Dr. Richard Hoffmann, Ask the Pharmacist, 09/04/12

Q: I take Propecia for hair loss and have experienced some sexual side effects. If I stop taking the drug will these side effects go away?

A: Male pattern baldness is a very common condition. Hair loss in males may start in the late teens or early 20s and, by the age of 35 to 40, about 66 percent of male Caucasians will have some degree of hair loss.

It is commonly found in the same family and is probably due to a person’s genetic makeup and hormones produced. The hair loss usually begins in the front sides on the top of the head and may be extensive, depending on the person’s age at the time it starts.

It is now thought that hair loss is due to a hormone called dihydrotestosterone or DHT, which adversely affects the hair follicles where hair grows.

Propecia (finasteride) taken as a 1 mg tablet once daily is approved to treat male pattern hair loss, also known as androgenic alopecia.

Finasteride, the active ingredient in Propecia, is also approved to treat men with an enlarged prostate or BPH, but at a much higher dose. Finasteride works by blocking an enzyme that converts the hormone testosterone to dihydrotestosterone in the prostate gland, liver and skin.

This leads to a significant reduction in DHT in the scalp, which is believed to cause hair loss in men. Unfortunately, like all drugs, Propecia can cause adverse effects in some men, including sexual side effects.

These sexual side effects can include erectile dysfunction, libido disorders, ejaculation disorders and orgasm disorders.

Recently (2012), a study in The Journal of Sexual Medicine suggests sexual dysfunction associated with Propecia use may last for many months or even years in some men, even after the medication is discontinued.

Richard P. Hoffmann, Pharm.D., has been a pharmacist for more than 40 years. Send questions to him at 2960 E. Coventry Court, Hernando, FL 34442.