DR. R
did this patient you mentioned last week take propecia by any chance as well? I just want to know as to if he lost non transplant hair after the transplant through the years was it with or without propecia

So everyone is up to speed, the post from last month you’re referring to is here — Great Hairline, Thin Top and Crown, Low on Donor Hair

This patient did not take Propecia (finasteride) over the period of time we worked with him. Many people who are satisfied with their transplant results don’t “officially” recognize that they have a progressive process and in men like this, practicing denial as it goes on is common. In older men (like this man, over 40 years old), their decision to not take Propecia is common, as these men feel as if they beat the balding process and will not bald more over time. And in men over 40, this is not an unreasonable conclusion as the balding process often slows or stops on its own — but clearly this man lost his gamble as his balding pattern acted as if he was in his 20s, not 40s.

When I see a man under 35 years old losing hair, I stress the need for Propecia to guarantee, as much as possible, that the balding process has slowed or stopped. It is often a battle between us, as no one really wants to take the drug, especially with good transplant results. I can not stress the importance of staying on the drug to stop the type of changes that this man had and although there is no real guarantee, it is reasonable to take the drug for life.

Hello Doctors

I am 20 years old and Ive been using 5% Minoxodil foam for 4 months now (on a recommendation from my practitioner), and im seeing little in the way of progress (been losing hair and receeding since I was 18). I am going to see my practioner next week about getting a prescription for Propecia (im not worried about the side effects).

Would you recommend continuing the use of 5% Minoxidil along with Propecia, or stop using the foam whilst using Propecia?

Many patients use minoxidil (foam or liquid) while taking Propecia. If your doctor prescribes the Propecia, you can continue the minoxidil daily. There is no problem with this. Keep in mind that if you see positive results, you won’t know which medication was the reason (or if both were) — so you’ll need to continue using both for life or risk losing the benefits by stopping one.

I wouldn’t have expected much progress at only 4 months of minoxidil use, particularly if you’re looking to treat a receding hairline. These medications work best at the crown.

I got two questions linked to finasteride and side effects:

1. Why does testicular pain occur when taking finasteride?

I’ve read somewhere that the testicle is working overtime to produce more testosterone as it senses that DHT is low and is trying to compensate. I don’t know if this is true or not, but is there any “official” explanation?

2. Is there any connection between finasteride and penile shrinkage?

You should not have testicular pain when taking any medication, including Propecia / finasteride. If you have testicular pain it may be a serious medical emergency. I believe it was less than 1% that had this side effect in the clinical trials, so it is quite rare. I don’t have a reason for why it could occur at all, though.

I would strongly advise you to follow up with your doctor. What you read on the Internet (and even BaldingBlog) does not substitute for a face-to-face personal relationship with your physician, and that includes exploring the cause of your testicular pain. Finally, finasteride do not cause penile shrinkage.

I’ve been taking Propecia for almost a year now and don’t think I’ve seen any more loss but I’m curious about taking Propecia whilst drinking heavily. I drink every night due to a stressful job and also entertain clients. I am looking into cutting down but due to the nature of my work, it’s not always possible.

If I am taking Propecia whilst drinking a lot, is there a better time of the day for me to take it? If I take it in the morning before work after a night of drinking, will my body process it like normal?

You know this already, but you should cut down or stop your excessive drinking. Taking Propecia is not related nor interferes with alcohol intake.

However, if you develop liver disease from the excessive alcohol, this could negatively impact the metabolism of Propecia. But if it got that far, hair loss shouldn’t be your number one priority anyway.

Hello doctor,

I’ve been on propecia for about 8 months and its going well my hair is stronger and the crown is looking better every day..

I’ve noticed some long thin white ‘baby’ hairs on the front of my head where my hair recedes that were never there before. Could I be one of the lucky ones and get hair growth on my front too?!

Perhaps you are one of those rare lucky patients that sees some regrowth at the hairline from Propecia (finasteride). It would be nice to see your before and after pictures.

What you are calling ‘baby’ hair is not the strong hair that you need to consider it regrowing, but give it a full two years to see what emerges.

If one takes male enhancement supplements while in finasteride would that combat any possible male member negative effects from finasteride? Thanks

We all know about the prescription medications like Cialis and Viagra, but I do not know if there are any valid male enhancement supplements out there that really work. I realize they are advertised as such, but scientific research and actual effectiveness attached to these supplements are vague.

That being said, if you are having side effects from Propecia / finasteride, please speak with your doctor and make sure there are no other medical issues.