Hi,

Thank you for the query.

Propecia (1mg) contains finastride, which is a 5 alpha reductase blocker (enzyme present in hair follicles). This enzyme is responsible for conversion of Testosterone to Dihydrotestosterone (DHT), which in turn causes thinning of hair.

When this enzyme(5 alpha reductase) is blocked by propecia, DHT is not formed and thus it prevents from thinning of hair and prevents hair loss.

It is supposed to be a good drug and does show good response after taking for atleast 3-6 months. It works best on the vertex area of scalp.

As far as side effects are concerned, you are right that it can lead to some sexual side effects. But there are very few scattered reports in literature of the same. Approximately 1 in 50 males(2%) reported one or more sexual side effects during finastride (decreased libido, erectile dysfunction or ejaculation disorder).

Gynecomastia is also reported in only 0.4% of patients. Another point mentioned in the literature is that since the patient himself is aware of these side effects it becomes all the more psychological rather than pathological.

Also since the half life of the drug is only 5-6 hours, the side effects are supposed to be temporary. Secondly the percentage of patient getting this side effect is very less. I myself has been prescribing this drug for last 11 years but has not come across any permanent side effects.

I would also like to comment that if your hair loss is genetic (same pattern in family, especially in your father), then any kind of treatment you take would show a temporary response. It may show improvement for say 2-3 years but then gradually you may show hair thinning again.

Now you need to balance things here and decide whether you want to take this medicine or not. There are no tests which can tell whether the treatment response would be good or bad regarding this tablet.

I would say that if you have fine hair left on the scalp, then it would be effective. But if you have developed bald patches (with no hair follicles seen) then there is no point taking it.

Other safer options are also there which can be taken along with or separately for hair loss. There are laser treatment also available for male pattern hair loss properly known as Hairmax laser. These are low level lasers which needs to be taken for long periods.

Hope I have answered your query, I will be available to answer your follow up queries if any.

With regards,
Dr.Bharat chawda.

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Hi!,

Thanks for writing back,

There have been reports of the lower dose also being effective as far as hair is concerned.But regarding side effects being reduced there are no such reports .There are no reports of it being effective in alternate days dose.1mg is the prescribed dose all over the world.

If at all you plan to take ,I would advise you to take full 1mg pill every day rather than alternate days.After you decide to take the medicine for a long time ,its important that it shows results.

I can understand your apprehension regarding the side effects ,but as I told you earlier it is the psychological factor which come to play more once you have read all the side effects.

You can discuss this with your treating doctor as well regarding the need & its effectiveness of this medicine in your case .

I would also advise you to combine propecia with other medical options for hair loss as-well.

I hope this answers your query.

wish you good health.

Regards,
Dr.Bharat chawda

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