Category: Drugs

I started propecia just under 2 months ago, and within the last 2 weeks recently began experiencing sexual side effects in that i cant maintain an erection with my girlfriend

i have decided to stop propecia, as im nervous about the risks now – will my ability to maintain an erection return? how long does it take for the side effects to go away?

i’ve seen very disturbing blog postings on how these may be permanent sexual side effects – is that possible for me given i only took it for 2 months?

thanks!

Decreased erection is one of the side effects of Propecia which occur in 1 to 2 percent of the men who take it. It correlates with what I see in my clinical practice (as well as my colleagues around the country). These side effects are reversible within one to two weeks once you stop the medication, which also correlates with what I see in my clinical practice (as well as my colleagues around the country). I do realize there are some men on the Internet who claim they lost their ability to achieve an erection permanently, but I cannot validate the claims.

There was an article published that claimed persistent sexual side effect associated with Propecia, but it was not a scientific study. The published paper was an interview of 71 men with clear limitations. The study itself mentions this: “Study limitations include a post hoc approach, selection bias, recall bias for before finasteride data, and no serum hormone levels.” In my opinion, the publication of the study did more harm than good, as many are now citing this article blindly as proof.

If you are having trouble with your erection, follow up with the doctor who prescribed the medication or your primary care doctor. The Internet is a great source of information and misinformation, but it is not a substitute proper professional diagnosis or treatment.

Hey guys, love the blog. Big fan for years. So, I’ve been using proscar for over ten years and lately (due to lack of effectiveness) I’ve upped my dose from 4 equal parts to 3. I don’t know if it’s just coincidence because I’m having stress and anxiety but I’ve been having problems with shortness of breath. So, I put myself back down to 1/4 pills months ago, but the symptoms persist. I’m wondering if I should just go off the drug all together for a few wks and reset my gauges. Have you heard of this before?

Thanks

All drugs have side effects, but I do not believe shortness of breath is in the list of effects possibly caused by Propecia, although it might be indicative of an allergy. I don’t know if you recently switched brands of finasteride, but if there’s no allergy, shortness of breath can be an early indicator of heart or lung disease. Please follow up with your doctor.

Snippet from the study:

Before now, there has been no study of finasteride use exceeding 1 year in Japanese men with androgenetic alopecia (AGA) except the study subsequently conducted from the development phase. Since the launch of finasteride, no study in a larger population had been reported. Ethnic variation of the onset age, progressive nature and degree of hair loss of androgenetic alopecia are known. The therapeutic effect of oral finasteride (Propecia) was examined on androgenetic alopecia of Japanese men. The efficacy and safety of finasteride (1 mg tablet) was evaluated in Japanese men with AGA in the long term.

Read the full abstract — Evaluation of efficacy and safety of finasteride 1mg in 3177 Japanese men with androgenetic alopecia.

A new study has been published on the use of finasteride 1mg in the Japanese Journal of Dermatology, addressing the safety and effectiveness of finasteride in 3177 balding men, and the impact on 2561 men in this group was observed. Safety data was obtained by interviews and laboratory tests. Of the 2561 men who followed through the study, the published report says that “the overall effect of hair growth was seen in 2230 of 2561 men (87.1%), in whom hair greatly (11.1%), moderately (36.5%) and slightly (39.5%) increased”.

Adverse reactions were reported in 23 of 3177 (0.7%). It is interesting that the higher degree of sexual side effects in some other studies were not matched in this study at a single Japanese institution. If one subtracted the placebo group’s side effects in the US studies, the number seems to come closer to this recent Japanese report. The article also showed increasing benefits over time in those individuals who had the best results from the drug.

Hi Dr. Rassman,

First of all, kudos for the very informative and educational blog – I have used it extensively to become knowledgeable about the options available for MPB. My question concerns propecia and the impact of lowering DHT in the follicle…By taking propecia – one reduces the amount of DHT being generated by the body but what of the levels in the follicle? The conversion of testosterone to DHT occcurs in the prostate gland, liver and skin but how does propecia reduce the existing DHT molecules in the follicle? By halting the conversion – would the DHT levels in the follicles reduce on their own (over time) and result in either reduced hair loss, hair re-growth or increased fiber size?

I am not aware of any studies of what or how DHT is doing at the follicular level, so I really cannot get into the exact biochemical process behind hair loss and hair growth related to DHT.

However, in general DHT does impact hair follicles for those men who are specifically predisposed to androgenic alopecia (also known as male pattern baldness). So the concept behind Propecia (finasteride) is to lower the DHT level in your body and thus diminish the impact of androgenic alopecia. For a specific biochemical approach to your question, I will defer to the biochemists.

Snippet from the article:

It’s getting harder for me to deny that I’ve reached middle age, and the most obvious sign is that the men in my life are losing their hair. Many men struggle to come to terms with hair loss and yearn for a way to turn back the clock. Although I’m no expert on the subject, I’ve suggested they look into Propecia, a medication used to treat male pattern hair loss.

