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 Dr. Bernstein, founder and Chief Surgeon of the Bernstein Medical Center for Hair Restoration, is an Associate Clinical Professor of Dermatology at Columbia Unversity in New York. He is recognized world wide for developing the Follicular Unit Hair Transplantation (FUHT) technique used by the majority of hair transplant surgeons in the world today.
kevlarpcr
2008-01-15
abrupt discontinuation of long term propecia
Dr. Bernstein,
I am a neurologist in NJ in need of your expertise. I have been using propecia for about 5 years without any untoward side effects. I have rarely missed a dose. Last week, I missed 2 consecutive doses and have had difficulty with libido, erections, etc. It seems highly unusual that cessation of that medication would lead to such symptoms. Is there any literature regarding any kind of \\\"withdrawal\\\" syndrome from long term propecia use that might lead to such idiosyncratic symptoms? In the past when Ii have missed one dose, I have felt the beginnings of those symptoms but prompt resumption of propecia has reversed them. Not so this time. I wonder what endocrinological adapations to the chronic use of this drug might occur and whether actually ceasing its use might lead to hormonal imbalances or some other hypothalamic-pituitary axis disturbance. Any feedback would be greatly appreciated. (I am 36, in excellent athletic shape and I have never smnoked, been overweight or been excessive with alcohol intake. There are not new or siginificant stressors in my life at this time.)
Sincerely,
P. Roblejo, M.D.
P.S. I have received hair transplants and may be needing a 4th procedure within a year or two.
Dear Dr. Roblejo,
Generally, it takes 1-3 weeks to note any change in side effects from starting or stoppin finasteride, so it would be my guess that these side effects are phychology - and, as you point out, they are in the wrong direction i.e. should improve with cessation if you had them. You might want to get Free T and Estradiol levels, to see if any of these are abnormal.
e-mail me at rbernstein@bernsteinmedical.com if you have additional information.
Best,
Dr. Bernstein
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