HT - are meds necessary as well?

[Chromium]

I'm thinking of having a hair transplant but don't want to take Propecia/Proscar because of the possible side effects. I realise this may mean I continue to lose hair elsewhere, and increases the chances I'll need a second HT - but does it mean that the HT itself won't work? Will the transplanted hair still grow even if I don't take meds?

 

Grateful for people's views.

[Chromium]

I'm thinking of having a hair transplant but don't want to take Propecia/Proscar because of the possible side effects. I realise this may mean I continue to lose hair elsewhere, and increases the chances I'll need a second HT - but does it mean that the HT itself won't work? Will the transplanted hair still grow even if I don't take meds?

 

Grateful for people's views.

[imissthebarber]

Chromium

 

The HT will still work because hair should be taken from the "safe zone" which is not susceptible to the DHT that causes male pattern balding. However, I think you'll struggle to find many people to recommend what you are thinking of doing. HT is a major investment financially and emotionally and there is no going back. Most people decide that the possible risks with meds are worth taking and in most cases people do not experience side effects.

 

Also since there is a limited amount of donor hair, it could end up looking unnatural if you do not do what you can to protect the hair you already have (using meds).

[biscuit]

Prior to my HT I made the decision that I was not going to take meds. Dr Wong took that into consideration when placing the grafts. If I had decided to take meds he would have placed fewer grafts in my crown, those grafts would have gone up front.

 

My "success" case is not that common. I'm lucky that I have super strong donor hair at 50 years old. I can easily get 4,000 more grafts if I need them. I had already lost most of the hair on the front of my head, so meds wouldn't have helped much for me.

 

Most doctors will recommend that you take meds. It's a no-lose situation for them. If the meds work everyone is happy. If you get side effects they tell you to stop taking them. If you get long term side effects it's the med manufacturer that takes the heat.

 

The med manufacturers say the numbers of problem cases are very small. Lots of people are happy with the results and experience no side effects. Search the forums for success cases and see if your hairloss pattern is similar.

 

But there are people who have had short term and long term problems. Spend some time reading forums like this one and http://www.propeciahelp.com/forum/ and do a google search for "propecia side effects". Read the manufacturers claims and warnings carefully.

 

Other factors worth researching:

 

Blood testing. If you decide to take meds you should have frequent blood analysis to make sure your levels are correct. Get a baseline test before you start taking anything so you have something to compare.

 

Drug interaction. If you take meds other than for hairloss you should do some research to find drug interaction studies.

 

Long term immunity to the drugs. It's not uncommon for people to lose the benefits of the meds after around 5 years. If you have banked on the hairloss drugs lasting forever you will need to alter your strategy.

 

Lifetime commitment. If you ever decide to stop taking the hairloss meds you will quickly lose everything that you gained. Ask yourself how commited you will be at 40/50/60/70/80 etc. What is the likelyhood that you will continue to take hairloss meds if you develop a serious medical condition (heart problem, etc) and the doctor recommends that you stop taking the hairloss meds?

 

Family planning. If you are going to be starting a family soon, do some extra research on reproduction complications.

 

It's a complicated decision. Take your time. Do a lot of research and make your own decision.

 

- - -

 

Disclaimer: I'm not against drugs. I have no problem with anyone else taking hairloss drugs. I hope everyone that takes them has success and no side effects. I am not a doctor. Most of what I write is my opinion, not scientific facts. I decided to not take hairloss drugs for my own personal reasons that apply to my case. I understand that other people have their own goals, and they're entitled to make their own decision.

[imissthebarber]

Biscuit

 

Thanks, this is a really thoughtful post and the forum you linked is certainly eye-opening.

[ShavedDethMonk]

Originally posted by biscuit:

Prior to my HT I made the decision that I was not going to take meds. Dr Wong took that into consideration when placing the grafts. If I had decided to take meds he would have placed fewer grafts in my crown, those grafts would have gone up front.

 

My "success" case is not that common. I'm lucky that I have super strong donor hair at 50 years old. I can easily get 4,000 more grafts if I need them. I had already lost most of the hair on the front of my head, so meds wouldn't have helped much for me.

 

Most doctors will recommend that you take meds. It's a no-lose situation for them. If the meds work everyone is happy. If you get side effects they tell you to stop taking them. If you get long term side effects it's the med manufacturer that takes the heat.

 

The med manufacturers say the numbers of problem cases are very small. Lots of people are happy with the results and experience no side effects. Search the forums for success cases and see if your hairloss pattern is similar.

