Time to do something

Ok, thanks. Fair enough.

Bill, I appreciate your function as the moderator of this forum and praise the job you do. I've learned so much from this site and it has helped me through some very difficult times. I'd like to make an observation concerning posts. I understand there are categories for various subjects and if a post pertains to a certain category it should be assigned to that area. However, we all know which category receives the most attention (just look at the numbers) and that is 'Hair Restoration Questions and Answers'. I posted a 'question' last night and woke up this morning expecting at least a couple of answers and there was nothing. I soon realized my question had been moved to 'Hair Loss Drugs' which explained why I had no answer because that category doesn't have nearly the viewers that the other category does. Would it be possible (I know you've done this before) to leave a question like the one I posted about issues with finasteride and minoxidil in the 'Hair Restoration Question and Answers' category for at least a couple of days allowing it more visibility and then make a post that in two days this post will be moved to another category? I think this would serve everyone better. It would allow for my post to be viewed more frequently, allow others to see a question they might otherwise not have seen because they won't or don't go to other categories and allow the forum to keep the site in order by categorizing material. Thanks for your consideration.

Bill, I appreciate your function as the moderator of this forum and praise the job you do. I've learned so much from this site and it has helped me through some very difficult times. I'd like to make an observation concerning posts. I understand there are categories for various subjects and if a post pertains to a certain category it should be assigned to that area. However, we all know which category receives the most attention (just look at the numbers) and that is 'Hair Restoration Questions and Answers'. I posted a 'question' last night and woke up this morning expecting at least a couple of answers and there was nothing. I soon realized my question had been moved to 'Hair Loss Drugs' which explained why I had no answer because that category doesn't have nearly the viewers that the other category does. Would it be possible (I know you've done this before) to leave a question like the one I posted above in the 'Hair Restoration Question and Answers' category for at least a couple of days allowing it more visibility and then make a post that in two days this post will be moved to another category? I think this would serve everyone better. It would allow for my post to be viewed more frequently, allow others to see a question they might otherwise not have seen because they won't or don't go to other categories and allow the forum to keep the site in order by categorizing material. Thanks for your consideration.

