Jose from Dallas calls the show to ask about one of the most common, transient side effects that occurs with the early usage of Propecia, testicular pain. Though not indicative of any serious known side effects of the drug, the dull aching pain that effects some who use the drug, can be difficult to tolerate if severe, however, according to most professionals it appears that in most cases it’s a sort lived transient side effect lasting no more than a few weeks for most who experience it.

Spencer Kobren: Hey. You're on the air. Who's this, and where are you calling from? Hello?

Jose: Hey this is-

Spencer Kobren: Yes.

Jose: Hello?

Spencer Kobren: Hi. Hello?

Jose: Hi. This is Jose from Dallas.

Spencer Kobren: Jose from Dallas. How are you, man?

Joe: How are you doing Jose?

Jose: I'm doing well. Doing well. How are you guys?

Joe: We're good. Are you on a speakerphone?

Jose: I am. Should I turn it off?

Spencer Kobren: Yeah. It'd be easier if were just speaking into the mouthpiece.

Joe: Yeah.

Jose: Is that better?

Spencer Kobren: Much better.

Joe: Much better.

Jose: I've got to say, the show is very helpful, very informative. Thanks for doing it.

Spencer Kobren: Oh, no problem, man.

Joe: It's our pleasure.

Spencer Kobren: Yeah. Thanks for listening or watching wherever you are. Are you listening or watching?

Jose: Listening and watching, but the phone's a little ahead of the video. 

Spencer Kobren: Yeah. Well, you know what? That's just ... Turn down the video and just listen at us on the phone. What's going on?

Jose: Yeah.

Spencer Kobren: What can we do for you?

Jose: I took the plunge at the beginning of the month and started with brand name Propecia, and I'm dealing with a little growing pain. I've been with it for, I want to say, almost the beginning. The first week, started, and I'm on week three.

Spencer Kobren: Okay.

Jose: Still hasn't gone away.

Spencer Kobren: Let me ask you. How old are you, first of all?

Jose: I'm 29.

Spencer Kobren: Okay. I was about your age when I first got on Proscar. I can tell you that my ... I don't know if it was my left nut or my right nut. One of them hurt like hell for at least, on and off, for at least eight weeks.

Jose: Okay.

Spencer Kobren: You know? So,-

Joe: I felt like I got kicked in the nuts in basketball practice for close to a month.

Spencer Kobren: Yeah.

Jose: Okay, so-

Spencer Kobren: I would say that this is not something that's atypical. It doesn't, at least to my knowledge ... and again, we are not physicians, it doesn't indicate any longterm adverse side effects. It just seems to be a very common effect once you start to use the drug. Are you still there?

Jose: Is there any ... Yeah. Is there any effect on the dosage that I'm taking? I'm taking one milligram. Should I just keep at that?

Spencer Kobren: You know what? It's possible that you'll feel less testicular pain if you lower your dosage. In most cases, I've never heard of this being a longterm. I think I'm one of the guys who had the longer term feeling like he was kicked in the balls effect.

Joe: Yeah.

Spencer Kobren: It's called ... What is that?

Joe: Nut ache.

Spencer Kobren: Yeah. What is that called? What is that tube that brings your sperm-

Joe: Oh-

Spencer Kobren: It starts with a p. Why can't I think of it? What is going ... I did stop drinking. That's the problem.

Joe: I can't think of it.

Spencer Kobren: I can't think of it. Anyway, that can happen. It's actually happened throughout my life on and off. Yeah, there's no doubt that that's very common. It happens to a lot of guys. You know what? No pun intended, it's a pain in the balls. It's something that you unfortunately have to deal with if you want to take this medication. I know very few people who have escaped it, to tell you the truth.

Joe: I would say that if you want to reduce your dosage to maybe reduce the impact, you're also reducing the efficacy as far ... my opinion anyway, just my experience. It is a dose dependent efficacy relationship with this medication. Some people say it's not, and there's conflicting information. My advice, my non-medical professional advice is, because I'm not a doctor, would be to power through. Just give it a few more weeks, and it should dissipate.

Jose: Yeah. Actually, that's what the doctor said to push through for a couple more weeks. I'm worried that in two weeks it's going to continue, and I mean, other than the ball pain, I'm performing every other aspect ... I have no other side effects. So,-

Spencer Kobren: Well, I mean, that's exactly the way that I was. What was interesting is, especially at the beginning, for whatever reason, and it could have been my age because I was around your age when I started, it was like a silo, man. It was nonstop. I was more amerous than ever when I first started taking that drug.

Joe: Yeah. It's a strange effect. It's like you suddenly got to just have everything all the time. It could almost be like an effect in the gym as well.

Spencer Kobren: Yeah.

Joe: I've had patients report back that they can do more reps, more sets, and more weight.

Spencer Kobren: They're growing faster, yeah.

Joe: Yeah.

Spencer Kobren: That is the exact type of reaction I had from the drug. I mean, people have different reactions. Here's the good news, like you said, you're having no other adverse side effects. Your doctor's familiar with the side effect and gave you his opinion of how to deal with it. Now, is it a constant ache, or does it come and go?

