Balding Blog

My fiance and I are planning on trying to start a family in a few months (after the wedding). I’ve read in some places that Rogaine can lower sperm quality or affect an unborn fetus somehow, but I can’t find it anywhere that looks official. Is there any truth to this? If I do stop using it, will a large portion of my hair fall out within weeks? I’ve never gone more than a day without using it.

I’ve been on Rogaine for about three years now and it appears to have slowed my hair loss. If the choice is between keeping my hair and the health of my unborn child, obviously I’ll pick the latter. But I’d rather not have to choose. Thank you!

Rogaine (minoxidil) should have no effect on your sperm, nor have I have read anything supporting what you read about it affecting the fetus. Of course, if you’re concerned you should talk to your doctor.

Perhaps you’re confusing it with Propecia (finasteride), which has rare side effects related to ejaculate and fertility (but not change sperm count).

Hi Dr Rassman,
I’m 29 yrs old and have been on propecia since 1st Aug 08, so its just coming to 7.5 months now. My hair growth has gone from strength to strength since then, mainly on the top and cranium of my scalp where the hair was thinning. However i’m suffering from sexual side effects mainly erectile dysfunction (ED) and a libido drop. I got them in the 3rd month but i thought I had to give it a fair period of time to see whether it was a passing phase. But the problem has persisted and the volume of semen has gone down and my erections are not as full as before I started taking it. I have decided to half the dosage. What is the best way to incorporate this? Shall i stop taking propecia for say 3 weeks or perhaps longer or shorter and then start taking half a pill on a daily basis instead?

Also, I never tried minoxidil but I have read people complaining about dark circles and skin roughness on the face as permanent side effects. And apparently the results are nowhere near as good as propecia? Is this true? Also, does it also cause ED & drop in sex drive? If i do decide to go on Minoxidil would you recommend the 5% solution or the 2% solution?

If you have just erectile dysfunction (ED), Viagra might help. If you can not solve your libido problem with Viagra, you may have to stop the Propecia. Cutting the dose in half often helps and even 1/4 of the dose might help further. You should discuss this with your prescribing doctor.

Rogaine is not a DHT blocker and as such, stopping your Propecia will cause a significant hair shed even if you take Rogaine at the same time. Rogaine does not have the sexual side effects you are experiencing with Propecia, but it also doesn’t work to halt the hair loss (though it can grow hair). You can start with the 2% and go up to 5%, but it’s up to you. Both are available over the counter (at least here in the U.S.).

I’m very seriously considering starting a course of propecia/proscar. But before I began I wanted to ask two questions.

1. It has been said that if you start propecia early the better chance you have of slowing down/halting hair loss, but that doesn’t tally with the propecia chart from studies which show that it generally peters out after 3 years. so surely you’d only save your hair for 3 years and then it would quickly regress, not making much difference how early you start because you only have 3 years of good hair.

2. I was wondering if you could recommend a good dermatologist/hair doctor in London, who I could have a consulation with before I begin taking proscar, do you know any who do miniturisation tests or some kind of form of monitoring on hair loss? There are a lot of snake oil merchants in London that are willfully telling you that you must get on medication and I just want to talk to who is honest and experienced.

I have many patients that have reversed their crown loss and held the reversal over 10 years. Everyone is different, but the official studies show that the expected maintenance should be about 5 years on average. That means that some men get better than 5 years and some worse results while on the drug. It depends upon how aggressive your genes are.

As to your second question about London-based doctors, Dr. Bessam Farjo is a contributor to this site. He and his wife are terrific doctors and worthy of a trip to their offices (in London and Manchester). They may be able to give you a referral if you call their office.

Hi Doctor,

I read in one of your posts, that people continuing on propecia for 10 years have been able to retain most of their hair. So are they also able to retain the regrown hair also or only their baseline hair??

Some men have great success with Propecia after 10 years, as it seems to hold onto the hair in many patients. Some men continue to lose hair progressively, making it appear that the drug slows down. The key is that Propecia, even at the 10+ year mark, is slowing the rate for hair loss.

Hi, Just wanted to say that your blog is amazing! It’s helped me to answer so many questions.

Now i was just wondering, i started propecia on monday (2 days ago) and have there been any reported cases of lowered libido immediately after taking propecia which die down in the coming months? Thanks

If you have a libido side effect from Propecia, it might take weeks or months to appear… not a couple of days. The power of suggestion is very significant in those who get libido effects, so worrying about it is going to do more harm than you may realize.

Then again, I suppose the power of suggestion from reading this post may be in competition from the power of suggestion from other information you are inundated with.

Hello,
are there any side effects on Propecia that affects the heart? I know that right now it’s not part of the official listing on Propecia’s side effects, but as an expert, I believe you hear a lot from people who’s taking it and might have any information regarding it.

I started taking propecia about 2-3 weeks ago. Since yesterday I started to feel a strong pump in my heart every now and then, specially at night, and it seems to intensify when I lay down. The strong pump is a bit odd, it feels like an uncomfortable tension in my chest, and it’s also slightly respiratory.

Ps: I’m 25 years old, weight 175 pounds. Don’t have any heart issues, and never felt this before. I also take another medicine, an anti-depressant: Zoloft.

Congratulations for the blog! Thank you.

I have not had any patients in the years I’ve been prescribing Propecia that developed heart related side effects. If you have heart related issues, you need to speak with your doctor ASAP. It probably is unrelated to Propecia and can be a very serious medical condition.