If you were to make a list of “male worries,” baldness would come in at a solid number two — right after sex problems.

But if you go to a mainstream doctor for one, there’s a good chance you’ll end up battling the other. The FDA is warning that the hair growth drug Propecia (finasteride) can cause erectile dysfunction and problems with ejaculation and orgasm, including poor semen quality and infertility.

The drug can also cause your libido to come crashing to a halt, which might actually be a blessing if you can’t achieve orgasm or even an erection.

What good’s the desire if you lack the ability?

But the real outrage here isn’t the side effects, which can last for months after you stop taking the drug.

It’s the FDA’s foot-dragging that led to this too-little, too-late warning, since these problems have been reported for years — problems that should have been obvious from day one, since the drug “works” by blocking the very nature of manly function.

Thinning hair is actually a sign that the male body is working right — evidence that it’s successfully converting manly testosterone into the even more manly hormone dihydrotestosterone, which is about 10 times as powerful.

Maybe that’s why women have always swooned over bald men like Yul Brenner and Telly Savalas — or, for my younger readers, The Rock and Vin Diesel — because bald men are practically oozing dihydrotestosterone.

Too much dihydrotestosterone, however, can cause hair to stop growing. Since finasteride blocks the conversion of testosterone into dihydrotestosterone, it can help restore hair… but at a huge cost.

So it’s not at all surprising that men who take the med can end up battling severe and lasting sexual dysfunction. The only surprise here is that these side effects aren’t even more common than what’s been reported so far (and remember, no man likes to admit to sex problems — so the reported numbers could very well be just the tip of the iceberg).

By the way, excess dihydrotestosterone can also lead to prostate growth, which is why the same drug is sold for enlarged prostates under the name of Proscar.

In fact, that was the drug’s original purpose — but when its makers noticed that men who took it got hairier, the side effect quickly became a marketing bonanza.

Don’t bother.

Saw palmetto is far safer, taken both internally and used topically on the scalp. One recent study found that 60 percent of men with mild to moderate hair loss improved after taking a combination of saw palmetto and the plant sterol beta sitosterol for five months, compared to 11 percent of those on a placebo.

The only thing worse than the sheer hell of an enlarged prostate is the disappointment from pricey supplements that do practically nothing.

But luckily, there’s another option on the table: a cheap, widely available and perfectly natural way to get the relief your prostate is begging you for — and the only shortcoming is the name.

“Beta-sitosterol” doesn’t exactly roll off the tongue, does it?

But while this natural plant sterol can’t do anything about its name, it can do plenty for prostate health — and there’s solid evidence to back it up.

Not just a little, either. We’re talking life-altering improvements in some of the most nagging symptoms.

In one study, the men who took beta-sitosterol produced a 35 percent increase in urine flow — so trips to the toilet don’t have to end in frustration. You won’t find yourself rushing back five minutes later, either, since it also did a much better job of emptying men out: 54 percent less urine in the bladder afterward.

All told, patients who took beta-sitosterol reported a stunning 350 percent improvement on their International Prostate Symptom Score — a standardized questionnaire that measures prostate issues.

Like I said, this stuff is life-altering… so why haven’t you heard of it before?

One word: marketing.

Saw palmetto became the darling of the natural health industry a few years back, when the early research was promising — and since then, it’s been marketed like few other supplements out there.

As a result, it’s become a victim of its own success: As supplement makers ramped up production to meet the demand, quality and consistency plunged.

And now, a major new study shows just how hard it’s fallen.

Researchers gave increasingly higher doses of saw palmetto to prostate patients for 72 weeks — and by the end of the study, they did no better than those who took a placebo the entire time.

That leaves two possible explanations: Either they used a bad saw palmetto supplement… or saw palmetto itself is ineffective.

Given the inconsistent quality I mentioned, my money’s on the former.

But since it’s your money — and your prostate — on the line here, I’d go with something that has a better track record… even if it doesn’t have a catchy name.

Next time you wake up in the middle of the night for a bathroom break, take a quick look out the window.

You might notice plenty of other bathroom lights on at the same time–because you’re not the only one “going” at that hour.

In fact, researchers now say that more than 1 in 5 U.S. men–21 percent in all– wake up at last twice a night to urinate, a condition known as nocturia.

And the older you are, the more likely you’ll be one of them: While just 8 percent of men between 20 and 34 have the condition, it affects up to 56 percent of men at least 75 years old, according to the study in the Journal of Urology.

The researchers only looked at data on men, which might not surprise people who think of nocturia as a prostate-related condition.

But that’s not always the case, and other studies have found that women suffer from it at roughly the same rate. And for men and women alike, it’s not just a sleep-disrupting inconvenience–it could also be a serious warning from your body that something is amiss.

One study last year found that nocturia patients have double the risk of an early death. Another study found that each extra trip to the bathroom per night increased that death risk.

Nocturia can also be a sign of an undiagnosed condition, including diabetes or even heart problems, or a side effect of common meds.

Tell your doc about it, and he might try to get you on even more meds–often synthetic hormones with side effects that can be even more unpleasant than those nighttime interruptions.

Some studies have found that up to 70 percent of the people who try those meds quit within six months.

Instead, simple lifestyle changes can often have you sleeping better and longer than you have in years.

One study last year found that a little exercise, a little less time awake in bed, keeping warm at night, and drinking less (especially in the evening) led to significant improvement in just weeks.

And if your nighttime potty breaks are caused by an enlarged prostate, try saw palmetto.

One study found that it works for up to 73 percent of men–dramatically reducing the number of nighttime bathroom breaks, or even eliminating them altogether.

And if it can cut back on all that flushing, who knows–it might even shave a little off your water bill, too.

December 2007 PDF Redefining “normal”: Is your doctor aware of these emerging markers of heart-health risk? The medical mainstream clings to measuring cholesterol levels as if they were the last life raft in the sea of civilized medicine. It seems as though too many doctors have been programmed to believe that cholesterol numbers are the [...]