Painful, Clumpy Ejaculations After Starting Propecia

Hi there-

I’ve surfed through past entries, and was unable to find a post specific to the problem I’m having.

I began noticing the signs of MPB in my late teens, and a more prolific loss in my early twenties. I’m 24 years old now, and have been on a Propecia/Rogaine regiment since visiting a dermotologist last year.

Within two weeks of consistent Propecia use, I began to have painful ejaculations and the consistency of my semen became clumpy/very gelatenous. I was told that sexual side effects usually subside with continued use, and indeed, ejaculation is no longer painful. My semen consistency is mostly normal now, but it occasionally reverts back to that of the initial months of taking the medication.

Ever heard of a similar experience?

I have been aware that the consistency of the semen changes in some men, but I have not heard about painful ejaculation. Talk to your prescribing doctor about this issue.

Contrast Between Scalp and Hair

Female – I have been thinning for years and as a result, have been bleaching my hair. My rationale is that this lessens the contrast between the scalp and the hair and makes the hair loss less noticable. Recently, I went to a new stylist who told me that my theory is false and that dark hair will make the hair less transparent and therefore less noticable. It’s been three days since she did my hair and I have to say that I think I was right. I think the new darker shade makes the hair loss more noticable. Am I nuts? Should I go back to being a blonde or should I stay a brunette?

When the scalp and the skin are closer in color (white skin and blonde hair) the impact of thin, see-through hair is less obvious. Styling with puffed-up hair styles are popular in women who also dye their hair to get a fuller look. That is more of a styling issue. Don’t worry, you’re not nuts. If you’re more comfortable with being blonde, I’d say you should go blonde. Go with what you’re comfortable doing, and with what you think looks the best.

I Switched to Dutasteride And I Have More Hair But Does It Cause Sterility?

I am a 33 year old male. I had been using Propecia for 3 years and switched to Dutasteride approximately 6 months ago. Since switching to Dutasteride, I am experiencing less sexual side effects than Propecia, even at 1.0mg daily dose (twice the dose which is recommended in treating BPH) – I am also experiencing more hair regrowth than Propecia. I am wondering how and where you draw the inference that Dutasteride has the potential to cause sterility. Any firm evidence, clinically?

Just like your positive hair growth experience with dutasteride there are others who have negative experience with sterility and sexual side effects.

I cannot find a study or firm evidence, but I always try to balance risks and benefits. If you are never planning to have children, then it may not matter but if you are, why would you want to risk it? In addition dutasteride is not approved for the treatment of genetic balding and there is also no clear evidence it is much better than Propecia (despite your personal experience). If you want to know if you now have a problem, your doctor can order a sperm count which will show a problem if there is one.

Could a Fungal Infection Mimic a Norwood Classification of Baldness?

Does fungal infection if not treated mimic Male pattern baldness say (norwood 5)?. Could u explain types of infections or fungal infections in general a little better?? would we see hair loss in patches or one might start losing hair from the front due to infection to all the way back? if treated do these conditions reverse back to having a full head of hair??

Simply put, if you let the fungal infections go on for years, it might look like patterned hair loss to the inexperienced eye. For more on fungal infections, see Wikipedia – mycosis.


2007-09-13 09:31:25Could a Fungal Infection Mimic a Norwood Classification of Baldness?

Patient’s Comment on Scalp Micropigmentation (SMP)

Dear Dr. Rassman: Had the 2nd of my three procedures today. Almost like a sculpture, it really now has started to take shape. Sure, I’ve looked at photos and seen real live guys at your Open House shows who’ve had this process, but there’s nothing like having SMP done to your own challenged head.

Once again, Kudos to the technicians who worker harder than stainless steal and have the patients of angels and Dr. Pak who stepped in mid-way and said: “Now it’s time to mail down your front hairline” which he did with the precision of a rocket shop landing on the moon.

But I do have one regret… which I expressed to your staff openly: “Where were you guys 40 years ago when I first coulda used this?

Dr. Rassman’s comment: This man started his hair transplant process too many years ago. He is now in his 60s and shaved his head for the procedure. He will eventually allow his hair to grow on top of the SMP. This type of comment occurs almost every day in our office. Scalp MicroPigmentation is one of the most satisfying procedures we have ever offered.