I would like opinions from others concerning finasteride and minoxidil. I've been using minodixil since 2007 and finasteride since November 2009. I am in very good health and have always had from what I gather talking with others an above average libido especially for my age. Around the time I started using minoxidil I noticed my erections were not as hard. They were still there but just of a lesser quality. I also noticed that it was more difficult to climax sometimes. I just figured it was ageing and never thought much more about it. Then I started on finasteride. In the last couple of weeks I've freaked out because there have been times when I've been aroused and there is no reaction downstairs and that was a bizarre unknown feeling for me. I immediately got on the internet and started researching this and found some interesting information which appears to be from credible sources. We all know the potential side effects from finasteride but I'm also finding out that minoxidil, yes minoxidil can cause ED and loss of libido and the manufacturer even lists this as a possible side effect. Here is my question. These side effects have scared me to the point where I want to stop both finasteride and minoxidil. I was a NW 5 with a strip of native hair across the top of my head and the rest was bald before my hair transplant. I will be 49 in three months so my balding pattern is well established. The hair transplanted is genetically immune to the effects of DHT and will not fall out so what is the purpose for me to be using these drugs with the side effects they have if the transplanted hair isn't going to fall out without these drugs anyway? My understanding is we need DHT for erections, libido and other things. To reduce DHT to a low level upsets the balance causing sexual dysfunction in some of us. I know I will probably receive responses from guys saying they've been on it for years and have no negative effects but we all respond to medications differently. Medicine is not 'one size fits all'. If it is recommended that I stay on finasteride for some reason would it be acceptable to take 1.25 mg every other day instead of the 1 mg daily I'm taking now? Perhaps a 'drug holiday' would keep the DHT level down so it wouldn't adversely affect my hair but also keep it high enough on the off days to maintain libido and erections. I also found it interesting that currently there are trials underway to test the effectiveness of supplemental DHT to increase libido! http://clinicaltrials.gov/ct2/show/NCT00163566 Did you know that there is a medical condition where some boys are born with the lack of the enzyme 5 alpha-reductase which is what turns testosterone into DHT? Finasteride lowers or eliminates DHT by inhibiting 5 alpha reductase. The results of reduced DHT in boys is not pretty. Its responsibility lies in all of the male secondary sexual characteristics such as deepening of the vocal chords, male hair patterns on the body, hair on the face, oily skin (especially when you first hit puberty and your natural test is raging), and last but definitely not least, male sexual drive and function. DHT means hardening of the physique, lack of water retention, favorable fat-loss, increased sex drive, and increased strength gain. If you aren't already aware of the information I've posted below you may find interesting. Notice the part about testing your DHT level. I would think it would need to be checked on the scalp and not in the blood. Reduction of DHT can also cause gynocomastia. Great! I'll have a full head of hair and have hairy hooters, with no libido or chance or an erection. DHT also has many beneficial functions. Indeed it is through DHT that many of testosterones positive effects are mediated. DHT helps maintain: Secondary sexual characteristics (e.g. body/facial hair growth) (59) Libido (60) Erectile capability (61) Again, the concept of hormonal balance is paramount. Maintaining a healthy ratio of testosterone to DHT is the objective (ideally about 10:1) (62). One can then receive DHT's benefits without suffering from its disadvantages Androbalance kits can help you determine your personal DHT levels; particularly important for men using Propecia/Proscar to reduce DHT and thereby combat male pattern baldness (MPB) or benign prostatic hyperplasia (BPH). Excessive DHT reduction can cause side effects such as impotence (63,64) and gynocomastia (30,63), whilst insufficient reduction won't allow the full therapeutic benefits of the drug(s) to be realised. Only by measuring DHT levels will you know what effect your prescribed dosage is having on your own hormonal profile. In view of DHT's effects on sexual functioning (61) this analyte may also be a useful kit addition for men suffering from erectile or libido difficulties. This transformation serves a very important biological function in these tissues. You see, DHT is a much stronger androgen than testosterone ??“ it binds about 3-5 times more strongly to the androgen receptor. If you took away 5-AR from these tissues and blocked the formation of DHT, then you would see some dramatic changes in physiology. A good case in point is demonstrated in male pseudohermaphroditism due to congenital 5-AR deficiency. This is a relatively rare disorder, however it is actually quite common in the Dominican Republic. In this disorder, males are born with little or no 5-AR enzyme. They have ambiguous genitalia and are often raised as girls. When puberty occurs, their testosterone levels elevate normally although their DHT levels remain very low. Their musculature develops normally like that of other adults, however, they end up with little or no pubic / body hair and underdeveloped prostate and penis. Their libido and sexual function is often disrupted also. DHT is still very important for the full performance enhancement effects from testosterone. What I specifically mean here are the effects of DHT on the central nervous system, which lead to increased neurological efficiency (strength), and increased resistance to psychological and physical stress - not to mention optimal sexual function and libido.

Yes, I have plenty of photos which I posted while all of this was going on that caused a firestorm on this site. I don't want to rehash all of that again. I'm just glad I was able to find a quality, caring doctor who provided me with a HT free of charge.

No, as far as I know Dr. Epstein is no longer a coalition doctor on this website. I have gone through nearly three years of hell. The excitement I had with my first procedure was indescribable. Then nine months into it to realize that something wasn't right and to have that confirmed by other members on this site when I posted photos and other doctors who looked at me was stressful to say the least. I felt like I'd had my heart ripped out. I felt a sick feeling in my stomach. Epstein offered to do a second one free. Then when very little came out of that I was beside myself. Dr. Ron Shapiro read the posts about my situation and offered to do a third procedure free of charge. I sent photos of my results to Dr. Epstein but he didn't believe there was anything wrong with the results and refused even a partial refund. If it weren't for Dr. Shapiro I honestly don't know what I'd have done since my resources were depleted and Dr. Epstein felt he has done an adequate job. Of course it has been just under three months since my procedure with Dr. Shapiro so I can't judge the results yet but I do see hairs surfacing which I never saw this early in my previous procedures. Even if this doesn't work out the idea that Dr. Shapiro who had no interest or involvement in my situation would clear out his valuable time when he could have had a paying patient in the chair to try to make me whole again speaks volumes about this man. I might add that after I had this terrible experience I did more extensive research to find the absolute best hair transplant doctor out there so if I were ever in a position again to have another procedure I'd know who to go to. I had it narrowed down to three then two then I had four close friends compare the hairlines of the two finalists. They all chose Dr. Shapiro. To my amazement the top doctor who I'd have paid to go to if I could have afforded it offered to perform a procedure for free. I was absolutely blown away and my mood picked up to a point I hadn't felt in months. I pray by the end of the year this will have all worked out. The finasteride is scaring me a little bit but that is another topic.

If you could get up to Minneapolis Dr. Ron Shapiro is excellent. He is well known for top notch repairs.

