Hello, Dr. Rassman. I’ve read your blog for a while and am always impressed with your frankness and professionalism. I don’t see a lot of people that have had good results using finasteride posting, probably because once the problem is corrected you stop endlessly searching for answers on the internet. I started noticing hair loss about four years ago, and decided to control it a couple of years back.

From my experience, when I started finasteride I was looking for any of the side effects that might come with it under a microscope, but there were none. The only noticeable difference I saw (besides the shedding almost disappearing) was that I started getting morning erections again (I’m 31 and hadn’t really noticed I had stopped getting them for a few years). I would probably have been scared away from it if I hadn’t read your blog and your professional opinions. Good work, Doctor.

There are some who are vocal about Propecia’s negative side effects and you will find their thoughts readily on various forums and even the comments section on BaldingBlog. I wouldn’t be surprised if the same few men that write comments on nearly every Propecia related posting leave a comment on this one.

As you state, the many who are pleased with the results will almost never write about their experience… as they will stop reading this blog or spend countless hours on the Internet on the topic. The happy ones just move on and find other topics of interest. Those that feel slighted will spend an awful lot of time trying to drown out the rest.

Good luck, good morning to you, and thanks for your kind words of support.

Hello,
Just a quick question about the 2011 Alaska meeting. You spoke briefly about Minoxidil and spironolactone used together by a doctor in Thailand with good results. Can you elaborate on this?

Thanks a lot

Not much more info than is already all over the web separately on each medication. The study in Thailand was with systemic minoxidil, which is clearly not suggested for treating hair loss.

I am a 46 year-old male and a loyal reader of your blog. Based upon the positive results you have seen with Propecia, I decided to try it, after consulting with a hair-loss surgeon. I have taken 4 pills thus far. I was more than willing to tolerate the side effects reported by Merck if it meant stopping my hair loss. However, I have began to experience possible side effects not reported by Merck, including difficulty sleeping, mental fogginess, breaking out in sweats, along with the more common side effects of decreased energy and drive.

After experiencing these, I began doing some research and ran across sites you may be familiar with, such as Propeciahelp, on which users complain of side effects such as these along with others (e.g., hypogonadism) even after stopping the drug. There are various reports that the drug alters the brain (e.g., mood and thinking) by affecting neurosteroids and can permanently alter the neuroendocrine system.

Obviously, I am freaked out about this and will probably stop taking the drug. I would like to know your opinion on the reports of these side effects, the possibility of permanent alterations of various bodily systems with use of this drug, and your opinion on websites such as these (Propeciahelp) in general. Thank you for your trusted advice.

Suggestions can produce side effects (see “placebo effect” and “power of suggestion”). Your gonads will not shrink in a few days. It is possible (albeit very remote) that there are brain effects, but you should discuss this with your physician and that is why a doctor’s prescription is required for this drug in the United States and many countries. Have an open line of communication with your doctor. If you’re unable to sleep and you think it is related to the drug, talk to your doctor about stopping it.

While forums can be helpful, one must remember that many times they are full of unverified claims and feed into irrational fears. I’ve written about this before here.