I wanted to know, if you have an undefined hair loss pattern, for example thinning in ur frontal hairline in one corner then some in the middle and none on the right hand side. Would propecia be effective in treating that, and would the hairloss be aggressive since it has an undefined pattern or would it not be aggressive?

Thank you.

It sounds like you do not have a clear diagnosis of your hair loss. Propecia is for the treatment of male pattern baldness (MPB), but if you indeed have diffuse unpatterned alopecia (DUPA) then Propecia would not likely help. Some patients mistake MPB for DUPA when hair loss is worse on one side.

Eventually (especially under the microscope) the hair loss pattern may emerge, thus a good examination and diagnosis is important. The status of the hair in the very back of your head will tell the doctor if you have DUPA or not.

This was a comment we recently received on an older Propecia post:

DO NOT TAKE THIS DRUG! My fiance took it for years, with no side effects (although we are realizing now that the emotional/mental trauma he has been suffering since he took the drug is very likely related) – but once he quit the drug he experienced genital shrinkage, low libido, trouble maintaining erections, etc.

Some studies have shown that ~95 % OF MEN SUFFER these side-effects to some capacity – no long-term side-effects were studied by Merck and what makes it tricky, is that RIGHT AFTER you stop taking the drug, you go back to normal for a few days/weeks – then, the symptoms worsen!! Stay away!

Genital shrinking after stopping Propecia is a new complaint, something I have never heard before. What you are saying is just not enough information for me. Of note, where are you getting this “95%” statistic of men suffering from this issue? It sounds like you’re confusing stats.

If I were to entertain this possibility, I would need to know the following bits of information: for example, are you talking about his penis or testicles that shrunk? Or are you talking about the size of his erection? He would need to see a doctor and find out:

1. What his testosterone levels are
2. What his sperm count is

He would need to get examined by a competent urologist. That is a start if he is really worried.

Hi Doctor,

Was wondering if you have heard anything whatsoever about this product called “Herbal H” for hair loss, I came across it a few days ago. I am attaching a link to their website; herbal-h.com

They have minoxidil listed as an ingredient which is obviously FDA approved. But I wanted to know if you have any information regarding the other listed ingredients or the product itself, for hair loss.

Thanks you.

This seems to basically be just 3% minoxidil with supplements in it (iron, saw palmetto, zinc, copper, angelica, and other things I’m not familiar with). There are a variety of products out there that contain minoxidil with other supplements, and I don’t know that one is any better than the other.

So the only thing I can really say is that topical minoxidil does grow hair, but the strength of minoxidil that is recommended for men is usually 5%.

Hey I wrote to you before about low/watery sperm volume when it comes to propecia. I just wanted to ask: could a side effect like this occur earlier if I’m only suffering from a receding hairline. Could 1mg of propecia be too much for a patient with only a receding hairline & thickness of hair everywhere else on the head? Should I think about lowering my dosage and try it out?

If you just have a receding hairline, it’s unlikely that Propecia will regrow the hair there, though it could keep further loss at bay. Watery ejaculate isn’t specific to those with just hairline recession, nor do I believe that the speed at which it might occur is related to the degree of loss.

You’ll need to talk to your prescribing doctor about dosage changes. I don’t know anything about you and you’re not my patient, so I can’t tell you how much or if you should be taking a prescription medication.

I had been on Propecia for years but unfortunately suffered with notable side effects, particularly sexually. I had little libido, suffered with incomplete erections, testicular pain, and limited ejaculate volume. I realized that it was negatively impacted relationships with women since I had little interest in them sexually.

I decided in January to come off Propecia as a trial. I noticed a bump in libido after a few weeks off and improved mood and motivation. My erections did not return however until about four months off Propecia, firm by five months. I am now in a dilemma because the hair loss has been terrific. I went from excellent hair to thinning lifeless hair (made worse by using Rogaine) and noticeable loss of temporal region hairline. My appearance has definitely suffered and I am not in a relationship.

I am contemplating going back on Propecia and wanted to know if you would recommend 0.25 mg starting dose or 0.5 mg? Can I expect some regrowth on top at these doses? What is your experience with these lower doses. Some have recommended 1 mg every two to three days due to the long action of the medication (in an attempt to limit side effects). Any assistance would be greatly appreciated!

My assistance and recommendation for you is to discuss your issues with your doctor who prescribes you the medication. This is a general source of information. I do not and cannot advise you on personal medical issues.

If you have side effects from medications then it is something you inform your doctor. Some patients continue to take the medications after the risks and benefits have been considered. Some patients take a lower dose in hopes that the side effect would be less and the benefits would continue.

There are reports that at even half the dose (0.5mg finasteride daily) can be about 70 to 80 percent effective on the treatment of androgenic alopecia. I’ve prescribed a lower dose to some patients and they’ve had continued benefits from the medication, but that is something you’ll need to discuss with your prescribing doctor.

