I recently got my hair examined under the microscope to see if there were signs of thinning. The dermatologist informed me that everything looked fine. However, two months before I had noticed some thinning on the tip of my crown and I had used rogaine for two months around my head, crown and front too. Could the results of the test be because of rogaine, or if I had male pattern baldness, would the hairs show signs of that despite the use of rogaine?

Rogaine (minoxidil) may have had an impact on the new hair that grew out, and the lower inch of growth is what I would expect in the 2 month timeframe you mentioned. I would cut a long hair and see if the lower half is different than the upper half. That might answer your question.

Dear Dr. Rassman,

I am a 22 year old male, and I have been on Propecia and Rogaine for about 2.5 months now. I was developing slight hair loss at the crown, and a receding hairline. It seems as though hair loss in all these places is being reversed as a result of the medication. I can still see room for improvement, but I am pleased with the results thus far.

I have two questions: can either of these medications cause hair to grow on other parts of the body? I’ve always had a lot of body hair, but it seems as though some parts of me have gotten hairier.

The other question is on sexual health. I’ve noticed that my semen has become much less viscous than before; the color remains cloudy white, but it is not as sticky and thick as before — almost like a fairly runny liquid — and orgasms seem less potent. Could this be because of the medications? Can I expect the problem to reverse itself over time? And, a matter of great importance to me: could that be a sign of compromised fertility?

My libido remains as high as always.

Propecia (finasteride) can give you less viscous semen and a smaller volume of semen. These are well known side effects. This drug does not compromise fertility.

Rogaine (minoxidil), if you apply it on other parts of your body, can give you more hair. I recall a patient that worked outdoors, and sweating in the hot sun caused the Rogaine he applied to his scalp to run down his neck. As a result he grew more neck/back hair than he was used to. I do not know if Propecia is making you have more hair on your body, but it has been reported.

I am 27 years old and I write regarding a side effect of propecia which is making me extremely nervous — to the point that I haven’t been able to sleep for many nights, and have been surfing the internet in search for answers and hope leading me to your site).

I took propecia for about four weeks, and at the fourth week mark, I noticed that my erection was significantly weaker. Because I am only 27, this was very odd — it had never happened before. I apologize for being graphic, but by weaker, I mean that the erection was only “half way” and “half full” and it was noticeably smaller, even though I was still able to ejaculate. The experience was not that pleasurable. Moreover, even when I am walking around on a daily basis, my penis “feels” smaller. One month later, the problem is just as bad.

I read online that a small percentage of men can suffer permanent, irreversible ED from propecia. I have already set up an appointment with a urologist, but suppose the worst happens and I am in that 1% group. Then, what could the urologist even do? And, what could I even do? Will I need to take Viagra the rest of my life?

This wouldn’t be as big of a deal if I were 50, but because I am only 27, I’m so, so worried that the rest of my life will be worse. I am being serious here: How can I ever be happy if I cannot perform sexually anymore? How can I even have a girlfriend or get married to someone or have a fulfilling life? Of course, if I had to take Viagra the rest of my life, I guess that wouldn’t be as bad as never again experiencing a full erection — but will Viagra even work for me?

Again, I know that you will advise me to see a doctor, and I will. Until my next appointment, though, I just need some hope. Besides, through your site, you probably have more knowledge and information about this problem than the urologist I will see.

Please, please help. I feel like my happiness in life is on the line.

You need to make an appointment with the doctor who prescribed you Propecia and discuss these issues with him/her. I suppose the appointment you made with the urologist may help too. I may be a doctor, but I am not your doctor and can’t give specific medical advice. I simply don’t know any of your medical history. There’s absolutely know way for me to know if you need to take Viagra for the rest of your life or if it would work for you.

In general, patients who have erectile dysfunction (ED) issues with Propecia can stop the medication and have the side effects go away within a week. That is the norm. I am not sure of reports that reflect permanent ED in men from Propecia, so there is hope in that regard. According to data in the medical literature, sexual side effects are not permanent in the less than 2% of men that experience them.

Is it possible that cut pills (generic Proscar in fourths) have a shorter half life than Propecia with its protective coating still intact?

Propecia and Proscar aren’t time released medications, so the protective coating wouldn’t change the half-life of the medication. A big reason for the coating is to protect pregnant women, as women that handle a cut finasteride pill run the risk of absorbing the active ingredient through the skin. The coating also helps make the pill easier to swallow and helps to extend the shelf-life by protecting it from the environment to some degree.

I know you realize the following information, but just in case some readers out there aren’t aware — some people choose to cut a Proscar (5mg finasteride) pill to make it equal to Propecia (1mg finasteride). Different generic pharmaceutical makers may make different shapes and sizes of the pill, but generally it’s easier to cut the Proscar into 4 equal pieces (making the dose 1.25mg). Why do people cut the Proscar? Well, Proscar (and the generic variant) is much cheaper than Propecia, which has no generic legally available in the US due to patent laws.