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Hair Loss/Finasteride and Fertility

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Question
Hi Doctor,

I am 27 year old male. My hairs are thinning. More thinning is in the front. I have family history of baldness. My father is bald.
Though i have head full of hair and i can cover my thinning with daily shampoo. But they are thin are now don't grow much in length except in sides and back. I think i am moving to NW2.
I am using Minoxidil 2% for last two years and it helped in checking my hair loss but thinning continues. I am thinking of moving on to Finasteride. But i am worried about that studies showed that it effects semen parameters and can make a man infertile. I will be getting married in a year or two. I want to have kids in future. So i will like to have your advice should i go ahead with finasteride or not.
Or should i get my semen checked before starting medication.
Thanks in advance.

Answer
 AS a 27 year old who is about to be married I sympathize with all the contradictory reports about finasteride which are flooding the internet. In the initial studies there were NO permanent problems and the vast majority or those who had a problems with either ED or diminished seminal fluid found that they adapted after a few months of being on the medication. Diminished sperm count after discontinuance which persists is very rate if it exists at all.
I personally have been taking 1mg finasteride since 1993 and started my 28 year old son on the same medication when he was 20, not just to preserve his hair but to help prevent prostate cancer. There is a family in the Dominican Republic missing the type II enzyme the finasteride inhibits and the boys in that family never go bald and never get prostate cancer.
 My advice would be to get your semen checked before treatment and 4 months after treatment. If there is a problem any change should resolve itself in 2 to 3 weeks.
   Instead of 2% minoxidil why not use the 5% Rogaine Foam twice a day. It is more effective.

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Peter J. Panagotacos, <B>M.D.</B>

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I have 30 years experience in the field of medical and surgical Hair Restoration and am Board Certified in Dermatology and Hair Restoration Surgery.

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I have 30 years experience in the field of medical and surgical Hair Restoration and am Board Certified in Dermatology and Hair Restoration Surgery. More information can be found at my website www.hairdoc.com

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