Category: Drugs

Hello,
i’ve recently had my second transplant and i’m almost 27, I had my first just before my 25th birthday. I have only had temporal recession mpb in the front, and I had figured that with such small areas to fill and such a good donor sample that I would be able to fill in the areas not fully but maybe 80% of the density it once was when hair existed there. I was semi happy with my first transplant yet wasn’t near the density I wanted maybe 20% with a random guess. I just had my second 4 months ago and from what I see hairs are growing in but it’s hard to tell at this point if it will get to the density where you won’t be able to see through my hair to my skin. I’m a bit skeptical. Also I am not positive but I think I have just a tad of shockloss, which I refused to take finasteride because of all these horror stories on the internet i’ve seen.

My question is where can I get the straight facts, not opinions but actual documented cases that the FDA uses in it’s analysis? I get conflicting opinions everywhere I go and it’s hard to decipher which is correct, based on fact, logical, and applicable to my situation. Now I’ve read posts on your shockloss and i’m a bit bummed I hadn’t atleast known that shockloss in men in their 20’s with an HT without using Finasteride is common. My Doctor said shockloss most of the time is temporary. Your posts say otherwise. Also I have seen posts on finasteride some saying side effects such as decreased libido or penis size is permanent, others say no. I can’t risk my sex life and would rather be bald then mess with it, but I do like having hair on my head as well. Which side do I take? It’s probably already too late to counter any of the hairloss 4 months after the surgery right? Sorry for the long question. Thanks.

I appreciate your situation, but your fear of Propecia (finasteride 1mg) makes no sense to me. If you took the medication and experienced a negative sexual side effect (1% of men), the drug will be out of your blood stream in 24-48 hours from the time you stop taking it. There is nothing permanent about it. Concerning your hair transplants, you need to have a Master Plan for what might happen to you. If you got 20% of what you expected, then do you have enough hair to follow your hair loss without Propecia as you lose it? Your doctor is just plain wrong when he tells you that hair loss from a transplant (shock loss) is temporary and I would challenge that comment if given the chance.

I agree that giving up sex is not an option, but where are you getting the idea that it is either sex without Propecia or no sex with Propecia? That is not what millions of men are experiencing today, including 99% of the men I treat with that drug.

First of all, I am a big fan of the site. As such, I know your first response will be to “see my doctor,” which I may do soon, but I wished to hear your input as well. I’m a 22 year old male with a small/moderate amount of hair loss. I started taking propecia 5 months ago. I’m not sure if I have had any hair regrowth, but I certainly have not had any more hair loss (which is fine by my standards). However, as many others, I have noticed the sexual problems, mostly that my erections are sometimes soft and not as large as normal. Also, I seem to have acquired an on/off again dull pain near my left testicle.

I’m not sure if the testicular pain is related to propecia. As such, I am not sure whether to see a urologist or the dermatologist first. Also, in regards to sexual problem, I have thought about taking half the dosage (.5) myself and observing whether these things go away before consulting a doctor (my budget is small as it is). Thank you for any input.

I’m concerned that you’re talking about taking a prescription drug (or altering the dosage) without consulting a prescribing physician.

I’ve written about groin pain and Propecia (finasteride) before –

• Throbbing in the Right Side of My Groin — Linked to Finasteride?
• Testicular Pain 2 Days After Finasteride Use
• Within 3 Days of Starting Propecia, I Feel Sensations in My Testicles
• Swollen Testicles from Propecia

You are your own man, and if you already have Propecia and decided to half the dosage, that is ultimately up to you. Legally, as I am not your doctor, I can’t give you suggestions like what you’re asking about. However (you knew this was coming), you really should meet with your doctor sooner rather than later. A urologist is a better choice when it comes to the diagnosis for testicular pain.

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Dr. Rassman,

I’ll try to keep this as short as possible.

I started Propecia in Summer 2007 as it was prescribed to me after a dermatologist visit in which the doctor diagnosed me with MPB. I took the 1MG 1x daily up until December 2007. I discontinued the drug because of the cost as well as a couple of close friends’ stories of libido loss and worries about impotence.

As I’ve now learned is common upon stopping the pill, I began losing my hair again and it has now become visible and very depressing. I want to get back on Propecia to help curb the hair loss as well as try any other supplements that may help the battle. However, I’m worried sick about some of the stories I have heard/read about concerning long-term use of Propecia and sexual/Prostate problems that are irreversible. How do you feel about these stories? There are multiple websites dedicated to getting the word out about permanent semen reduction, watery semen, ED, depression, etc. Is there evidence to back these stories up that you know of besides the hearsay? What is your professional opinion on these stories and the fact that the drug has only been out 10 years so no long term studies have been conducted?

