. All drugs have their limitations.

Paid advertisements (not an endorsement):

In a recent blog post you wrote about sexual side effects associated with propecia use, “These side effects are reversible withing one to two weeks after you stop the medication.” You then went on to say that Dr. Irwig’s study in Journal of Sexual Medicine was not a scientific study.

When you read through the FDA hearing on Propecia (FDA link) Keith Kaufman of Merck talks about the 3.8 percent of finasteride users experiencing side effects versus 2.1 percent of the placebo. He then goes onto say that these patients then completed a validated sexual function questionare. I am not a doctor but Merck basically based these figures on self reporting, should those numbers not be considered scientific?

In July the Dr. Irwin Goldstein the Editor-in-Chief of the Journal of Sexual Medicine wrote “I think of the frequent phone calls I receive from distressed men with varying degrees of hair loss who have used 5 alpha reductase inhibitors and now have newly manifested sexual and cognitive complaints that often persist despite discontinuation of the 5 alpha reductase inhibitor. Often such 5 alpha reductase inhibitor users have sought help only to be belittled, betrayed, misdirected, and sometimes misinformed. In general, these patients feel deceived becuase of the lack of information warning them of the potential side effects.”

I am one of the individuals suffering from persistent sexual dysfunction after stopping propecia and it appears pretty certain to me that in a small subset of men the persistent sexual dysfunction is due to the medication.

I am not going to get roped into an anti-Propecia agenda. I will leave that up to those who regularly comment on almost every post where the word “Propecia” appears.

My heart goes out to you if you actually have long-lasting sexual side effects, but the questions of validity ring true to your cause of sexual dysfunction. I am not in a position to judge your problem or to put the pieces together for you. That must be between you and your doctors. I am a doctor, but the posts here are just my opinions on my blog. Some may not agree with me, but that is OK! As the disclaimer on every page says, BaldingBlog is not a place for treatment advice or diagnosis. If the readers want to discuss their issues on a professional basis, they can always make an appointment and see me.

I will post an interesting excerpt from the 1997 FDA Drug Evaluation Hearing that you quote (the last sentence particularly worth noting):

“We attempted to obtain followup on all patients reporting sexually-related adverse experiences. Of the 36 patients on finasteride reporting these adverse experiences, 21 reported resolution of the adverse event while continuing finasteride therapy. Seven reported resolution following discontinuation from the study, and seven had persistence of the adverse event while continuing in the study on finasteride therapy. The pattern for patients on placebo was essentially similar, with most patients resolving either on or off drug, four patients reported persistence of the adverse event while remaining on placebo therapy.”

Dear Drs,

I was wondering which is the difference between “scalp DHT” and “serum DHT”. I guess “scalp DHT” needs “serum DHT” concentration to reach the scalp; am I right? Then, what means in the dutasteride/finasteride studies the differentiation of “scalp DHT” and “serum DHT”?

I know Avidart inhibits, 90% of serum DHT and 55% of scalp DHT, what it mean? The 55% is inhibited from the total DHT or from the 10% (respect the 90% serum inhibit)?

Thank you.

When a drug like finasteride is introduced into the body, it works its way through all of the fluid systems of your body. In theory, almost every cell in your body gets exposed to the drug and some of the cells will do something to the drug. So when you take this finasteride pill, 50% of it will remain in your blood stream after 4-6 hours, and every 4-6 hours the concentration halves.

The drug then works its way into the body fluids around the cells, and it may (finasteride does) attach to the hair follicles and the skin of the scalp. Slowly this process reverses (probably about a week), as the drug does its job on the individual hair follicles, minimizing the DHT. This DHT working, becomes less effective because of the competition for the sites in the cell. That is a very simplified way to explain how it works.

As I’ve said before, I am not a biochemist. I really do not know how scalp DHT or serum DHT are measured.

I, like another member on here recently, was prescribed Finasteride in the 5mg tablet once a week by my dermatologist. I’ve researched here that it’s better to take it daily for the most effective treatment, however, the pills that I picked up at the pharmacy are very, very small. They are circular shaped, blue in color and have an ‘H’ on one side, and a ’37’ stamped into the other side. Are you guys familiar with this pill and is this the size that I am expected to cut into fifth’s?

I need to know if I should try and get a larger size, go ahead and cut them (into at least thirds?), or just stick with the once a week treatment. Thank you!

