Doctor..

Had slow diffuse thinning for years. Just turned 60 with what many thought was a full head of hair. Though i knew it was thinning. Thought I was years away from needing a transplant until switched to Rogaine foam which devastated my hairline within a month. Lost years in days. The company told me to stop using it. So the question is, should I consider a transplant now or wait to see if the hairline grows back? Read a lot about minoxidil shed hair grows back (though all I did was switch brands) and am on another brand now, but grow back at the hairline? I highly doubt it. What do you think?

Without an exam, this is a highly subjective question to answer. Moreover, we do not give medical recommendations on BaldingBlog.

Rogaine (minoxidil) can sometime cause initial shedding, but it should generally reverse over time (should wait at least 1 year). You may see the reversal in as early as 3 months.

Snippet from the article:

This baldness cure was a bust. For nine months, William McKee took the generic version of Propecia, the pills that promise to halt hair loss. But the drug had radical side effects: Instead of becoming a better-looking man, he started becoming a woman, he claims.

“My rock-hard chest from the gym began to soften . . . reaching the point where I had noticeable ‘breasts’ even under my clothing,” he says.

Among other changes, the 38-year-old software engineer claims, “my shoulders were literally falling into a more feminine position, and my hips were loosening and becoming wider, as on a woman’s body.”

McKee, who says he wasn’t inclined to cross-dress before, began feeling like a woman. He is now only attracted to men.

Read the rest — NY Post – Software engineer claims generic version of Propecia turned him into a woman

Wow. The article starts with calling Propecia a cure that didn’t work, so the story itself begins with a loss of journalistic credibility right off the bat (there is no cure for hair loss). The story and the source are highly suspect, and this is hyped up BS. I have an extremely difficult time believing an ounce of truth to this. The guy said he bought a generic finasteride online from India (probably without a prescription), and now he is frustrated that he can’t sue Merck… so this is the story that gets spun and published.

For all that Propecia has been blamed for, this is a new extreme. Propecia does not turn you gay and it doesn’t make you want to dress like a woman. But I guess with all the hysteria out there, Propecia becomes a convenient catch-all excuse for anything and everything.

dr.Rassman/Pak

is inhibiting type 1 alpha 5 reductase also important in combating hairloss?

Studies have shown only type 2 is the cause of hairloss, as the peusohermaphrodites had normal levels of type 1 and still had to hairloss or prostate problems. whats your thought on type 1 as well?

people say dutasteride block more DHT, and in my opinon thats becuase of its ability to block type 1 as well.

finasteride 5mg blocks about 70% of DHT. Dutasteride 0.5 mg blocks about 90% DHT. Merck did have an experimental drug called mk386 that inhibited type 1 as well. In the clinical trials in produced no benefits to hairloss. The only reason dutasteride block 90% at 0.5 mg is because of the type 1 inhibition as well. if dutasteride does not inhibit type 1 then it would block DHT just like finasteride.

You state the science as I also understand it. The value of dutasteride seems to be a more complete block of DHT than finasteride and that is probably why we see better response in some people who are resistant to finasteride.

The MK-386 study I remember was from the mid-1990s on macaques, and while it did lower serum DHT, it didn’t have much of an effect on hair weights. I found another study from 1997 involving MK-386 on humans, which concluded that: “The current findings are consistent with the hypothesis that an inhibitor of 5αR1 may benefit conditions associated with excess skin androgen activity, such as acne, androgenetic alopecia, and hirsutism.”

I don’t know if anything was published about MK-386 beyond that, but I’m hopeful that some readers out there can point us in the right direction if they’re familiar with more studies done.

I was just wondering about the doctor saying that going off the medication does not reverse breast enlargement. That is, frankly, a bit scary. Websites like Livestrong.org (not exactly Encyclopedia Brittanica but I’m tempted to trust it) say that all the side effects of propecia are reversible. Can you clarify?

Link: Livestrong.com

In my experience, the few patients who had breast enlargement did not always reverse. I find that this one complication is the most persistent of all side effects and some of the patients ended up treating the breast lumps with surgery.

Dr R
Perhaps a rhetorical question but…..
amid all the blog postings, magazine articles, support groups, “chest pounding”, editorials etc – why has there not been a well-controlled, scientific study that has prospectively followed a group (perhaps 200-300) of men who begin Propecia for a period of several years? This type of study can then quantify the incidence of persistent sexual dysfunction (that is said to be common), use nocturnal penile tumescence to document further; understand any baseline factors that can possible predict who is more likely to have such an effect, and explore/evaluate all the differential diagnoses that predispose to erectile dysfunction or libido problems (psychological including social issues and life stresses; concomitant medications; coexisting medical conditions such as diabetes, hypertension, lipid disorders; endocrine abnormalities including testosterone/prolactin levels; cigarette smoking; chronic alcohol use; vascular problems, etc) as well as influence of different therapeutic options.

Such a study, which could be done outside of the influence of a pharmaceutical company, seems to be able to be done by any leading urology academic center that sees large number of men placed on Propecia, and would be relatively inexpensive and noninvasive. At present, the field seems to be highly dependent upon retrospective questionnaires in men who have these effects, and an absence of extensive data.

I completely agree. We need to have a statistically valid audience for a good prospective summary. Unfortunately, that type of study will take years to obtain and someone has to pay for it.

I ordered generic propecia online and got a product called proscalpin… ever hear of it or know if people have achieved good results?

I’ve never heard of Proscalpin, but there are a variety of names the generic 1mg finasteride is sold under, mostly by pharmaceutical companies based out of India. I’m not familiar with all of the brand names, but I’ve heard of or have been asked about many (Appecia, Finpecia, Finax, Finara). The drug patent hasn’t expired yet and these generic 1mg pills aren’t legally available for sale in the US.

Based on what I found online, Proscalpin is made by an Indian company called Dadha Pharma that sells generic medications primarily for the online market. There doesn’t appear to be too much info on Dadha available online that I can find, and I’m at a loss to even find a website for the company.

So long story short, I’ve never heard of this particular brand and I have no way to know if what you’re getting is really 1mg finasteride. I don’t recommend buying prescription drugs from online pharmacies that aren’t legally allowed to sell them in the US.

I have been taking propecia for roughly 10 years. Excellent results, stopped hair loss with slight regrowth. no sexual side effects, if anything my libido was increased. when I started taking propecia I had multiple lipomas on my body. about 5 years ago I went back to my prescribing physician regarding lumps i noticed in my left breast. I had mammography completed but nothing showed up. but the lumps are palpable. regardless the dr concluded they were benign. no significant changes since.

should I be concerned given the new warnings about propecias side effects?

If you had multiple lipomas (benign tumor) on your body before the medication, it’s quite possible that the Propecia is unrelated to more lipomas in your chest. It sounds like your doctor did the right assessment. Keep to his advice.

I’m not sure what new warnings you’re referring to, but I wouldn’t be concerned. Always talk to your doctor if you notice any changes in these lumps.