I am in my 20s, and starting to lose my hair.  I've studied the topic
of male pattern baldness extensively, and have decided that I should
try Propecia.  Only one problem: it's a prescription drug and I have
no idea how to go about getting it.  I don't have a "family doctor" or
any sort of an "in" with a general practicioner; I don't know if you
need to see a specialist for it or not, for that matter.

I live in Fairfield, IA; I'd like the name(s) and contact info of
someone willing and likely to prescribe this, and how a person should
go about broaching the topic with a medical professional.  To be
blunt, I don't care about side effects or opinions on its
effectiveness; I see this as a "nothing to lose except money"
situation.  I'd prefer not to go too far for it (let's say, not
outside a 200-mile radius, give or take).

This next part of my question should be considered an optional
"rider": I hear it's cheaper to get Proscar and a pill cutter instead
of Propecia; how does one generally convince a doctor to prescribe
that instead?

Mostly, I'm quite versed in the topic of balding itself, but
completely underinformed on the inner workings of the medical
industry.  Thanks in advance for any help on this one.

Hello Grrrrrrr,

   Because Propecia is a prescription, you will need to make a
doctor?s appointment to obtain one. I have found a clinic in your
town, with quite a few physicians that you may call. When calling, ask
the receptionist if that doctor has experience with male pattern
baldness, and if not, ask for a recommendation. Making a doctor?s
appointment is easy! You can also ask for the physician?s fee on the
phone before you go, so you can be prepared when you arrive. Be
prepared also to tell the doctor of any other medications or
supplements you may be taking. S/he will want to know this so as to
avoid any interaction problems with finasteride (Propecia, Proscar).

Fairfield Clinic
http://www.fairfieldiowa.com/chamber/business_dir.php?show=296


   Don?t let the words ?Center on Aging? scare you when looking at
this site! These doctors will treat a young man like yourself as well,
and may be a good option for you, if you are unable to find a doctor
on the above link!
http://www.centeronaging.uiowa.edu/GeriatricLocator/GeriatricWeb3.shtml


   There are online sites that sell Propecia, but I?ve read bad press
about such sites, as you can?t be sure of what you will be sent. While
you may feel you don?t care about side effects, healthwise, it?s
always a good idea to be checked before starting a prescription drug ?
that?s why a prescription is required!

  Propecia (finasteride 1mg)is known for not having many side effects,
but you still need to be monitored while taking it. Your doctor may
want to run tests called LFTs for your liver before prescribing the
drug, especially if you've ever had hepatitis or other liver problems.

?Conditions to tell your Doctor about before taking Propecia:
If you're going to get a blood test for PSA (Prostate Specific
Antigen), the Propecia will alter the results.
Liver disease - you may need a lower dose or special monitoring during therapy.?
http://www.askdocweb.com/propecia.html


?HOW TO USE: Take one tablet daily or as directed by your doctor. This
drug may be taken with or without meals. This drug usually must be
taken regularly for 3 months for the benefits to be noticeable. Once
treatment is stopped, any gain in hair quantity will be lost. If this
medication is crushed prior to administration, it must not be handled
by women who are pregnant or who may become pregnant.?

?Before using this drug, tell your doctor your medical history,
especially of: liver disease, prostate cancer, urinary tract disease,
drug allergies.?
http://www.medicinenet.com/finasteride-oral_hair_growth/article.htm



  You should not have difficulty finding a doctor who will prescribe
Propecia for you, but your insurance my not cover it. Your doctor MAY
consider prescribing Proscar (finasteride 5mg.) to save you money, but
Proscar is a 5mg. dosage of finasteride, while Propecia is a 1 mg.
dose. You?d need to slice the tablet into fifths!

?Finasteride is a 5-alpha reductase (5AR) inhibitor. 5-alpha reductase
is an enzyme in our body that converts the male hormone testosterone
into DHT. DHT is a more potent derivative of testosterone that is
believed to be the main cause of male pattern baldness. Hair follicles
that are sensitive to DHT will fall off when exposed to the hormone.
Finasteride works by inhibiting the 5 alpha reductase enzyme that is
responsible for converting testosterone to DHT.?

?Oral dosage: Use as directed by your physicians. Typical dose is 1 mg
finasteride per day. However, due to the short half life of
finasteride, some suggest that finasteride should be taken twice
daily, 12 hours apart between doses.

Topical application:  Some suggest that topical finasteride may be
effective as an anti-androgen treatment. Some pharmacies are already
compounding their own topical finasteride preparations.?
http://www.farrellmanual.com/drugs/finasteride.htm

?How should I take Proscar?
	? Take Proscar exactly as directed by your doctor. If you do not
understand these instructions, ask your pharmacist, nurse, or doctor
to explain them to you.
	? Take each dose with a full glass of water.
	? Proscar can be taken with or without food.
	? It is important to take Proscar regularly to get the most benefit.
	? Your doctor may perform blood tests or other forms of monitoring
during treatment with Proscar. One of the tests that may be performed
is called PSA (prostate-specific antigen). This test is used to help
detect prostate cancer. Proscar will reduce the amount of PSA measured
in the blood. Your doctor is aware of this effect and can still use
PSA to help detect prostate cancer.
	? Store this medication at room temperature away from moisture and heat.
http://www.drugs.com/proscar.html


Here is the circular on Proscar
http://www.proscar.com/proscar/shared/documents/proscar_pi.pdf


   More isn?t always better! ?Overall prevalence of prostate cancer in
finasteride-treated men was reduced by 24.8% from the prevalence
normally expected in men of this age and medical condition, indicating
that finasteride 5mg (Proscar®) is effective in preventing or delaying
the appearance of prostate cancer.

In men who developed prostate cancer during the study, finasteride 5
mg was associated with a small increased risk for developing a
high-malignancy cancer. The reason for this small increased risk is
not understood.
Meaning of the study for users of finasteride 1 mg (Propecia®):
 
Results of the study cannot be generalized from finasteride 5 g
(Proscar®) used to treat prostate enlargement to the lower-dose
finasteride 1 mg (Propecia®) used to treat hair loss due to
androgenetic alopecia. Safety tests of Propecia® have been accepted by
the Food and Drug Administration as an indication of safety for use in
treating hair loss.?
http://www.ishrs.org/articles/finasteride-prostate-cancer.htm


I hope this has answered your questions! If anything is unclear,
please request an Answer Clarification, and allow me to respond,
before your rate this answer.

Regards, Crabcakes

Search Terms
============
Physicians + Fairfield Iowa + Men?s health
Propecia
Proscar

I got them!  Thanks for your help.