 

But there are people who have had short term and long term problems. Spend some time reading forums like this one and http://www.propeciahelp.com/forum/ and do a google search for "propecia side effects". Read the manufacturers claims and warnings carefully.

 

Other factors worth researching:

 

Blood testing. If you decide to take meds you should have frequent blood analysis to make sure your levels are correct. Get a baseline test before you start taking anything so you have something to compare.

 

Drug interaction. If you take meds other than for hairloss you should do some research to find drug interaction studies.

 

Long term immunity to the drugs. It's not uncommon for people to lose the benefits of the meds after around 5 years. If you have banked on the hairloss drugs lasting forever you will need to alter your strategy.

 

Lifetime commitment. If you ever decide to stop taking the hairloss meds you will quickly lose everything that you gained. Ask yourself how commited you will be at 40/50/60/70/80 etc. What is the likelyhood that you will continue to take hairloss meds if you develop a serious medical condition (heart problem, etc) and the doctor recommends that you stop taking the hairloss meds?

 

Family planning. If you are going to be starting a family soon, do some extra research on reproduction complications.

 

It's a complicated decision. Take your time. Do a lot of research and make your own decision.

 

- - -

 

Disclaimer: I'm not against drugs. I have no problem with anyone else taking hairloss drugs. I hope everyone that takes them has success and no side effects. I am not a doctor. Most of what I write is my opinion, not scientific facts. I decided to not take hairloss drugs for my own personal reasons that apply to my case. I understand that other people have their own goals, and they're entitled to make their own decision.

 

The site is worthy for the collection of studies related to Finasteride, however I have serius problems with the bias on the site and the constant misinterpretation of the information. Most of the comments are of forum members struggling to understand what the research means.

 

I have taken graduate courses in critically appraising medical literature and there is a total lack of such on that forum. People are acccumulating all studies that have potentially 'negative' effects highlighted. One study sticky showed an increase in HDL-C (High Density Lipoprotein - Cholesterol) and the posters were freaking out that it would affect their hearts. Obviously the forum members who commented didnt realize that an increased HDL-C is actually beneficial to heart health while LDL-C, Triglycerides are not helpful.

 

Another sticky lists the % of side effects from an undisclosed dosage of the drug. Most likely it was 5 mg which people dont take for MPB, additionally they did not compare the % of side effects to placebo nor any confidence intervals or p-values to show whether these percentages were significant.

 

I did find the study useful of the concentration of DHT after a single dosage (varying dosage) of finasteride which will allow me to now calmly take one dosage every two days; though I will look to see if I can find any other academic articles to support this.

 

For these studies many things need to be looked at: Is this study well designed. What are the number of subjects. Are the subjects similar to me. What have other similar studies said, do they contradict or agree. Does a certain percantage decrease in a physiological parameter have a real world effect on me (10% change in some parameter may not mean anything to the whole organism, whether it be rat or human). Was the study done on humans or rats, we are not rats so you can not blindly apply results to humans. There are way too many factors like that .........

 

so if you are not familiar wirh critically appraising scientific literature (study design, confidence intervals, significance values, validity) I would freak out over the biased presentation of data from that forum.

 

I am not a propecia or proscar rep. or lobbyist but rather trying to stop fear mongering by using scientific literature in a pseudo-science quack arguement way.

 

SDM

[latinlotus]

Side effects of finasteride is very very rare (around 2%). Don't even think about it.

 

You will probably have a bigger probability than 2% of getting low growth or no growth HT.

[blowdry]

I take .5 two days in a row and one day off. I repeat this cycle with good results.

Blood testing is also a good idea regardless if you are on Propecia or not. Read Sommers book ageless. The key is in the Hormones. Bioidentical of course.

[Uk_lad]

shaveddeathmonk, so are you taking 1.25mg fin /1mg proprecia every two days now, obviously if it works the same, can only be better to take less of the medication, as i suspect their would be less chance of side effects!

[biscuit]

Like I said, it's a complicated issue. On one side you have fear mongering, on the other side you have marketing hype from billion dollar corporations who want you to use their product for the rest of your life. Somewhere in between is reality, it's up to each individual to weigh the benefits/risks and determine their priorities.

 

Spex, regarding reproductive complications, I'm talking about limiting risks. Being a parent myself, I would do anything possible to reduce the chance of a birth defect. No smoking, no drinking, no drugs. Hairloss medications are serious drugs that affect your entire body from head to toe. The majority of the research and studies on propecia/finasteride were done on people well past child-bearing age, which is fine because it was developed to treat enlarged prostates in older men. But that doesn't necessarily mean that they've determined that it poses no risk to young men starting families. I'd like to see more studies on young men, and more studies on drug interaction, but that probably won't happen because they've already met the requirements for approval. A lot of people assume that since it's approved it's safe.

