Whatever you do, there are always benefits and costs. It’s exciting to drive a fast car but, the faster you drive on a busy highway, the more likely an accident. Tearing yourself away from the television or PC screen can reduce the risk of short-sightedness, but lead to boredom unless you find something like reading or knitting exciting. Making choices is a chance to see what you find interesting, what abilities you have and how you want to spend your free time. So this week’s burning question is what your decision would be if you are about thirty years old and you find yourself showing early signs of male pattern baldness. For many, hair loss is a frightening prospect. Although the majority of men are married or in a stable relationship by the age of thirty, there’s considerable embarrassment. Society has managed to persuade young men they must all have thick hair sprouting from all visible surfaces (and then some). Rather like the rites of passage involving large quantities of beer and throwing up in your best friend’s car, men have been brainwashed into thinking themselves less than manly if their hair thins and falls out. In fact, the younger they are, the worse the apparent “crime” against their gender nature. This means everyone would immediately start popping the pills to stop the loss – right?

Well, perhaps you might want to slow down the panic reaction. The research world works by looking at the evidence. Whichever side of the argument has the better facts in support wins the day. The “traditional” view is men who start losing their hair earlier have a higher risk of prostate cancer. The reason is the way testosterone works in the body. The evidence suggests men lose their hair early because they have too much testosterone. When this turns into dihydrotestosterone and builds up in the scalp, hair thins and, when it falls, it does not regrow. This same high level of testosterone is also associated with the development of growths in the prostate. Some are benign but the majority are malignant. But the precise cause and effect is uncertain and complicated by the fact that growths in the prostate seem to affect an increasing number of the male population as it ages. Perhaps all men are at risk of growths simply because they are getting older.

The other side of the argument comes courtesy of the University of Washington which has just published the results of a study of some 2,000 men aged between 40 and 47. It seems men who were balding by the age of thirty had the lowest risk of developing prostate cancer. Why does this matter? The most effective of the drugs used to treat male pattern baldness is called propecia. It works by preventing testosterone from acquiring the dihydro bit in front. If there is less dihydrotestosterone, the hair stays thicker and regrows when it falls out. Now here comes the kicker. What no one can tell you is which represents the trigger for prostate cancer. It could be the presence of more dihydrotestosterone is what slows the cancers down. Taking the propecia could therefore be increasing the risk you will get cancer. So which is more important? Do you want to keep your hair no matter what? Or do you want the lowest risk of cancer? Until there’s more research into the way testosterone works in a man’s body, this is all guesswork, but what you decide will tell us something important about you.