Question re Propecia and Sperm Count. I take Flomax and Finasteride. Side effects are reduced libido and ejaculation. I noticed if I discontinue taking the pills, I regain libido and ejaculation volume in 3 – 4 days, although I had only been on these pills for three weeks. My question is, can I periodically take a “prescription holiday” and then resume medication after, say a week without risk of return of BPH? I.E. will the long term benefits of this prescription program remain in effect if I take periodic holidays?

I am not a urologist, but I suspect that when the “flow problem” has resolved, you might be able to stop if for a week, but I would first check with your prescribing doctor for a more definitive answer.

Hey,
I read your post about not cutting finasteride ahead of time because it may make the drug less potent. I was unaware of that and have been cutting them ahead of time for the last 6 months. I am on my second cycle and cut them the day I get them. That would make some of my cut pills months old. Would this make the drug entirely ineffective? I am not sure yet if some hairs are miniatures or new ones, so I was beginning to worry. Thanks a lot for any response.

The cut pills can absorb the moisture out of the air. The tablets have a coating on them that help extend shelf life and make them resistant to moisture, so cutting them one at a time before use won’t see any effectiveness problems. I don’t think your pills will be entirely ineffective, but certainly exposing them to the air without the coating isn’t how they’re intended. You’re running the risk of the shelf life being less than the date of expiration printed on the packaging. How much less effective can they eventually become? To be perfectly honest, I have no idea… but in the future, cut them as needed.

Dear Doctor,

there are many people suffering from hairloss, who use topical spironolactone as dht blocker. Do you think that it is an effective treatment against MPB? Is this a safe treatment or is spironolactone absorbed through the skin resulting in side effects? I thank you in advance.

Spironolactone can have significant sexual side effects in men. Finasteride 1mg (Propecia) works best with the least amount of side effects. I’ve written about spironolactone use here and reported on a clinical trial in Australia that recently started to treat hair loss in women here.

Hello – I recently added some new supplements to my daily routine and wanted to know if any them or the amounts could be potentially damaging to hair?

1. vitamin b6 – 200mg – is this excessive? I have read that a lot of b6 could potentially stimulate hair growth in men. Have you heard of this?
2. vitamin d – 2400IU – again, I feel that this is a necessary vitamin that is often overlooked. But how much is too much?
3. magnesium – 900mg

Vitamin B6 — Recommended dosage is between 1.3mg-2mg daily, depending on age and sex; Maximum dosage is 100mg… so you’re taking double the maximum. (source)

Vitamin D — Recommended dosage is around 200 UI, though it varies depending on age. The upper limit is 2000 IU. Again, you’re taking more than the maximum recommended. (source)

Magnesium — Recommended dosage is between 300-400mg, depending on age, weight, and sex. (source)

Now I do realize that when taking supplements the Recommended Daily Allowances (RDA, also known as DRI) are many times thrown out the window, but you should talk to a doctor about the potential side effects of taking too much of any particular vitamin. I’ve read that excessive about of vitamin B6 or vitamin D can help with hair loss, but that’s not been proven (and keep in mind it’s just what I’ve read online, not in a medical journal). Magnesium can help with healthy hair growth, but generally it is deficiencies in these vitamins that can cause problems. I’ve never told a patient to take excessive amounts to help their hair, though. I can’t find any information that shows potential damage to hair, but again, you should consult with your physician about taking so much of these supplements on a daily basis.