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Hi,

Me and my girlfriend are trying to have a baby. This morning, my girlfriend maybe touched, maybe not, some dust of finasteride… I am not really sure that I’ve well cleaned after cutting the pill. If she’s pregnant, it should be for 4 or 5 days because she stopped contraceptives two or three weeks ago.
Is there a risk for the foetus (if there’s a foetus… some cells actually - which is not proven at all…) ?

Thank you in advance for your reply. Best Regards.

I would not worry about this. To get the fetus to be impacted by finasteride, there has to be absorption of the drug into her body and the fetus must be in the process of forming sexual organs. At 4-5 days, this does not happen and the ‘dust’ you are reporting is doubtful to be putting her at risk. Enjoy the pregnancy without worrying.

I’ve been using Rogaine for the past 6 months and I’ve notice that since I’ve been using the product I get erections, especially at night. Is this normal?

Maybe you feel better taking Rogaine and that is your now, normal state. Rogaine (minoxidil) does not produce erections.

I am getting good results from Propecia. My question is: would using a testosterone gel for low testosterone overwhelm the therapeutic benefits of Propecia and speed hair loss, or would the DHT inhibitor deal with this increased but now clinically normal amount of testosterone?

Probably not a problem if it returns your testosterone to normal levels.

-

(On an unrelated note, this is the 10,000th post on BaldingBlog!)

Hello Dr. Rassman,

First of all, thank you for this website. It actually helped me stopping wasting money on some useless products.

I have been on minoxidil (Kirkland) and propecia since Aug. 2011. So far there is no significant improvement but no visible further loss either. So I think I should stay on them for another 8 months to see the results.

However, for minoxidil, my head always gets a little itchy after I apply it. In day hours I don’t feel much so it was all right, but recently I was told that I rub my head a lot while in sleep. I am wondering if I should stop using minoxidil at night since rubbing might accelerate the hair loss. Or maybe I can find something like a hat to wear at night. I would like to hear your suggestion on this.

Thanks

Traction alopecia can occur from rubbing your scalp on a regular and rough basis. Some people do report irritation (or sensitivity) when using topical minoxidil. Some try different types, such as the foam version (Rogaine) and maybe you’ll see some improvement.

It may seem silly, but maybe you could wear mittens while you sleep. I’ve suggested that to my patients who have similar problems.

i have been using rogaine 5% foam for 2 wks now a as directed by my dr. dermatologist, i have gained 5-6 lbs over these past 2 wks and feel swollen in the face. what do i do and can this be due to the use of rogaine?

Weight gain has been reported with the use of Rogaine, but the cause is not known or even proven. “Unexplained weight gain” is listed as a known side effect (see here). Still, 5 to 6 pounds seems quite drastic in a short time span. Swelling of the face can be a sign of an allergic reaction.

As you are under the care of a dermatologist, I would suggest that you seek his advice on the weight gain issue.

I’m very seriously considering starting a course of propecia/proscar. But before I began I wanted to ask two questions.

1. It has been said that if you start propecia early the better chance you have of slowing down/halting hair loss, but that doesn’t tally with the propecia chart from studies which show that it generally peters out after 3 years. so surely you’d only save your hair for 3 years and then it would quickly regress, not making much difference how early you start because you only have 3 years of good hair.

2. I was wondering if you could recommend a good dermatologist/hair doctor in London, who I could have a consulation with before I begin taking proscar, do you know any who do miniturisation tests or some kind of form of monitoring on hair loss? There are a lot of snake oil merchants in London that are willfully telling you that you must get on medication and I just want to talk to who is honest and experienced.

I have many patients that have reversed their crown loss and held the reversal over 10 years. Everyone is different, but the official studies show that the expected maintenance should be about 5 years on average. That means that some men get better than 5 years and some worse results while on the drug. It depends upon how aggressive your genes are.

As to your second question about London-based doctors, Dr. Bessam Farjo is a contributor to this site. He and his wife are terrific doctors and worthy of a trip to their offices (in London and Manchester). They may be able to give you a referral if you call their office.

