Balding Blog

This is a purely hypothetical question. Would a man taking female birth control pills have any effect on male pattern baldness? What would be the effects on DHT, Testosterone, and hair health. Thanks!

The following post is by UK-based physician Dr. Bessam Farjo:

Written by: Dr Bessam Farjo United Kingdom

Female birth control or contraceptive pills are most often a combination of synthetic forms of the female hormones, estrogen and progesterone. With regards to effect on men’s hair you may get a decrease in facial and body hair in terms of thickness and growth, although male-pattern baldness may improve somewhat or at least stabilises in a similar vein to finasteride for example. We see this effect most commonly in our practice when dealing with male to female transgender patients who use similar hormones to achieve their transformation.

However, these medications may cause a number of adverse effects in men similar to those seen with the use of other female hormones. You may experience changes in the appearance and function sex organs. Risks may include erectile dysfunction, decreased libido and lowered sperm count. Some men may also develop gynecomastia (man boobs). There may be a negative effect of general body muscle mass. In addition, the bones may develop osteoporosis (brittleness). There are other potential general health side effects of course making this an unreasonable approach to control male pattern baldness.

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Learn more about the author of this article, Dr. Bessam Farjo, on his BaldingBlog profile or at his website.

Dr. Rassman,

It seems there are a lot of young men frequenting your site, myself included, that are concerned about hair loss.

My questions is how much recession from a juvenile hair line must occur before hair loss can be diagnosed and a treatment can be issued.

Would a responsible doctor issue finasteride to maintain a Norwood 1 hairline?

Finasteride does not usually bring back frontal hairlines and I do not prescribe it to men who are not balding. Norwood 1 or 2 patterns are not considered balding.

From your practice, what is the worst progression of balding that you have seen with someone taking only Propecia and not anything else like Minoxidil? Like what Norwood was he before and after and how long was he taking it and how old was he?

I routinely prescribe finasteride for all balding men, so progression is not evident as the process slows down considerably. In the days when Propecia was not available, the balding process was very evident in a matter of a few years, but now when Propecia is used, I just have not seen the radical changes in balding patterns.

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.)