Invariably, they’re intrigued. It works by preventing testosterone from turning into another hormone that causes hair loss. Over five years, the majority of men who take the drug report that their hair loss slows, their bald spot gets smaller and the appearance of their hair improves. However, the threat of drug-related side effects such as impotence, male breast cancer and perhaps prostate cancer has caused many of my friends to seriously reconsider the importance of a full head of hair.

Read the rest at the LA Times — So what’s the risk of taking that medication?

You should always weigh the risk vs reward for any medication, and this article touches on Propecia side effect risks. The bigger message in this piece is how oftentimes people will give more weight to the negative than the positive. Regardless, the FDA is looking into ways to make drug information easier for the consumer to understand so you can make the choice that is best for you.

Hello!
I’m a 19 year old male and I’ve been on finasteride for about 9 months. I was born with a hairline that has fairly deep corners, so my doctor put me on fin to halt any farther loss. My question is regarding side effects. I’ve experienced a decrease in libido, so I have started taking Vimax. This is an all natural supplement. My question is if the Vimax will counteract the fin since it raises testosterone.

Thanks for your help!

My stance of supplements has always been “buyer beware”. If it works for you then, that’s great. But this Vimax pill claims to make your penis longer, which already makes me think anything it claims is bogus. I wouldn’t be concerned, but with respect to prescription drugs (finasteride/ Propecia) and side effects, I would discuss your issues with the doctor who prescribed you the medication.

Hello Dr.

I am on finasteride for hair loss and dutasteride for my prostate. Is their potential risk or benefits from combining the two since they are similar compounds. I am also on TRT hence the prostate growth prevention.

Thank you

I would ask this question to your prescribing doctor. I do not know your complete medical history or your issues. If you are being prescribed finasteride (Propecia) from one doctor and dutasteride (Avodart) from another doctor, you need to tell each doctor your complete medical history and ALL the medications that you are taking.

In general, taking these medications should be fine. If you are on dutasteride daily, the finasteride may be unnecessary.

Have you seen anyone who has ever used dutasteride topically for temporal recession and had good results from it? I have heard through the grapevine that mixing the contents of one 0.5mg dutasteride (avodart)gel pill with aloe has helped some people maintain thick hair in their temple region. I think they also were taking oral finasteride while using avodart topically.

Propecia isn’t a cure as you’ve said, so it only seems natural to try to find a supplementary treatment to keep as much hair alive on the scalp as possible! I know you can’t recommend this experimental approach as avodart isn’t FDA approved to treat hair loss yet, but I figured I’d ask. It seems if other topical hair growing agents like bimatoprost (LATISSE) can be applied topically to the skin and still benefit for the follicle, the dutasteride gel would have to have some benefit for thickening the miniaturized hair (even if it’s not taken orally).

What do you think? I seriously doubt putting a DHT inhibitor on the scalp would cause any harm and am really thinking of trying it.

There are no medications that I’ve seen really work to treat or stop temple recession… and I have never heard of topical dutasteride used for treating hair loss by a legitimate doctor. Not sure where your grapevine source got his/her info, but it probably isn’t worth experimenting with unproven lotions and potions.

Hi there

I am 25, have been told by multiple doctors around that I have pretty good hair, but maybe within 10 years might have some noticeable troubles. I have wanted to be proactive, and find a good at home program to combat and keep thicker hair.

I was told to use a year program of laser therapy, but then directed otherwise by others as it might be a scam. I decided to start basic and work to more advanced ideas: Currently using Rogaine Foam 2 times a day, and Finestride 1mg a day.

Research just leads to thousands of new avenues: I am looking for a proven system and no sales rep with a bogus product:

considering Kevis, Provillus, or Revivogen, are any of these good, if so which is best?
Shampoos: are they helpful with DHT blockers and reducing oily hair? Which is best?
Laser: Igrow/comb worth a try?

Would definitely love the shampoos for the reduction in oil and itching, look forward to hearing from you. Thanks.

If your doctors have told you that your hair is fine, there’s no reason to start using any product proactively. You might end up doing more harm than good. I hope you’re not treating yourself, but since you’re on finasteride (Propecia), I’ll assume your doctor prescribed it to you because he/she saw some loss… and in that case, stick with that daily routine. I’ve seen finasteride slow down and even reverse existing hair loss in young men. Rogaine hasn’t shown to be as beneficial, but many people do use it and it has been proven to show some regrowth benefits in the crown.

If you get your hair bulk assessed in different parts of the scalp and follow that up with yearly tests, you will know where you are on your hair loss timeline. The key is to stop the hair loss from happening, and the earlier you start the finasteride (provided that your bulk analysis says you are in the balding process) the better you will keep what you have.

Unfortunately, there are many scams out there, and many products that are marketed and sold to people that will seemingly pay anything to stop the future from happening. Treating hair loss isn’t perfect, for if it was you wouldn’t likely see many balding men. We’ve have covered much of these shampoos and treatments here before, so using the search in the top right of the site should show my opinions on those. Most of them don’t show benefits that match the claims they make. You can try out as many shampoos or lasers that you’d like… but keep in mind that if you waste your time on things that don’t work, then each passing day is another step closer to meeting your genetic balding state.