[ShavedDethMonk]

Originally posted by Uk_lad:

shaveddeathmonk, so are you taking 1.25mg fin /1mg proprecia every two days now, obviously if it works the same, can only be better to take less of the medication, as i suspect their would be less chance of side effects!

 

Uklad: For 2 years now I have been taking 1 mg Propecia and recently (within the last 3 weeks) switched to 1.25 mg Proscar (now I have it covered by my drug plan ). I only really reviewed the site that Biscuit linked today and than I did a literature search on PubMed on the pharmokinetics of finasteride and only found one other article (from 1999) confirming that lowering of DHT lasts much longer than the half life of the drug so I think I will start tommorow by SKIPPING my 1.25 mg dose. If you look at the chart:

 

http://www.propeciahelp.com/fo...viewtopic.php?t=1170

 

DHT does not rise much on day three, not having taken finasteride since day one. I believe that I doubt that the ever so slight increase in DHT from day 2 to 3 would have a real world difference in my hair while allowing me to effectively cut the amount of drugs I put into my body by HALF!! which I think is a valuable trade off ... though I am not experiencing any side effects I still think it is a worthy action to take.

[ShavedDethMonk]

Originally posted by biscuit:

Like I said, it's a complicated issue. On one side you have fear mongering, on the other side you have marketing hype from billion dollar corporations who want you to use their product for the rest of your life. Somewhere in between is reality, it's up to each individual to weigh the benefits/risks and determine their priorities.

 

Spex, regarding reproductive complications, I'm talking about limiting risks. Being a parent myself, I would do anything possible to reduce the chance of a birth defect. No smoking, no drinking, no drugs. Hairloss medications are serious drugs that affect your entire body from head to toe. The majority of the research and studies on propecia/finasteride were done on people well past child-bearing age, which is fine because it was developed to treat enlarged prostates in older men. But that doesn't necessarily mean that they've determined that it poses no risk to young men starting families. I'd like to see more studies on young men, and more studies on drug interaction, but that probably won't happen because they've already met the requirements for approval. A lot of people assume that since it's approved it's safe.

 

Hi Biscuit,

 

I agree that the reality is somewhere in the middle. And as a person ready to start my family I will find out first hand whether it has affected my fertility or not

[biscuit]

Fertility is an issue, but my main concern would be avoiding birth defects and health problems with the child. I'm not saying that I know of any issues with propecia and birth defects. But it's reasonable to say that you have less risk if you aren't taking a bunch of drugs during conception.

[Mr. GQ]

some people are risk takers while others are not.

some people are afraid of illicit drugs some are not

some people are more paranoid some are not.

some people look at their life like 'whatever you live only once' while some don't.

and so on and on and on.....

so to each its own and i think by now everyone knows the pros and cons of propecia so the posts are just getting redundant imo.

 

P.S.

biscuit - i'm very impressed with your ducks team this year in playoffs. who would it thought eh? you ready for tonight's game?

[Uk_lad]

About the fertility issue, surely a drug company would have done extensive trails on this issue? Imagine if they come out with a drug that causes infertility, which is not mentioned on the potential side effects! They would go bankrupt with the amount of court cases against them. Yes they make alot of money from proprecia, but they would lose that and more if it caused men in there 20's to go infetile. Mild pain killers like nurofen have a huge list of potential side effcts just to cover their own asses!

[biscuit]

I haven't really looked into this for about 4 years, but here are some articles that came up on google:

 

Propecia, Infertility Link Suspected

 

http://www.renalandurologynews...cted/article/104651/

 

Finasteride-associated male infertility

 

http://biblioteca.universia.ne...arams/id/304968.html

 

Safety info (talks a little about what kind of testing has been done)

 

http://www.otispregnancy.org/pdf/propecia.pdf

 

59 pages of interesting feedback on Propecia, some of the comments are pretty funny.

 

http://www.askdocweb.com/propecia59.html

[Take a chance]

People that don't experience side effects are very lucky. I did experience a lot of side effects whilst on the drug and no longer take it. I know that side effects occur in a lot more people than the suggested 2%. Just have a look at propeciahelp.com

I did have a HT and don't take finasteride and quite happy that i'm not. The risk is just not worth the reward.

I wouldn't be taking it if trying to start a family. Just not worth the risk. Just my opinion...

[mgoldberg]

SPEX - Congrats on the Twins on the first try - you were fortunate. Your sperm count was probably lower, but still high enough to have kids. Two peer reviewed medical literature articles:

 

Propecia-induced spermatogenic failure: a report of two cases.

