Safe to use propecia after surgery? Dr.'s opinion appreciated.

[chocorange]

Hello all.

I'm currently considering surgery for a relatively mild case of gynecomastia (puffy nipple) that I've had since I was an overweight teenager.  I'm now 25, no longer overweight, in good shape and I can finally afford surgery. 

Here's the dilemma.  For the last year I've been using propecia for hair loss.  I have suffered no side effects and, as far as I can tell, my gyne has remained the same throughout.  The question is, if I have the surgery, is it safe to go back on propecia afterwards?  Clearly, the propecia did not cause my gyne, I have had it for much longer than my course of treatment.  So I suppose my question is this: am I more susceptible to regrowth from propecia after surgery, given that I had the condition before?

I know this subject has been raised on this forum before - I have searched the archive.  But as far as I can tell, none of the surgeons who contribute to this forum have weighed in on the matter.  I'd be curious to hear their thoughts, and their experiences of patients using propecia after surgery, if they have the time.  A lot of fuss is made about propecia on the net - about side effects, dangers etc.   While some is true (I don't doubt the existence of side effects in some people), a lot of opinion and conjecture on the net about this drug seems to have no scientific basis, so I'd appreciate a doctor's clinical assessment. 

Many thanks.

[scballersc]

Same exact situation for me...I am waiting eagerly for an answer.

Would be such a crappy choice, no hair or no puffy nipps. 

PS. A topical hair loss medication would be ideal here.

[Paa_Paw]

Because of the very nature of this site, We often hear from men who have had adverse side effects from Propecia. Especially, of course, Gynecomastia. Conversely we are not likely hear from those who use it without ill effect. The view of the drug here is much less than objective as a result.

I think that it would probably be safe to say that if you previously used the drug without undesirable side effects, it should be safe to use in the future.

[Doomed]

No Doctor can tell you if it is safe to go back on Propecia because no Doctor will know how your body will respond to the alterations in your hormones caused by Propecia.  Simple fact is, gynecomastia is a listed side effect and is therefore a possibility.

If you have been on the medication for 1 year and have not had any signs of gynecomastia then it is possible that you may not get this side effect.  However, I have read cases on various hairloss boards/forums where gynecomastia did not show up for some men until they had been on the medication for a few years.

You just need to weigh the pros and cons and make a decision with the thought in mind that gynecomastia may be a possibilty down the road if you continue with the med.

I would also think that if you developed gynecomastia with the use of Propecia and stopped the medication at the first signs of gynecomastia then it would likely not progress.

Good Luck

[Dr. Elliot Jacobs]

Interestingly, I have posed this specific question to Merck & Co, the manufacturer of Propecia.  I have had a number of patients in the identical situation.

Merck has informed me that there are no scientific studies about this particular situation.  So the answer truly is that we do not know and cannot predict if gyne would occur or recur if you continued Propecia after surgery.

My professional opinion is that if the gyne preceded use of Propecia (as it was in this case) and did not seem to have any adverse side effects (including added growth of gyne), then it would probably be safe to continue it after gyne surgery.  However, there are no guarantees for any one individual person.

I have had a few patients who did return to Propecia after gyne surgery and it seemed to have no adverse effect -- but this is not a scientific study -- only "anecdotal" stories.

Dr Jacobs

[MSJ108]

screw it, id rather be bald than have gyne!

[DrBermant]

I've read a paper by an endocrinologist about propecia that said it caused a persistent form of hypogonadism in some individuals, even after they stopped taking it this hormonal imbalance persisted, and the endocrinologists don't know exactly why this is happening.

Actually, I have seen many patients who have complained of breast growth and tenderness after starting propecia.  In discussing cases like these with endocrinologists, many have told me that they have had cases that were difficult to treat once started with something like propecia.  Some of my patients have described tenderness and growth after starting the drug.  Stopping the drug resulting in the tenderness stopping and gland becoming smaller.  A few then described new tenderness and growth when retrying the drug.

Studies or not, I advise my patients to avoid such problems.  However, there are a few papers about this condition:

http://www.ncbi.nlm.nih.gov/pubmed/9224349?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DiscoveryPanel.Pubmed_Discovery_RA&linkpos=1&log$=relatedarticles&logdbfrom=pubmed

I prefer sculpting stable gynecomastia to minimize recurrence whenever possible.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Male Breast Reduction

[cecly]

There seems to be waaaaaay too many side effects to even want to start that medication. I would rather be bald than not be able to become erect.

[headheldhigh01]

agree.  i've seen too many guys here who got their gyne from propecia, the effect had its own website, i think it might have been propeciasideeffects.com or something. 

gyne twice isn't worth the risk.  wear a rug! 

[MSJ108]

Thanks for the info Doctor B!

[DrBermant]

Thanks for the info Doctor B!

You are welcome!

Michael Bermant, MD
Learn More About Gynecomastia

[nikolas]

guys! trust me! DO NOT take propecia! I started taking it about 2 yrs ago. Didnt notice any side effects until about a yr and a half in when i started noticing that my nipples were puffier. Slowly I would notice my shorts woudnt look as well because of the puffy nipples/gyne. It was gradual and slow but it did have its effect. I ended up getting surgery. Granted, the gyne was not a severe case nor was it something that went from flat chest to boobs but it was noticeable enough for me to feel uncomfortable wearing tshirts. I used to use bandaids to get rid of the pufiness when i went out.

Propecia did wonders on my hair but..frankly not work the risks. Cost me $6k for a surgery, the pain and healing of the actual surgery, and the anticipation to see if my chest will end up looking right. There are ways a man can embrace his receding hairline or baldness and stil look good and manly. Not realy sure there is a way to embrace gyne and look good and manly.