Dr. Cole, advice please

Yankee

I had a 3000 strip/FIT procedure Nov. 3 2006 and posted an 8 month update in the patient testimonials forums about how amazing and life changing the results have been. In late Aug. I got my prescription renewed for Proscar (I was cutting the pills) and was given the generic brand. Within a few weeks I got sexual side effects (loss of libido, softer erections and at times no erection). After reading many stories of men who had the same side effects I decided to stop taking the drug. I cut the pills in half (.5 mg) and took that a few days. After completely stopping I felt like the side effects were wearing off the first week and then things seemed to get worse. I felt exhausted, had no libido at all and depressed. It's now been 6 weeks since I took the finasteride and I feel much better. I haven't had any more side effects and morning erections are back (never had them the entire time I was taking the cut Proscar). I think my body's hormones, (especially testosterone) crashed after stopping the drug. In the last 6 weeks my hair has thinned quite a bit in the front. I'm petrified that DHT is raging since I'm no longer on the fin and that it will continue to get thinner. I'm shampooing/conditioning with Hair Cycle but am asking for advice. I considered taking Saw Palmetto but am hesitant about messing any more with my hormones. Does this sound like hair shed due to my hormones crashing and if so will the hair return?It still looks great but I'm very scared that the thinning will continue. I apologize for the long post but I would greatly appreciate your advice. Many thanks.

drcole

i suspect the shedding is from stopping proscar. the usual dosage for hair loss is 1/4 pill every day. when men have side affects, i tell them to take 1 mg of finasteride on monday, wednesday, and friday. this will usually take care of side affects. finasteride has a long half life. you don't need to take it every day.

i've not heard of side affects with saw palmetto. try it and let me know if you have problems.

also, start on rogain foam quickly. use it twice a day now and also use nizoral shampoo twice a week. leave all your shampoos on for 5 minutes before washing them out.

hair sheddng is due to a shift from telogen to anagen. this forces resting telogen hairs out and new anagen hair resume. you can also get it when multitudes of hairs shift from anagen to telogen, but you have to have a new anagen cycle to force the old hair out. sounds to me like you have more hair entering anagen.

stay on the roagain, nizoral shampoo and hair cycle products. add saw palmetto and later on consider propecia only 3 times a week.

one way to check night time erections is to put paste mailing stamps to them selves around your penis at bed time. if the single roll of stamps are broken in the morning, you had a night time erection.

Yankee

Dr. Cole,
Thank you for the fast reply and great advice. Very interesting about taking Propecia 3 times a week. I've never heard that discussed before but it makes perfect sense. I'll pick up the Rogaine tomorrow and start immediately with that. If you don't mind, I've got a few more questions. In your opinion, will Saw Palmetto maintain the hair I have now almost as well as Propecia or is it a much weaker DHT blocker? Also, is the 1% Nizoral effective enough or should I get a prescription for the 2%? Lastly, some of my non-transplanted hair in my hairline and front is what shed after I stopped taking finasetride. Do you think think the hair shed from stopping Propecia will grow back or is it probably gone since Rogaine doesn't work as well on hairlines? Once again, thank you for all of your help!