Hey Doc, I just wanted to share my opinion on Propecia. I was noticing some recession of my hairline & got it checked by mt Derm. He told me it’s just my maturing/adult hairline forming. But I panicked & asked for a 1 month Propecia Prescription. I’ve taken it for only 2 days & have noticed a low volume in sperm when I masturbate; almost liquid/watery. Much less thickness then before. What I’m going to do is get my Hormone Levels check in a week since that might be enough for Propecia to exit my body. Could it be that I might not need Propecia if my DHT levels come back normal. And the low volume could have been a sign saying there’s no need to decrease your DHT levels since you have normal DHT levels. Again I’ll wait and see what happens.

The last thing I would like to state is that I think at least a good 70-80% might notice low volume when it comes to the sperm. Now this could just be a common side effect of your body getting used to Propecia, and will return to normal within a few weeks- hence the only 2% notice sexual side effects of a period of years when it comes to the trials. So basically I think the low volume when it comes to the Semen could be just like Shedding or mild headache from something like Rogaine which a lot of people experience while using Rogaine & then it goes away. So maybe the Low volume in Semen could be the same- first few weeks it could be low & then return to normal after the body gets used to it.

The thing is if this is true and Merk knows it, then they should state it clearly: That most men taking Propecia will notice a low count in the volume of semen in the first few weeks but then it will subside and return to normal. I think this very much is true, but Merk might be scared to state this clearly as it will scare of customers from hearing about low volume in semen in the first few weeks. Again I would love your insight on this, as I believe it is true. I’m not saying Propecia has a long time effect on Semen Volume, but it could have a short time? maybe a few weeks as the body is getting adjusted to the levels. Again Merk should state this as it could also put rest to all the stories of side effects ruining peoples life.

Thank You & I hope you take your time reading this

One of the side effects of Propecia involves the volume and/or viscosity of the semen, but I would be surprised if it would occur in just 2 days. This has nothing to do with the sperm count per unit volume of semen or one’s erection or libido.

The mature hairline evolution may not be impacted by finasteride, but I really am not sure on this statement.

Hi There Doctor!

Im a 22 year old guy with a pretty good head of thick hair currently. No one currently would ever know I am thinning. Recently I went to get my haircut and my stylist told me i may have some “thinning issues” as she noticed short hairs near the front of my hairline. Crown is very thick at the moment.

I made an appointment with a dermatologist and she said that right now is a great time to catch it and potentially preserve everything I have and started me on Finasteride 5mg cut in half once per day. (2.5mg daily) and she said “see ya in a year!” I have been on it for two and a half weeks with no side effects yet.

My question is if it takes a year for Finasteride to show any results, isnt a year a VERY LONG time to lose hair? Couldn’t I lose A LOT of Hair in that period of time? I hate this feeling that I’m on the best medication for hair loss, but at the same time I’m gonna be losing hair at the same rate for a year before it even starts working?! Am I understanding how Finasteride works correctly Or does it immediately start to “help” but will just take a year to see any major preservation or potential regrowth?

Thanks!

It may take up to a year before you notice the effects of finasteride on treating androgenic alopecia. Maybe some will see signs in 6 months, but I generally inform my patients that they should be prepared for a 6 to 12 month time span before they can see results. That being said, Propecia (finasteride 1mg) is for the treatment of androgenic alopecia on the crown and top of your scalp. Some patients and doctors use it for frontal hairline thinning, but it is generally not effective.

As for the dosage you were given, the recommended dose is 1mg taken daily. Many patients and doctors, in the interest of cost saving, choose the generic 5mg which they break into quarters (1/4) to make 1.25mg of finasteride. There is no generic finasteride in 1mg dose legally available in the US yet due to patent laws. While breaking up a small 5mg tablet in to four small semi-equal pieces may be annoying, it saves hundreds of dollars a year. For example, a one year supply of finasteride 5mg taken 1/4 pill a day will cost you under $30 per YEAR. The brand name will cost you close to $800 a year depending on where you buy it. There is no difference in efficacy in taking the generic drug. Taking 1.25mg a day as opposed to 1mg should not have any significant difference. Ideally you should be cutting the pill in to five equal pieces, but this is not practical.

Taking 2.5 mg daily is more than doubling the dose and it would not have any beneficial impact in treating your hair loss. Taking more does not mean it will work better. Rather, it will give you more side effects. But some doctors have their own opinions and they’re in their right to practice medicine and prescribe medications as they see fit. If you do not agree with your doctor and have concerns, you should seek a second opinion. After all it is called a “practice” of medicine. Just to be clear, I am not your doctor and this is not a second opinion.

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