Also, if I do begin the Propecia again, is Nizoral a good supplement to combine into a regimen? I have heard good things about Zinc supplements as well. Any recommendations?

Thanks so much for your time and help,
It is much appreciated

Nizoral is a good shampoo, but it won’t do anything to regrow your hair. I’ve addressed the side effects questions many, many times before on the blog — the most vocal are the ones with complaints. There are hundreds of thousands of men that use the drug that don’t spend all day on forums discussing it in a positive or negative way. Also, the complaints are unsubstantiated — I could say that Propecia grew a 6th finger on my left hand and made my skin turn silver, and how are you going to disprove that? The FDA published that the side effects occur in less than 2% of men.

You already have experience with the drug and if you did not develop side effects in the 5+ months you took it, it is doubtful that you see them when/if you restart Propecia. We are in total control of our decisions, but unwise choices may lead you further down the course of more and more hair loss.

(Note: The above image is Photoshopped, and it was not caused by Propecia. I hoped I wouldn’t have to point that out, but I don’t want any emails about it.)

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Although you stated in your answer to the question entitled “I Had No Hair Loss, But Tried Rogaine and Now My Hair Is Different”, I believe that I am experiencing the same thing. I started using Rogaine after experiencing telogen effluvium on the recommendation of my doctor. He recommended I try it for a few months saying that it might jumpstart me out of that cycle. Anyhow, my hair has been getting thinner and ive continued to have hair loss. While it appears for the most part to be in a typical male pattern loss (crown and top of the head thinning), I’m also thinning on the sides and back, where i dont even put the rogaine. I also have a larger mixture of thin and thick hairs now, which I never really had before trying the rogaine. My question is if the rogaine causes normal hair and hair densities to thin to a new “normal”, thinner density. Hope that makes sense…

Rogaine (minoxidil) should not impact normal hair and there is no evidence that it makes hair thin when applied.

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If finasteride can’t be absorbed into the skin, why aren’t women supposed to handle it?

Great question! I assume that it is a medical-legal issue (drug company is Merck) for pregnant women, as this drug is known to have side effects on the baby in the first trimester of pregnancy. This is just my best guess, however.

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Does 2.5mg of Fin every other day increase chance of side effects compared to 1.25mg everyday?

Because I cannot cut my generic proscar into 4 pieces, it crumples, and my doctor suggested I split the dose into 2 pieces and take every other day, but I’m worried that starting to take 2.5mg of finasteride when never taking the medicine before might be too excessive? Thank you doctor.

Finasteride stays in your body about a day, so after a day 95%+ will be out of your body. Does the extra dose make for a more effective treatment? Well, that is answered by the science, which showed that higher doses do not impact the value of the drug when treating hair loss. I doubt that there will be more side effects, but frankly I would not know for sure. Each person reacts differently to medication. I would stick to the recommended (or close enough to the recommended) dosage — 1mg daily. Try using a sharp knife to cut the generic Proscar into 4 pieces, rather than using a pill cutter. You may have better luck getting the proper dose that way. Or, you can buy Propecia and get exactly the correct dose without any cutting hassle.

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I am a 42 year old male and my hairline began to recede about 3 years ago, primarily on the sides. In addition, the hair in the sideburn area began to thin as well.

To combat this I decided to go to a medical hair treatment consultant 8 months ago. They suggested hair transplants of about 1000-1400 grafts, but I could first try the Propecia & Rogaine combo. I opted for the latter.

After about a month I noticed a huge difference in hair loss. I went from seeing dozens of hairs on my pillow and on my hands when washing my hair, to just a few here and there. At the 6 month mark I began to notice small peach fuzz hairs along the hairline which had been smooth before. Now I am beginning to get hair where hair did not grow before in the lower temporal and side burn areas. Instead of a horseshoe area it is shaped more like a triangle.

My question to you is, will this peach fuzz hairs become thicker? Also, is the hair that was never there before an anomaly?

It is a known side effect of Rogaine (minoxidil) that it will grow hair on other parts of the body, possibly from systemic absorption. When the drug was first developed it was used as an antihypertensive and the side effects were not detectable in women treated systemically with abnormal hair growth on the face and elsewhere.

I can not answer your question directly, but you may be unusually sensitive to this drug’s side effect (of hair loss). Wait it out or stop it. If it continues to grow hair, make sure it is in the areas you want to or just stop it.

Theoretically, how much finasteride would we have to consume to equal the amount those tuber-eating hermaphrodites ate?

I think that the answer to this question has never been quantified. I would guess that it would be hundreds of times the dose, but I really don’t know. A very interesting question, but one that I just don’t have an answer to.

For those interested, a couple years ago I wrote a post about genital abnormalities in babies exposed to finasteride — Proscar Warning Label and Possible Birth Defects.