Joe: It comes and goes.

Spencer Kobren: Okay. Well, that's good. I have to tell you, there was a time when mine was constant and I just kind of had to live with it. I was so new into the game, there was nothing online, there was no one to tell you anything about it. I knew it was related to the drug, but it wasn't in the literature. Back then, all you had was the Physician's Desk Reference to give you information about the drug. There was nobody talking about it online, so I-

Jose: You'd think it'd be more common and it would have showed up in one of the studies.

Spencer Kobren: Well, I actually think that is one of the listed side effects.

Joe: Yeah, I believe it is.

Spencer Kobren: Yeah. Anyway, the good news is that it come and goes.

Jose: Yeah.

Spencer Kobren: Is it happening more often or less often, say, in the last week?

Jose: Actually, like two days ago, I thought it was going to start tapering off, but it just came back. I had a really good day, and-

Spencer Kobren: Yeah.

Jose: ... it came back.

Spencer Kobren: Now, is there certain times of the day when it happens more or it's more painful? Is it after you've been sitting for a long time? Is it after sex, whether it's-

Jose: Yeah, after I've been sitting.

Spencer Kobren: Okay. Now, what about after you have sex, or with yourself or with anybody?

Jose: No, no difference.

Spencer Kobren: I mean, does it feel like the pain goes away at all after-

Jose: No. I don't alleviated. It's not like blue balls-

Spencer Kobren: Okay.

Jose: ... and that I feel alleviated afterwards.

Spencer Kobren: Yeah. Well, you really have blue balls, you don't feel alleviated afterwards. Jesus, blue balls.

Joe: Where are we going with this?

Spencer Kobren: Yeah. Anyway, I would say that your doctor gave you good advice. The good news is you had no other adverse side effects. Now, a lot of people listening to this, a lot of the anti-Propecia crowd will be like, "Oh my God, you've had ... He's had a side effect, and these guys are saying that this seems to be a normal thing," and that no side effects should be normal. Well, with any drug you take, there's a possibility of some side effects. In many cases, these side effects are transient.

Again, I'm going to repeat myself. There was a time when Aspirin was considered one of the most dangerous drugs to take because of the amount and the list of side effects, and especially early on when Aspirin first came on the scene and people were getting fucked up.

Joe: I remember reading some several years back where some ... I forgot who it was, but someone was saying that if Aspirin were introduced today, it would be a regulated prescription medication.

Spencer Kobren: Oh. First of all, people would not be taking it.

Joe: Yeah. Well, you remember-

Spencer Kobren: The internet would go insane.

Joe: You remember my video about Propecia where I'm reading off the side effects on the side of a bottle, and it's pain reliever?

Spencer Kobren: Yeah.

Joe: It's like a nightmare of side effects. Right?

Spencer Kobren: Yeah. Read the side effects just from-

Joe: Advil.

Spencer Kobren: ... Advil or just read the side effects of birth control.

Joe: Yeah.

Jose: Yeah.

Spencer Kobren: If you take a list of those side effects from all these other drugs that are prescribed like candy compared to finasteride, finasteride really has a very short list. So, I just think it's so important. Now, I remember when my doctor first prescribed it to me. He had known nothing about the drug, and he read about it in the PDR. At least in the clinical trials, he said, "This is probably the safest drug I've ever prescribed as far as side effects."
Now, we're talking about guys who are dealing with hair loss and they're taking drugs like Zoloft, other serotonin uptake inhibitors. When I was dealing with major depression at a young age from my hair loss, I was on tricyclic antidepressants, old school antidepressants, which did make me impotent. I called my doctor and I was like ... I was waking up with it every day of my life. I was a kid, and I'm like, "This isn't working." He's like, "Stop taking the drug."

Joe: Yeah.

Spencer Kobren: Just a host of other things. Yeah, man. All I can tell you is that I've been through this, I know Joe has been through this, all of my contemporaries who've taken the drug have been through the same situation. I've never heard it going on for really more than a month or so. I think that I was one of the anomalies where it went on for about two months.

Jose: Okay.

Joe: That is atypical for sure.

Spencer Kobren: Yeah.

Jose: That's good to know.

Spencer Kobren: I would hang in there. As long as you're feeling well otherwise, I'm pretty sure, again I'm not a doctor, but I'm pretty sure it's just going to go away.

Joe: Jose, was this prescribed to you by a hair transplant doctor, or your family doctor, or dermatologist, or who?

Jose: Hair transplant doctor.

Joe: Okay. Yeah, that makes more sense for me-

Spencer Kobren: Yeah.

Joe: ... because I wouldn't expect a regular family doctor to have the low down on the side effects like a hair transplant doctor would.

Spencer Kobren: Yeah. Yeah. Well, listen, I wish you the best of luck. Let us know how you do. Call us next week or week after. You know? Maybe it will be gone by then.

Jose: Will do. Thank you very much, guys.

Spencer Kobren: All right, and best of luck.

Joe: Yeah. Thanks for calling.

Spencer Kobren: All right. Take care.