Introduction
Propecia is the world's first proven hair loss treatment in a pill. Approved for sale by the FDA in 1996, Propecia helps eliminate DHT, the root cause of Androgenic Alopecia or Male Pattern Baldness. DHT or Dihydrotestosterone is a hormone produced in the body from Testosterone and has been shown to induce hair loss by causing the hair follicle to miniaturize until it no longer produces terminal hair.

What it is
Propecia is a tablet that contains 1mg of Finasteride. It is taken once daily and causes body to stop producing DHT. Originally developed as a treatment for shrinking an enlarged prostate (BPH) under the name Proscar, Finasteride's ability to regrow hair was noticed by doctors and was developed as a treatment for Androgenic Alopecia.

How it works
Finasteride is a potent inhibitor of 5-alpha-reductase, the enzyme in many tissues that converts Testosterone to Dihydrotestosterone (DHT). The androgens Testosterone and DHT control the development and function of the prostate gland and are believed to play a role in causing Androgenic Alopecia, commonly referred to as Male Pattern Baldness. Scientists have discovered that men and women who are genetically predisposed to Androgenic Alopecia have a greater number of androgen receptor sites in follicles taken from the balding areas of their scalp. The suggests that the reason why the DHT affects these follicles is that they allow a greater amount of DHT to bind to the cells of the follicle. There is additional evidence to corroborate this and research shows that men who suffer from Androgenic Alopecia have higher levels of DHT in their scalp tissue.

In other studies scientists have demonstrated the effects of DHT on these follicles by taking follicles in a test tube and exposing them to DHT. At certain levels it was shown that the follicles growth was severely adversely affected by the DHT. It is believed that the DHTs effects on the follicles over time causes them to miniaturize and produce finer and shorter hair until they stop producing hair altogether. So by preventing the DHT from being created, it allows the follicles to grow unaffected by the DHT.

What to expect
In a two-year clinical study with 1,553 men ages 18-41, 83% of them were able to maintain their existing hair after 2 years, and 66% of them experienced regrowth. Since Propecia doesn't directly stimulate hair growth by acting on the follicle, it may be necessary to additionally use Rogaine if you have more severe hair loss. In men who have just started to lose hair or have recent hair loss, Propecia can have excellent results. Propecia does have to be used everyday to maintain the results and to prevent further hair loss.

Propecia Clinical Studies Results
Start of Treatment	6 Month	24 Month
Great Improvement		5%
Moderate Improvement		31%
Slight Improvement		30%
No change		33%
Decrease		1%

Propecia and Rogaine
While Propecia may be sufficient for some men with mild to moderate hair loss. Men who have severe hair loss will benefit by using Rogaine in addition to Propecia. There is no medical reason why you should not use these two drugs together, and in some clinical studies the best results that have been obtained have been with a combination of Propecia and Rogaine.

Propecia for women
Propecia is not approved for use by women. The main reason is that there is a risk of birth defects if a pregnant woman uses Propecia. However in post menopausal women there appears to be no risk using Propecia and some doctors will prescribe it. Women should consult with their physician as there are other Anti-Androgenic drugs like Spironolactone that can be safely used by women.

Generics
At this time there are no generic equivalents available in the USA. However some men buy Proscar, a 5mg version of the same drug, and divide it into quarters. This reduces the cost slightly but its recommenced to discuss this with a physician since Proscar is intended to treat the prostate and like Propecia requires a prescription. However there are no known problems with this method if the pieces are equal to the 1mg dose a person would be getting from Propecia.

Side effects
Since Propecia acts on the hormones, side effects can occur such as a lowering of libido and decreased amounts of seminal fluid. It is belied that about 3-5% of men will experience these side effects. Some men also complain of a tenderness in the breast tissue or testicular aches. If you are experiencing any of these side effects you should see your physician. Generally speaking side effects usually resolve themselves after a few weeks after the body readjusts to the change in hormonal levels. Some men experience positive side effects like an increase in strength as a results of the slight increase in Testosterone.

Hypoandrogenicity
This is a still relatively unknown phenomena but a small percentage of men seem to react negatively to the effects of the Propecia. In some men this can lead to an oily skin and an increase in hair loss. This is not normal and if you have experienced these effects from the beginning and they do not resolve themselves after a few weeks you should see a physician. Some men play it safe and start with a lower dosage like a half a tablet a day until their body adjusts to the Propecia. This approach should be discussed with the physician who prescribed the Propecia.