Hi Doc, I had a question about finasteride, because I’m thinking of starting Propecia for hair loss and I’m worried about the sexual and other side effects. Basically, what is more responsible for healthy sexual function in males? DHT or testosterone? If testosterone is responsible, then shouldn’t Propecia help to increase sex drive – because speaking from a chemistry perspective, if Propecia reduces the forward reaction rate of the reaction that converts testosterone to DHT, then shouldn’t that lead to excess testosterone in the body? Unless Propecia inhibits testosterone as well?
Because I don’t understand how herbal DHT inhibitors like Procerin claim to have no sexual side effects, if they ultimately perform the same function. Unless of course there are other factors into play which I’m unaware of.
We have written about this over and over. Here’s some bulletpoints:
- See your doctor (as only a physician can prescribe Propecia) and ask him/her these questions in detail after they take your history and examines your scalp to determine that Propecia is something that would be recommended.
- Propecia has a side effect of decreased erection/libido in 1 to 2% of men. This side effect has been greatly exaggerated on the Internet. Moreover, many other drugs that treat blood pressure from cholesterol lowering drugs (any many other drugs) can also develop depression and have a similar negative sexual side effect.
- If you have a negative side effect, talk with your prescribing doctor and you may choose to stop taking Propecia. The side effects are reversible.
We can all hypothesize about the biochemical reaction of Propecia and testosterone and DHT, but in the end it works for male pattern baldness… and ultimately it is your choice to take it. I do not mean to brush off or not answer your question on the mechanism, but it will spiral us down a never-ending hole of “if this” and “if that”.
Healthy sexual function in men has nothing to do with drugs, Propecia, testosterone, or DHT in normal men. If you are a healthy individual in a healthy relationship, then you should have a healthy sexual function with or without Propecia. Propecia will not enhance or impede your sex life or health in greater than 98% of patients. If you think it does, then talk to your doctor. Of course, if you have your testicles removed, then you will have reduced testosterone and DHT, and will have wiped out your sex drive. DHT comes from the degradation of testosterone in the body, so if you do not make testosterone, then you will have very, very low levels of DHT.
Procerin is not a medication or a drug. It is a clever marketing name for an over-the-counter herbal product (saw palmetto) that sounds similar in name to Propecia. Procerin is not regulated by the FDA, nor has it been proven to actually treat hair loss.
As we’ve said over and over, the most common cause of hair loss in men is androgenic alopecia (AGA). This is often referred to as male pattern baldness (MPB). It’s a genetic issue and just as the term implies, the hair loss happens mostly at front and top (as you describe, in a pattern). Certainly many medications may list “hair loss” as one of its MANY side effects, but medications are often the last culprit. In other words, your loss may be completely unrelated to the medication.