 

Liu Kimberly E; Binsaleh Saleh; Lo Kirk C; Jarvi Keith

Division of Reproductive Sciences, Department of Obstetrics and Gynecology, University of Toronto, Reproductive Biology Unit, Mount Sinai Hospital, Toronto, ON, Canada.

Fertility and sterility ( United States ) Sep 2008 , 90 (3) p849.e17-9

OBJECTIVE: To describe the results of two cases of azoospermia and severe oligospermia in men during and after cessation of finasteride 1 mg. DESIGN: Case report. SETTING: Tertiary-care hospital-based clinic for andrology/male infertility. PATIENT(S): Two patients with azoospermia and severe oligospermia using finasteride 1 mg for hair loss. INTERVENTION(S): Discontinuation of finasteride. MAIN OUTCOME MEASURE(S): Improvement in sperm concentration. RESULT(S): Patient A had documented azoospermia over 1 year and was initially booked for a testicular biopsy. Six months after discontinuation of finasteride 1 mg daily he showed improvement in sperm concentration to 5.5 x 10(6)/mL. Patient B had severe oligospermia with a sperm concentration of 4 x 10(6)/mL. Sperm concentration improved to 6.6 then 18.7 x 10(6)/mL at 3 and 6 months after stopping finasteride. CONCLUSION(S): We report two cases of infertile patients with azoospermia or severe oligospermia who showed significant improvements in sperm concentrations 6 months after the discontinuation of finasteride. In one case, improvement in semen parameters prevented the need for testicular biopsy and corrected the azoospermia. Stopping finasteride in the infertility population may improve semen parameters, and may allow for less invasive fertility treatments.

 

 

The effect of 5alpha-reductase inhibition with dutasteride and finasteride on semen parameters and serum hormones in healthy men.

 

Amory John K; Wang Christina; Swerdloff Ronald S; Anawalt Bradley D; Matsumoto Alvin M; Bremner William J; Walker Susan E; Haberer Lynda J; Clark Richard V

Department of Medicine, Veterans Affairs-Puget Sound Health Care System, University of Washington, Seattle, WA 98195, USA.

Journal of clinical endocrinology and metabolism ( United States ) May 2007 , 92 (5) p1659-65

CONTEXT: Dutasteride and finasteride are 5alpha-reductase inhibitors (5ARIs) that dramatically reduce serum levels of dihydrotestosterone (DHT). OBJECTIVE: Because androgens are essential for fertility, we sought to determine the impact of 5ARI administration on serum testosterone (T), DHT, and spermatogenesis. DESIGN, SETTING, SUBJECTS, AND INTERVENTION: We conducted a randomized, double-blinded, placebo-controlled trial in 99 healthy men randomly assigned to receive dutasteride (D; 0.5 mg) (n = 33), finasteride (F; 5 mg) (n = 34), or placebo (n = 32) once daily for 1 yr. MAIN OUTCOME MEASURES: Blood and semen samples were collected at baseline and 26 and 52 wk of treatment and 24 wk after treatment and were assessed for T, DHT, and semen parameters. RESULTS: D and F significantly (P < 0.001) suppressed serum DHT, compared with placebo (D, 94%; F, 73%) and transiently increased serum T. In both treatment groups, total sperm count, compared with baseline, was significantly decreased at 26 wk (D, -28.6%; F, -34.3%) but not at 52 wk (D, -24.9%; F, -16.2%) or the 24-wk follow-up (D, -23.3%; F, -6.2%). At 52 wk, semen volume was decreased (D, -29.7%; F, -14.5%, significantly for D) as was sperm concentration (D, -3.2%; [corrected] F, -7.4%, neither significant). There was a significant reduction of -6 to 12% in sperm motility during treatment with both D and F and at follow-up. Neither treatment had any effect on sperm morphology. CONCLUSIONS: This study demonstrates that the decrease in DHT induced by 5ARIs is associated with mild decreases in semen parameters that appear reversible after discontinuation.

[tuja]

Originally posted by Take a chance:

People that don't experience side effects are very lucky. I did experience a lot of side effects whilst on the drug and no longer take it. I know that side effects occur in a lot more people than the suggested 2%. Just have a look at propeciahelp.com

I did have a HT and don't take finasteride and quite happy that i'm not. The risk is just not worth the reward.

I wouldn't be taking it if trying to start a family. Just not worth the risk. Just my opinion...

 

Sir could you please tell what side effects you had? I am a little concerned because i am taking dutasteride for sometime now and i am 26.

 

Thanks.