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.).

Locally, there is a product on the market called, “Minoval” which is a 2% formula of Minoxidil. There is nothing said about having to have a family history of balding to use it. It is highly recommended by many which report remarkable results without a family history of balding. Do I really need to have a family history of balding to use the Rogaine for men or women? And what will happen, other than facial hair (5%) if I use it and I don’t have a family history of balding?

Minoval is another product out there that contains minoxidil as the active ingredient to regrow hair, and the biggest difference with this one is that it is produced in Haiti. Along with the hair growth, minoxidil can also cause small drops in blood pressure (producing fainting).

Minoxidil should have no effect on normal hair. I am not sure why a person would use it if they are not balding, though.

Hello Dr. Rassman,

Great blog and thanks for taking the time to help out so many people at not only no cost to us, but at the expense of extra time and effort on your part. It’s very appreciated.

Anyways, I am a 25 year old male with an equally diffused pattern of MPB that has been increasingly noticeable for less than a year. I have a couple detailed questions about Propecia. I understand that 10-17% of males on propecia still experience hair loss, but are those who experience a slower rate (but still losing) in hair loss included in this 10-17% or in the other 83-90%? Also, if I experience a Propecia side effect like chest soreness/pain/tenderness and I am I willing to live with the discomfort, is this actually going to hurt my body?

Keep up the great work!

I’m not sure where you got the 10-17% statistics, and I wouldn’t know how the figure was even calculated. There are percentages at the Propecia.com site and they explain how those numbers came to be — see here.

I do not expect that Propecia will produce chest pain of any type. I would hope that with these pain symptoms, you would seek out medical care from your primary doctor looking for real diseases that cause chest pain.

I have a question regarding to the use of 0.5mg or 1 mg propecia.

I’m a 23 year old male and i started using 0.5mg propecia since september 2008. Its a pitty that my hairline havent grown back, but my hair looks thicker and much healthier. And the hairs are not falling out anymore. And the side-effects are minimal to none, so thats great!

But I started using 0.5 mg instead of 1 mg because I thought i can begin low and when its needed i can always increase later. But now im actually curious what the results are when i increase the medication. Do you think its worth the try? And can there be any problems when i go back to 0.5mg later (that the drug then maybe isnt working optimal anymore because my body is used than to 1mg or something?)?

Also I just want to note: Because of the many negative news on the internet about propecia side-effects. I doubted for almost a year to begin with using propecia. Since I use it, i can almost shoot myself that i didnt begin with it immediately. I could have saved probably so many hairs!!

Thanks

Thanks for sharing the positive results with Propecia, even with just half a dose. Often times the success (or positive) stories of Propecia aren’t expressed on the Internet forums and websites because of our human nature. We seem to express our anger and share negative experiences in public more often.

I would discuss your results and goals with the doctor who prescribed you the medication. There are studies that show that a half dose may be 80% as effective as a full dose. While I am happy with your results, there are things about your story that trouble me. First, you are driving the process by the side effects you MIGHT get, not the optimal dose of the medication. Propecia generally does not work for restoring frontal hairline loss. At best Propecia may slow down a receding hairline. Drugs (like Propecia) do not just “stop” working. It is often difficult for patients to understand that Propecia may still be working as it slows down hair loss. If you are taking Propecia thinking that it will regrow hair or reverse hair loss completely, you are in for a big disappointment. In the end if you are going to go bald you will go bald. Propecia will slow this process down, but not stop it completely. In other words, Propecia will continue to work even if you notice that you are losing hair.

Finally, you are experimenting on yourself by changing medication doses around and asking for medical opinions without a physical examination (miniaturizationstudy). I cannot give you a recommendation one way or another because I don’t know if you even needed the medication in the first place. Hair loss is a medical and physiologic process. As such, I recommend that you discuss dosing with your doctor.

Hi Doc,
I’ve been taking about 0.25mg of Finasteride for 2 months. Due to paranoia, I was on the look out for sides. I noticed my erections, despite being just as hard, could not be ‘tensed’ quite as well. And didn’t feel as intense as a year or so ago (But I’m not sure if it was like that before I started the treatment). I’ve come off Propecia for 2 weeks with no change. Is it safe to say Finasteride was not the cause of this minor change, and it could simply be related to aging/diet? (I’m 22). It doesn’t cause me any problems as my erections are still easily hard enough for intercourse, it’s just I’d rather be at ‘100%’ if possible.

Thank you.

It sounds like you have an erectile problem which should be addressed by your doctor. It is generally safe to assume that once you are off finasteride for 2 weeks, it is essentially out of your system (if there is some tissue fixation) and should not be contributing to your problem. Plus, you’ve been taking only a fraction of the recommended dosage and say that you’re paranoid and looking for side effects (which could lead to a psychosomatic illness).