Hi dear Dr Rassman

I am a 43 years old man which have taken Propecia (1 mg) for 7 months. I know taking the said pill for women is forbidden and they should not even touch it. So, if a man who is taking Propecia and want to bring a baby, he should stop using the pill before intercourse with his wife? I mean the finasteride dose not transfer through the sperm.

If the answer is yes, how long before intercourse the man should stop using the Propecia?

Your soonest reply will be appreciated. Thank you

After extensive studies in this very issue, we know that the drug is not transmitted to the woman through sexual intercourse. We have not seen the problems of fetus sexual differentiation in women who were fertilized by men taking this drug at the 1mg dose for hair loss. It is generally considered safe to have a successful pregnancy while a man is taking finasteride (Propecia).

Dear Dr Rassman,

Have you had any patients who have taken very low doses of finasteride (i.e. less than 0.25mg)?

I am not keen to take propecia because I’m concerned of the effects to my internal body chemistry but would also love to keep my hair for longer. I have had issues with my sex drive previously and do not want to mess with my hormone balance too much as a man still in my 20’s. Another reason being that I’m an athlete and want to be at my peak physically. I’ve read a lot about how finasteride affects the hormones, particularly the obvious reduction in DHT but also the decrease in free (not total) testosterone and the rise in estrogen.

Then I read this forum post: Hairlosstalk.com

It seems that taking a dose as low as 0.05mg is enough to lower scalp DHT considerably while keeping 20% more DHT in the blood. Like the original poster in the forum thread who is considering crushing a pill and measuring smaller doses - this prospect is more appealing to me. If I could just lower my blood DHT by 40-50% instead of 70% then surely my hair would still get some benefit and I would be able to keep my hormones at a more normal level. I have ruled out taking 1mg but am really curious about taking 0.05mg if only I could just measure it accurately each time (I wouldn’t want to take fluctuating dosages each day).

It makes me wonder why propecia isn’t available at a much smaller dose (0.05mg or 0.1mg)

Could you comment please? I’d very much appreciate it. Thanks for such an informative blog.

Propecia (finasteride) at 1mg was determined to be the ideal dose for treating hair loss. Lower doses do work, but how low? I’ve said that 0.5mg produces 80% of the benefit, and 0.25mg probably give 50% of the benefit. I don’t have a clue about lower dosages.

But by dosing the 1mg level, it is the most effective treatment level to use… so why dose lower unless there are significant side effects?

Hypothetically can Finasteride for shock loss be discontinued after a period of time has elapsed after the Hair Transplant operation and the risk of shock loss has receded?

Yes, you can take finasteride temporarily to just protect against shock hair loss. I generally tell patients to take it for 8 or so months to bridge the gap between the transplant procedure and growth from the new grafts.

Hi Doc,

I’m a 26 year old male with a fairly aggresive NW4 developing, and need to do something to stabilize this before going for a HT next year.

I’ve grown pretty scared of finasteride side effects through the experience of a good friend who unfortunately suffered some of the psychological sides we’ve all been reading about online.

Question is, would a 1/4 dose (0.25mg) finasteride still be more effective for someone in my position than the full (320mg) recommended dose of saw palmetto? I’ve tried the latter before with no side effects, but didn’t stay on it long enough to evaluate the results.

Thanks doc and keep up the excellent work!

Propecia is finasteride in 1mg strength that you take daily for genetic male pattern (androgenic) hair loss. It’s been indicated that 0.5 mg finasteride daily is about 70 to 80% as effective as the full 1mg dose. I suppose you can infer how a 0.25mg dose may help. But in general if you are going to take a drug, you should take it as directed and speak with your doctor about all these issues. With saw palmetto, you really do not know the dose of the effective ingredients as they vary per manufacturer. Add to that the knowledge that saw palmetto has never been proven to work on hair reliably with a good scientific study.

My final point is that if you are going to read the issues of Propecia on the Internet and scare yourself with unsubstantiated reports without even seeing a doctor, the chances are you will likely have a side effect from the sheer psychological impact.