CaptainO, That is SCARY! I've been on it for three months. I haven't noticed the inability to get an erection but I've noticed they aren't as strong as they were. I wonder if this is in my head because of what I've read on here or if there is really something to it. Is there anyone on here who has been on finasteride for a long period of time who has had no sexual dysfunction? It has taken you THREE YEARS to get 75% of your erection back. I really think after reading this I'm going to stop. I would rather be bald than have ED.

In my case I have no idea what the reason for the poor growth was. I remember communicating with someone else who had the same issue with the same doctor around the same time I did and says he went elsewhere and had great results. I can tell you that in under three months I see hair surfacing and did not see that with my first two procedures. Of course I will not be able to make a judgment until the one year point. What really upsets me is the grafts that didn't surface are lost forever.

I had very low growth on my first HT. Because of that the doctor did a second one free which also produced very low growth. I had the first and second procedure checked by other doctors who agreed for the amount of grafts I was supposed to have had it was not close to where it should be. I complained long after the second HT and indicated that the results were as poor as the first HT. I requested a partial refund and was denied the request. The doctor said he did not know what I was basing a request of a refund on. I told him it was lack of growth. Dr. Shapiro learned of my unfortunate situation, felt sorry for me and offered a free procedure which was done in November. I already see hair surfacing and it hasn't even been three months yet.

I don't understand the mechanisms of the drug but if studies have shown the effects of finasteride remain in the system for a week or more, then how effective is it to take it every other day to give your body a 'drug holiday' to prevent sexual dysfunction?

In my opinion I'd address the front and sides for the next one. You probably aren't going to be satisfied with the density if you are a NW6 with one pass on the front and sides. I'd do the same area with a second procedure to achieve a thicker appearance. The crown is a hair pit and takes a lot of grafts even for a light covering. You could also consider what I plan to do when my procedure matures and that is wear a lace hair piece on your crown. I'm told they blend very well and are undetectable by guys who have done it and my stylist who does it.

I've noticed that many of you are taking your finasteride every other day. This is the course my doctor also want me to begin following. As you may have seen from another of my posts, I'm a bit apprehensive to take the drug do to the many patients on here who have complained of sexual dysfunction after starting this medication. Some patients say they had no problem while others have gone so far as to say it ruined their lives. I thought a happy middle would be to start the drug every other day and give my body a 'drug holiday' as my doctor friend put it. However, I found this information to be eye opening. I'm writing word by word recommendation of manufacturer Merk for prescribers "The recommended dosage is 1 mg orally once a day. PROPECIA may be administered with or without meals. In general, daily use for three months or more is necessary before benefit is observed. Continued use is recommended to sustain benefit, which should be re-evaluated periodically. Withdrawal of treatment leads to reversal of effect within 12 months". The drug has a half life of 4.5 hours. The rule is when half life of a drug is shorter it need to be administered more frequently. All the clinical trials documented by manufacturer, done with this drug, are with its daily dose. It appears taking it every other day may be ineffective.

If this will make you feel better about yourself then I say go for it. This procedure can be a disaster on a % of people. I had very poor results with my first two procedures and had a third in November with Dr. Ron Shapiro who is one of the best. It hasn't been long enough for the hair to sprout yet but I am very optimistic. From the years I've been on here Dr. Ron Shapiro has had consistent good results along with Hasson and Wong. I would stay away from hair mills like Bosley, because I've seen a lot of very unhappy patients from them. As poor as my results from the first two procedures were due to low growth the hair that did surface looks natural. There is nothing fake or bad looking about it. Hair transplants have been refined a lot in the past five to ten years. I don't know how you'd be risking your health in the hands of a good doctor. I think this person is speaking from ignorance. Who cares what other people think about you getting a procedure. I seriously doubt unless you tell them they will be able to tell any way, they will just think something looks different about you. Remember this is a gradual process over a year not overnight. So what if it is vanity or ego? I respect someone who has pride in their personal appearance and have no respect for someone who lets themselves go to pot. The idea that you'd be doing this to 'attract another woman' is insulting. What is wrong with wanting to look your best for yourself, wife and others? If this will give you extra confidence it will spill over into other areas of your life. Is the person offering you this advice bald? If not how can they offer you advice on something they haven't gone through? If they are bald then maybe this isn't for them but I wonder what their motive is for trying to talk you out of it?

Thanks for your input Markymark. What dosage and how frequently were you taking it? I'm thinking of changing from 1 mg a day to 1.25 mgs a day every other day. I wonder if taking it every other day and having a "medication holiday" would make a difference for the issues you described? Flac-do you and Pat take it? If so what has been your experience?