Could Hair Loss Be Due to External Causes, Rather Than Internal Causes Like DHT?

I read an article a while back that said resaerchers had found that acne was actually caused by a bacteria or fungal infection within the pores not an internal cause as previously thought.

Could it be, with Hair loss that resaerchers are only focusing on internal causes such as the DHT and actually overlooking other external causes like some kind of Fungal Folliculitis of the scalp that eats away at the folicles? Where does the DHT come from and why can’s we stop it?

Anything is possible, but the explanation you offered has not come to the forefront. I would not be surprised if there were other mediators for hair loss that make hair loss show up in one person and not another. We are not well informed enough to go there just yet.

This is what we know (taken from an article by Dr. David Whiting, a widely acknowledged leading researcher/dermatologist): “Testosterone and dihydrotestosterone can circulate systemically to follicles, or be manufactured locally in the follicle from circulating weak androgens (dehydroepiandro-sterone and androstenediol) via complex enzyme-mediated processes involving specific dehydrogenase and reductase enzyme pathways. All of these enzyme reactions are dependent upon specific pyridine cofactors. It is clear that reductase, dehydrogenase, and probably aromatase enzymes are of major importance in hair growth as they mediate the complex interchange of sex hormones implicated in anagen activity.

That is the biochemistry of DHT (dihydrotestosterone).


2007-09-11 14:33:08Could Hair Loss Be Due to External Causes, Rather Than Internal Causes Like DHT?

Could Propecia Have More Impact as You Age?

Hi Dr.Rassman,

Thank you for this great blog. I have found it to be very honest and informative. My question is regarding Propecia. I hear everyone talk about how it is wearing off or losing its effectiveness, etc. It is possible that Propecia works better for some over time? I have been on the drug for 8 years and i notice from pictures my crown looks better than it did 3-4 years ago. Keep in mind, I never did an actual hair count, but I take pictures in identical settings (same spot, lighting, no flash) every year to keep track of my hair loss.

Even in that small 10 year study, there was a significant portion of people who actually looked better than the 5 year mark. They’re reasoning that MPB is a slow progressive process, reversing it can be a slow process also. Or something along those lines. I’m 38 years old and I know that MPB starts to slow down at this age. I was just also wondering if Propecia would have more impact as the person gets older?

Thank you so much.

We actually do not know the answer. People respond in different ways. Some people remain sensitive to the drug for years and they are the ones that probably get the best results. If it is working, just stay on the plan to keep taking it. When and if it should reduce its effectiveness, certainly go back to your doctor and get his/her advice.


2012-07-03 13:18:00Could Propecia Have More Impact as You Age?

Why do people lose hair with chemotherapy?

The hair is a rapidly growing organ, possibly among the fastest of body well (outside the intestine). Cancers are also fast growing so when the cancer is treated with Chemotherapy, the treatment targets fast growing cells. That is why many people who get this get stomach and intestinal side effects. Hair loss occurs in the same way. We have written about the Cold Cap to prevent hair loss with chemotherapy and it is an important tool, review posts here: https://baldingblog.com/?s=cold+cap&x=0&y=0 and you can review the many posts on the subject.

Some people only partially regrow their hair if they lost it. This may be caused by permanent changes in the life of the hair follicle which is frequently limited anyway. When a hair follicle reaches the end of its life (from genetic balding or even old age), the cells undergo apoptosis (cell death). The Chemotherapy may damage the hair cycle clock limiting how many cycles the hair goes through. We know that hair goes through aging in all of us and we often see changes of hair character (from a coarser hair to a finer hair) or graying (as we lose the pigment cells that give our hair color.


2017-05-03 10:48:25Why do people lose hair with chemotherapy?

Could Transplanted Hair Fall Out Months After a Successful Procedure?

Dear Doctor

Is it possible that some transplanted FUs were rejected and (the respective hair) fallen some months or even years after a successful HT? I had an HT on a completely bald area. i had nice results, but i’m pretty sure the area looks thinner now than 8-10 months after the HT. My doctor says its my idea. I seriously doubt that. thanks for your time

On very rare occasions I have seen the “permanent” hair lost some years after a hair transplant. I don’t understand it, but I have seen this complaint. You are not crazy! You’re only 10 months out from a hair transplant — so how soon did you see the results that eventually disappeared?