We received a distressed email from a young patient who wrote saying he took Propecia after consulting with a doctor but it aggravated my situation and it catalyzed the hair fall instead. I was suggested that the hair fall will be temporary. I was scared so I discontinued the medicine.  He was also concerned if malnutrition may have also caused the patchy hair fall and the possible sexual side effects associated with Propecia medication.

When it comes down to hair loss, the first thing that needs to be verified is a family history of hair loss.  The reason for this is because most hair loss is genetically linked.  In this case, we can use this information to help prevent and reverse hair loss.

Vitamin deficiency can cause hair loss but generally if a person maintains a balanced diet they should be okay.  If vitamin deficiency is the issue, vitamin supplements can help correct that.

Finasteride (Propecia) has been clinically tested and proven effective for the treatment and prevention of hair loss and has been FDA approved.  You may experience some level of hair shedding during the first few weeks or months but hair growth should become evident within or after 6 months of treatment.  Sexual side effects have only been reported in only 1 out of 100 patients tested but the effects are usually temporary.  If Propecia medication impedes your libido too much, it is safe to either discontinue usage or reduce the prescription amount.

At this point, we highly suggest starting to establish a good relationship with a good hair transplant surgeon and consider getting a proper evaluation of your hair loss.  If male pattern baldness or typical male hair loss is the final diagnosis, we recommend starting a medication regimen and maybe even considering a hair transplant in the near future if need be.

A patient from India once wrote to me in regards to preventing male pattern baldness. He is 18 years old and has noticed that his hair is falling very rapidly. He also noted that he fears that his diet might also be playing a role in his hair loss since he finds himself to be too lean. He wants suggestions on how to restore his hair since he doesn’t want to meet with the same fate his father did with his hair.

In most cases hair loss is genetic and, in his case, he seems to be experiencing the early stages of male pattern baldness. Sometimes malnutrition may cause some form of hair loss but that is only experienced in patients whom are severely deficient in some particular elements.

We do recommend that you see a doctor to confirm the diagnosis of the hair loss especially if your hair loss does not follow a typical male pattern. Male pattern type baldness is seen in men as early as their 20′s and will continue to recede or deteriorate for many years. There are many products out on the market claiming to restore hair loss and re-grow hair but none of them have been truly proven. The only exceptions are minoxidil and finasteride and both have been approved by the FDA to be safe to use.

Q:

I am 30 now and I have been losing my hair since I was 18. I started taking finasteride last year and seen great result after taking it for only a few months. I think I may have been experiencing some side effects.  The thing is I noticed that it might have affected my erection and it takes me longer to get an erection. I know when you know you are taking a medication that has to do with your male hormone it may automatically affect your sex function negatively. So I do not know whether it is mental or real. I don’t want to stop Propecia if it is safe to continue it.

A:

You have been experiencing erectile dysfunction recently while taking Propecia (finasteride) for a year. Erectile dysfunction has been evaluated in patients who have been taking Propecia.  The incidence of erectile dysfunction is reported to be 1.3% of men who were on Propecia for one year.

The rate of erectile dysfunction was reported 0.7% among the patients who only took placebo. You can test this side effect of Propecia by stopping it for at least two weeks and see if you still have erectile dysfunction. If the erectile dysfunction goes away by discontinuing Propecia after two weeks, your problem might be a real side effect of finasteride. If you still want to continue taking Propecia despite experiencing erectile dysfunction, you may try a lower dose that can still help your hair growth without giving you any negative effects to your sexual function.