I believe it has been around for close to 20 years first as a medication for the prostate.

Labrat69, Just playing devil's advocate. Could it be that the people who are taking finasteride not for hair loss are guys who are taking it for prostate problems who already have a propensity for some kind of sexual dysfunction? The only two reasons I know of that this drug is prescribed is for hair loss or prostate problems. I think I look better with hair than without but I have a differing opinion about how attractive someone is perceived with hair vs. without. Maybe because I might be older than you and when one reaches a certain age and maturity level priorities and preferences change. I know of a lot of guys who are considered attractive without hair. Also, depending on your age if you are 'oversexed' now that may change as you get older. If you drive has diminished on finasteride and you are young what might happen as you age?

Labrat69, Interesting points you make and I'm listening. I'm a novice on this subject but in theory wouldn't preventing the conversion of testosterone to DHT allow for more testosterone in the body which is what allows for libido and erections? Not all guys convert testosterone into DHT and consequently have a full head of hair. Are those guys less horny and unable to get erections as freely? I'm trying to get all sides on this before I continue on this medication. It sounds like you are doing ok on the medication. I could deal with 'watery semen' if that is the main effect. However, if loss of libido or erection is also an issue then I'd have a major problem. I really need to research this because I've heard both sides of the argument. Some say it destroys their sex life and others say it's had no adverse effects. Maybe it just depends on the individual because we are all built differently.

I've started on Propecia at 1 mg a day. I'm about to change that to splitting a 5 mg pill of finasteride in half and taking it every other day to save money. This was approved by my doctor. However, a doctor friend of mine suggested that I split the 5 mg pill of finasteride into quarters and take one quarter every other day to avoid possible sexual side effects. I am terrified of the possible sexual side effects of this drug from what I've read on the internet. I'd rather be bald that impotent. Does anyone out there have any experience with this? Would I achieve acceptable results with ?? of a 5 mg pill every other day and have less of a chance of this causing any sexual dysfunction? I've read the half life of finasteride is such that taking it every other day or even every four days would not lessen the effectiveness.

I think I found the answer. However, it doesn't say if there is anything that can be done to return to the previous more desirable texture. Any thoughts? The texture of human hair can change for many reasons, but almost every person's hair texture changes as that person experiences puberty. During a child's early teen or pre-teen years, myriad chemical changes occur in the body to prepare the adolescent for reproductive capabilities. Among these changes are chemical alterations to the hair on the legs, body, genitals and head. It is very common for young children with fine, silky hair to develop coarse, wavy hair as a result of puberty. Some adults even experience changes in their hair's natural wave pattern as a result of natural growth. Although all of the effects of aging on hair are not fully understood, a person's hair naturally changes textures (and even colors) as the person gets older. Hair on men, for example, naturally falls out and is replaced by hair that is progressively thinner and more coarse. As the man gets older, his hair becomes thinner and eventually falls out because of this pattern.

Sure, I'd be glad to once I've reached the point where it starts growing. I looked in the mirror tonight and I can see hair sprouting!!! I did not see that this early with my previous two so I think that is a good sign. It's been a little over two months. I'm keeping my fingers crossed.

Thanks for your reply Dr. Charles. With that said is there a way to get back my softer hair? I'd rather have that back than the coarse hair I have now. My hair has been coarse for years but when I was a kid it was more like silk vs. straw. What do you mean by glandular function? My diet is clean and health good so I don't think that is the issue unless I'm eating something I'm not aware of that can cause hair to become coarse. Maybe I fall into the "unknown factors" category.

I had poor results with my first two transplants. I had a third back in November with a different doctor and feel better that this one will be produce positive results.

I was just thinking today about something that may seem odd but wondered what the answer was. Maybe there is someone out there who could answer this and maybe it happens to all of us. When I was younger my hair was fine and soft. As I've gotten older it has become more wiry and coarse. Why does hair do that as we age (or at least mine)?

A couple of you were interested in why I didn't go back to Dr. Epstein and it was because I was not satisfied with the results. Of the nearly 5000 grafts I had transplanted multiple doctors said it appears that approximately 2500 ever surfaced. This was after one procedure in July 2007 and one in August 2008. There were some subtle differences in the procedure between the two doctors but I am not qualified to discuss those differences or any others that I may not have noticed. I have no reason to believe that my procedure with Dr. Shapiro will be anything but a success as do other coalition doctors who have examined me to rule out any potential scalp condition that might prevent a positive outcome.