Start Small, Increase Propecia Dose Every 2 Weeks?

Hi Dr. Rassman. Congratulations for your great blog!

I’m a 22-year-old male with early hair loss. I took 1/4 of proscar daily for five days before having to stop due to the side effects. Apart from low libido and diffculty in getting an erection, these included very dry skin (never thought rubbing the index and thumb could be so unpleasant!), some discomfort in the prostate area, apparently water retention (i.e. urinating little and darker while drinking the usual amounts) and somewhat of an overall bloating of my body, which I put down to the excess fluids but seemed to produce increased tenderness around the nipples, esp. the left one. Since gynecomastia is the one reaction I am by no means willing to put up with, I thought better safe than sorry and quit the medication right away. It has been a few weeks since, however, and everything seems back to normal. I am very concerned about the hair, so I was thinking about starting again with a much smaller dose of finasteride (something like 1/8 of proscar every third day), and increasing it every two weeks or so all the way up to at least half of what I tried initially. Then my question is whether you have tried this approach to successfully manage side effects such as mine in your practice.

Thank you very much for your valuable time.

You should work this out with your doctor. The internet is not the place. I haven’t started patients on a low dose and gone up from there, but I often suggest that lower doses of Propecia may have value for the few men that have sexual side effects from the drug.