Staypuft,
The condition is known as Male Pattern Baldness.
It occurs only when two things come together A) a recessive gene B) testosterone and its inevitable derivative androgen dihydrotestosterone. Many men have high testosterone and high dihydrotestosterone but they do not have Male Pattern Baldness because they do not have the recessive gene that is also required.
If you have the gene then as a man you are bound to have hair loss and the only way to permanently prevent that is to adversely after your hormonal status.
You are reducing what it is that makes you a man hormonally by taking Propecia.
Noticed the way you don't see many bald women?
That is because they inherently lack the same quantities of testosterone and dihydrotestosterone.
So what you are saying is that you would rather be/become more womanly from a hormonal point of view than loose some/all of your hair.
Also you would have to take Propecia indefinitely/for life otherwise your dihydrotestosterone will act upon the hair follicles.
As you get older your testosterone and dihydrotestosterone will decrease and your SHBG will increase. This will mean that as you get nearer to 30 and then 40 and then 50 etc, your endocrine status will become more and more fragile. Given you have already shown a propensity to develop gynecomastia with propecia use;
You can look forward to years of progressively greater problems.
Your gynecomastia will most likely be significantly worse in years to come, you may loose the ability to achieve or maintain an erection or at least have erectile dysfunction and you might also loose your libido, partially or completely (I have known this to happen with many men).
If you were in the group of men that had no reported symptoms with Propecia, those likely to have high testosterone and high dihydrotestosterone then maybe the course of events over the years would not be as great a downward spiral, but you are not in that group and your hormonal status is already in question, hence the development of the problem so far.
In short if you are getting gynecomastia now I think by the age of 50 you could certainly expect to have a very difficult to treat form of hypogonadism that will make life miserable. Breasts, erectile dysfunction, low libido, depression/low mood and penile atrophy are all possible. If your free testosterone is lowered via the action of Propecia on SHBG then you have the chance of increased visceral fat, possible obesity, an increase in the risk of Diabetes, and increased risk of the development of Cardio Vascular Disease (CVD), an increased risk of developing osteoporosis, an increased risk of developing Alzheimer’s….I could go on.
Here is the story of one man
It all started back in October 2002 but just a brief history before that. I started losing my hair in my late teens, early twenties but it has been a slow decline rather than heavy shedding. I tried minoxidil but because my hair is long it always made it look messy. When I heard about Propecia I thought what a great idea. Take a tablet each day and that’s that. It really did look like the miracle cure us baldies had been waiting for.
I started taking Propecia in October 2002. I got it from the Internet because it wasn’t available in the UK as far as I knew. I contacted Merk in New Zealand which is were my batch came from and they confirmed it was legitimate and not a cheap counterfeit. I showed them to my doctor and although he hadn’t seen Propecia before he asked me a few questions about my general health and said I would be ok to take them if I wanted to. I read the note about the 2% of men suffering from a lowered libido but also the fact that this returned to normal on stopping Propecia and also went away in men who continued to use the drug. I wasn’t dating at the time so I really did have nothing to lose, I just figured if I met someone I would stop using the drug and hey if it meant I would masturbate less I really didn’t care. I took the tablet each day for about 5 and half months. The drug had a huge affect on my hair and it grew a lot quicker and a lot thicker. All my friends noticed including my stylist, I was very happy about the positive effects.
Then I met someone I was really excited about. I immediately stopped taking Propecia and we started dating once a week. After a couple of weeks that’s when I realized things were quite the way they should be in the trouser department. I tried to masturbate but I could not get an erection even after a long time trying. Previously I had never had a problem and had always been quite a horny guy. I put it down to finasteride and thought that maybe I needed to give my body a little longer but after more time still no change. I became concerned and started searching on the Internet with Google. My worst nightmare was staring at me in black and white on the computer screen. Not one, but many cases of finasteride induced impotence. Men who had not recovered even after 3 or 4 years of finasteride I was completely distraught. I could not sleep and I could not eat, and I could not think about anything else. I cried and cried many times and the angst was almost unbearable.
