I am in my late 40s and have receding hair and a slight thin spot at the crown. I’ve been taking Propecia for about 2 years now and while I haven’t noticed any hair growth, my hair seems to stay consistent. I am, however, unhappy with the decreased libido side effect. I would like to stop taking Propecia and try Rogaine or saw palmetto.

Would you advise this and if you would, should I stop the Propecia cold turkey or gradually stop it?

I can’t advise someone that isn’t my patient to start or stop a prescription medication, which is what Propecia is. I can just give general advice. There’s no weaning process when stopping the medication, but please talk to your prescribing physician about the best way to change your dosing. There’s a couple points you might be aware of, but I feel I should highlight for you just in case:

1. Any benefits you’ve seen from Propecia will start to disappear within months of stopping it, so if you want to try to maintain the consistency you’ve seen you might wish to ask your doctor about taking a lower dosage (some Propecia is better than none) to see if that helps with the side effects.

2. It’s also possible that the drug itself isn’t the cause of your lower libido and there’s another issue coincidentally going on. Stress, anxiety, and age can also be reasons for a lower libido. People seem quick to point the finger at medication first, but in reality people that don’t take medications still have these same issues every day.

Propecia is entirely elective medication for a cosmetic issue (you’re not going to suffer health risks by stopping it), so ultimately it’s up to you whether you want to take it or not.

Dear Doctor,

I am a 22 year old male who has been on Propecia for about 3 1/2 months. I have experienced a series of side effects that I believe are related to Propecia use. I list them here in order of appearance: thin/somewhat watery ejaculations (the first side effect I noticed, about a week into the treatment), loss of spontaneous erections, difficulty obtaining and maintaining erections, (the erections themselves are also weaker), and a loss of sensation in the genital area. I also believe I may have had slight penile shrinkage/penile tissue atrophy, and an increase in body hair growth.

I have become concerned about these side effects, and am pretty certain that they are not psychological, since I started Propecia being very certain that I would not suffer the side effects. I can attest that my sexual mechanism was optimal before starting Propecia, as expected for a man my age.

My question is, can I safely go off the drug? Can I expect that these side effects will clear up with time? Also, I have read about the effectiveness of reducing the dosage; what can you say about taking .5 or even .25 mg of Propecia daily? Should I switch to such a dosage now, or should I go off Propecia entirely, see if side effects subside, and start again with a reduced dosage?

I would greatly appreciate your help, as I am concerned.

Generally when you stop Propecia, the side effects disappear in a matter of days/weeks. Along with stopping the side effects, the value of the drug and all of its benefits will produce “catch up” hair loss, which means that your hair loss status will go back to what you had before you started the drug and you’ll lose any hair you would’ve lost had you not taken the drug at all.

I’ve advised some of my patients to try a lower dosage (0.5mg is better than none) and they’ve had some success with treating the hair loss and seeing a reduction in side effects, but it’s not an across-the-board finding that I can guarantee. Keep in mind that I’m not your doctor, and any dosing changes should be discussed with your prescribing physician.

Doctor

You’ve said you take propecia. Why don’t you use minoxidil as well? Do you feel it would be of no benefit? To be honest if you don’t take it one would wonder why they should start.

Also how do we know all hair treated with minoxidil won’t become dependent? Is this just a theory or has it been proven and if so how?

Thanks for such an informative site.

To clarify, I did use Propecia for years, but I stopped using it some time ago. I hoped that my hair loss stabilized and took a chance by stopping the drug, and thankfully I experienced no further loss. One of my sons is still using it daily, however. I didn’t use minoxidil for a couple of reasons — mainly because the twice a day application was cumbersome to me, but also because I was looking to maintain and not necessarily regrow. The Propecia was found to be sufficient for that.

As for minoxidil dependency to existing hairs, the drug spreads to the surrounding area, so some people will find the dependence extended beyond where they applied it. Sometimes it even spreads to the face, and in women, facial hair growth is a side effect of minoxidil.

To touch back on the reason that I considered minoxidil to be cumbersome — before starting any drugs or treatment regimens, one must consider the compliance factor. A pill a day is easy for most. Washing your hair then putting on minoxidil twice-a-day everyday takes time and most men are not the best at keeping to this type of regimen. Most men simply quit after a few months before seeing any results. This ends up being a waste of time and money. A drug or a treatment plan is only as good as the person who is willing to follow the plan.

Hello Dr,
I am wondering why there is no a magical cure for the baldness? is it because the researching costs, no ambitions, or the medicine maker companies are not investing to find a cure!

what do you think the new treatment in the near future? stem cells, PRP, Gene Therapy?

Thanks

One could theorize that there is some conspiracy to keep the world bald, but I tend to believe that the reason there isn’t a hair loss cure available yet is because there hasn’t been a successful cure developed. I suppose the drug companies are still working on it, but I really have no insight into how much they will invest into various hair loss cures. Treatments fail all the time and are quite costly in research and development.

Using common sense, I’d think that the company that comes up with and successfully markets a cure will be able to make a huge profit… and that alone would make it worthwhile to be ambitious.

Here are some past posts regarding stem cells and PRP (platelet rich plasma):

1. PRP Treatment Still Unproven?
2. Offshore Stem Cells Treatments Offer False Hope
3. Stem Cell Baldness Cure? Not Quite.

Hi Doc.

My Propecia price have just been raised almost 20% from one day to another. We have a different currency in my country, but the price was 79 US-$ before pr. month and now it’s 100 US-$. This seems extreme. I’m buying Propecia on prescription and at a pharmacy so I’m buying it legal. Have you heard anything about this???

Please help!

Best regards!

I don’t know anything about international Propecia pricing. You might want to call around to different pharmacies to see if perhaps it isn’t increased everywhere. Any international readers out there experience a recent price increase?

My costs for Propecia have not changed in a while. The price did go up about a year and a half ago, but currently we sell it for $190 for a 3 month supply (which breaks down to about $63/mo).