This is a problem that I’ve heard about before, depending on the generic maker. I’m not familiar with that exact pill you’re describing though. Some generic makers use various excipients to size the pill larger, making it easier to cut. Some may even add scores into the tablet to make it easier to break. You can either go back to your pharmacist and see if they have a different generic size available or try to cut the pill carefully.

It really makes no difference if the 5mg pill breaks apart, provided that the entire 5mg pill is consumed over a 4 day period. I am assuming that even with some crumbs lost in the cutting process, it will still amount to 4mg consumed. Taking 1mg every day is better than taking 5mg once every 5 days, but I’m not your prescribing doctor.

Is it true that Finasteride in Humans would reduce important Neuroactive Steroids like for example allopregnanolone? I know there was already a post about this in the past but that was about rats. In rats, Finasteride blocks both type I and II 5α-reductase whereas in humans inhibits only type II which it seems is not present in the brain unlike type I. I would appreciate your opinion about the following two studies:

Link 1: Finasteride Treatment and Neuroactive Steroid Formation (PDF file)

Link 2: The influence of low dose finasteride, a type II 5α-reductase inhibitor, on circulating neuroactive steroids

I do not think I can add much here, as I am not a biochemist. Mood changes have been associated with finasteride and depression has been reported, but I’m unclear on specifics beyond that.

The 1st link is a study of 20 men with an average age of 69.5 years that took 5mg finasteride. The 2nd link is a study of a dozen men that took the 1mg finasteride with no listed ages that I see. Both studies are small and offer nothing definitive, using words like “probably” and “might”.

This should go without saying, but finasteride is an elective medication with some rare side effect possibilities and is available by prescription only. Hundreds of other medications also come with side effect risks, and you must talk with your doctor about these risks and benefits so you can make an informed decision.

Could you tell me more about Laminins-511 please and whether you think it is a promising ‘solution’ to hair loss? I had never heard of it before reading this article, but i’m now very intrigued.

Link: Mens Health

I do not know much about laminin-511 besides this press release from 2008. These are studies performed on mice and the research is disseminated to the popular media, grabbing the interest of readers such as yourself. I don’t see a date on that article, but I’m guessing it was from back when the laminin-511 mouse findings were first announced. It says they’ll have trials in 2 years… so I’d assume there should be info already if it was successful, but I can’t find anything new.

These news stories create a definite interest, but the implications on hair loss treatment remains to be seen. We get these types of stories sent to us almost on a weekly basis.

First of all thank you for what you do with this site it is a tremendous resource. I am twenty and began to recede at the hairline about a year ago. I started taking one fourth of a proscar daily in April without a prescription and got a prescription for it in June after seeing a dermatologist. I have since been taking the generic version daily. The medication does not seem to be working as I have continued to lose much hair from my crown to the point where my scalp is visible in harsh lighting.

I have long hair but i have noticed in the last week that I am losing the very short (terminal?) hairs again after not noticing them for the past few months. Could this be due to the switch to the generic version? The proscar pills were individually sealed while the generic are together in a pill bottle could this air contact affect their potency? As it has been seven months and I have lost noticeably more hair should I discontinue the medication?

Thank you, my dermatologist is pretty clueless when it comes to hair loss, so I appreciate your knowledge.

Generic finasteride 5mg is the same drug as Propecia, which is just finasteride in 1mg strength, so there should be no difference in efficacy. I don’t think bottle vs individually sealed has any bearing on the potency.

Finasteride does not work that well for frontal hairline, so what you may be experiencing is just your normal course of hair loss that the drug cannot address. Harsh lighting will make the hair appear thinner. Do you have comparison photos to look at from before you started? You’ll need to discuss changes to your medication with your prescribing doctor.

HI, I have taken propecia for about 3 1/2 years. I recently stopped taking it which has been about 2 months because of fears of developing breast cancer. I had a form of gynecomastia which developed when I was around 12 years old. I had surgery to correct it 7 years ago. Also the only person in my family to get cancer has been my mother who had breast cancer 5 years ago. Now I was told by my doctor that propecia does not cause male breast cancer but I have read online that it might increase the risk.

The best medical advice is obtained from your medical doctor, not the Internet. This site isn’t a place for medical advice either. In general, Propecia can cause gynecomastia as a rare side effect… but it does not CAUSE breast cancer.

There have been reports of breast cancer in men who took Propecia, but the causality cannot be established and it is very, very rare by the reports I’ve read in the literature. So the lesson here is talk with your doctor and find the treatment option best for you.