I went to see my GP and told him everything, he was very understanding and made me an appointment with a doctor who was a Psychosexual specialist. I broke down in front of my girlfriend one night and told her everything and she was incredibly understanding and said she would stick by me no matter what. This was a huge relief and I was able to sleep and get back to some sense of normality. The specialist convinced me it was all in my head and he gave me some exercises to do with my partner and also Viagra to help me get over the problem. I believed him and practiced “sensate focus” with my partner and eventually used the Viagra. I did this over a 3 month period. Still suffering from impotence I decided after more research that the answer may lie within blood tests. I believed that Propecia had upset the hormone system and something was greatly out of balance. I went to see an endocrinologist and explained my symptoms as follows:
• No morning erections and no daytime erections.
• Great difficulty in getting or maintaining an erection for intercourse or masturbation. Watery semen
• I felt very passive
• My penis felt smaller, wrinkly, less full
• My testicles hung lower and felt less full, my testicles previously would well up if I didn’t masturbate for a day or so.
• My penis felt “disconnected” from my brain in some way.
• Sometimes my erections stopped short and my penis would arch to the left.
• An increase in tummy fat.
He did some basic blood tests and told me everything was normal but my Testosterone was slightly sub normal i.e. it was below the minimum range. He said that maybe I was a low Testosterone male. He said I could go on TRT either having Testosterone injected or a rub in gel. I didn’t like the sound of this as I would have to do this for the rest of my life. I also discovered that this would shutdown my testicles and I would not be able to have children whilst in this state. We agreed to leave it another 6 months and then see how things went. We did some more tests and this time my Testosterone was slightly above the minimum range. The endocrinologist was only open to basic TRT and was unwilling to try and restart my system or do any further tests to find out what was causing my the problems. As I didn’t agree he referred me to a Professor of endocrinology . I went to the appointment with great hope, after all the person I was seeing was a professor. I came out of the appointment and cried. He didn’t believe me and said it was all in my head and that I should stop doing research on the Internet. He wouldn’t treat me as everything was between the “normal” ranges in my last test. So this leads me to my present day. 3 doctors who don’t believe I have a problem and all unwilling to treat me, believe me or even investigate. I quit Propecia in March 2003 and I am still suffering side effects. I wrote to Merk a few times but they fobbed me off saying there was nothing they could do and they weren't allowed to help me. Although things have improved slightly I am far from normal. Not only is my quality of life suffering I am now increasingly concerned for my future health. No one knows yet what Propecia does to cause this condition and no one knows what the future ramifications are. Struggling with the symptoms is one thing, ignorant doctors just make the uphill struggle ten time harder. Still the fight goes on and I am currently in consultation with a doctor in the USA. I’ll keep you posted and if I could have my time again and I would never have taken Propecia. The truth is there are many men out there whose lives have been torn apart by a drug that was supposed to stop their hair falling out. I have heard of cases were finasteride has only been taken for as little as one month, the damage appears to be irreparable by the body alone and it is not known yet whether the damage can be repaired by treatment.
If you are considering Propecia exercise extreme caution and if you want my advice, stay well away.
The end
And here is a site with a link to men who have suffered from Propecia and Finasterid based products.
http://www.propeciasideeffects.com/P.S
I have a feeling no warning will make a difference to those intent on taking Propecia.
Of note very few endocrinologists will understand the mechanism of action of Finasteride, very few will test dihydrotestosterone and very few will notice/understand its often significant impact on SHBG and impact on free testosterone.
Most men who end up suffering pretty badly struggle to find an endocrinologist that understands what is going on; diagnosis and treatment being very hard to come by. I have spent a VERY long time per case in order to get a number of men's endocrinologists to understand what is going on and properly diagnose and treat them. On other occasions I have had to spend even greater time, somtimes months per case, in order to get men into the offices of endocrinologists who understand, diagnose and treat such problems.