Proscar Warning Label and Possible Birth Defects

Dr. Rassman,

Thank you for continually answering questions on this forum. I am amazed how I routinely learn about hairloss by just reading the answers you post in response to other readers.

My question is about proscar. I’ve decided to switch to proscar over propecia because quite frankly, it is much more affordable to buy and split proscar into fours. I read in the past on this forum how you stated that Merck removed the warning about possibly passing Finasteride to a female through semen. My information leavelet that came with the Proscar had the following on it (women should not) “be exposed to the drug through sexual contact with a man taking Proscar”. It suggests that you should use a latex condom during sex. Does this mean that you should not try to have children while taking Proscar/Propecia? Does the fact that the dosage in split Proscar/Propecia is significantly lower than that of regular Proscar eliminate or reduce the risk for “birth defects” in a baby’s sex organs?

Also what you heard or know about a product advertised on TV by the name of Procede? They claim it is once every three months treatment.

Thank You

What is known about finasteride is that if a baby in the womb is exposed to this drug (dosage is not understood) that the development of their sex organs and possibly the way their brain is wired (female vs male) may be influenced. Genital abnormalities can be created by the influence of this drug in the first trimester of pregnancy. These abnormalities, when associated with finasteride, had been observed when the natural form of finasteride was ingested in very, very large doses (based on the research of a mountain village in the Dominican Republic).

The warning by the drug company reflects that knowledge and that a risk may be present. These are clearly warnings that are meant to protect the drug company, but to my knowledge, even with the widespread use of Propecia in young men (over a million men) there are no reports that I know of that show that there is a link between women who got pregnant with their men on Propecia and the creation of genital abnormalities in any of their children. I have one of my sons on Propecia and when he is ready for a family, I will not recommend that he change his usage of this medication. He likes the hair that is now strong in the frontal area and was thinning before he started to use it.

A little bit of history (though having little to do with your exact question) — One of the untold stories in medicine are about the hermaphrodite whose sex is misdiagnosed at birth. The absence of a penis may cause a baby to be classified as female or the presence of a large clitoris, may cause the baby to be classified as male. These children are then raised according to the original sex designations from the birthing room. These situations lead to great tragedy. For those of you wanting to learn more about hermaphrodites, I suggest that you Google the term hermaphrodite. Also, I have recently read a best selling novel titled Middlesex by Jeffrey Eugenides (a Pulitizer Prize winning epic that follows many generations in a family that had a hermaphrodite inheritance pattern in the family line). It puts a face on this tragedy and is a recommended read.

With regard to Procede, please see past responses here.