Your hair loss questions, answered daily.

 

If I stop fin and or minox, is the rate of balding accelerated to greater than it would have been without trying treatment or just go back to pre treatment levels? thanks

When you stop these drugs you go back to point zero, where point zero is the amount of hair that you not only saved with these two drug but the amount of hair that you would have lost without taking these drug.

 

I currently have been taking proscar for 9 months and have still been thinning out. Im confused as to wait a year, when it hasn’t been working? Some people even say 2 years?. I guess what I am asking is how likely is it that I’m just a late responder ?

The drug finasteride (Proscar., Propecia) takes time to work. A year minimum, For young men, it is patience that you need. Sometimes it looks like it is not working but it may be slowing down the hair loss and without it, it might fall out faster

 

What if blocking the DHT does’t work?

The hair follicles in genetic balding have a limited number of hair cycles to their life span. Let’s say, for example, that the hairs in the leading edge of your mature hairline have 8 hair cycles of life to them and each hair cycle is 3 years, then at the age of 24, the hair will undergo Apoptosis (cell death).  When using a DHT competitive inhibitor like finasteride, this slows down the anagen cycle and the trigger that causes Apoptosis, but it is not always successful. I tell my patients that there is a ‘tug of war‘ going on between DHT and the genes that determine Apoptosis . Like any war, there are winners and losers. When finasteride does not work any longer, you may have lost the war.

 

You need to see a doctor to scope out the problem and then discuss many of the solutions which could include FUE of the recipient area, laser hair removal or just excision of the part of the hairline you don’t like. ?When I create a hairline with my patients, I always draw it on the head and get the person consent prior to doing the surgery because when it is made too low, it is a real problem because these hairs are permanent.  See a doctor with experience in managing these complications from other practices, like mine.

 

When you stop finasteride for as long as 8 months, you have given your genes control of your balding process.  The drug no longer has any impact on your balding. The drug, if you restart it, will probably be less effective and the hair that you lost, is lost.

 

If you find a connection between the drug finasteride and depression, maybe this is not the drug for you. Speak with your doctor.

 

The immediate possible side effects is one issue, but I’m curious about long-term effects down the line. I know that low DHT levels has been associated with poor cognitive skills as men get older. Aside from that, what are the long-term effects of having this chemical in your body for say, 10 years or so. I don’t want to make a decision that helps me now but screws me later.

We see that finasteride becomes less effective as a man ages because their testosterone levels drop and subsequently, their DHT levels drop as well.  Finasteride is a DHT competitive inhibitor (blocker) that is about 70% effective so as the DHT levels drop with age, the impact of finasteride drops off. For hair loss, the good news is that in most men, the rapid hair loss occurs in younger men in their 20s when finasteride is most effective and as a man drops his DHT levels in his 30s and 40s, the hair loss usually, but not always slows down. The a classic article in the New England Journal of Medicine many years ago, 25000 men were reported, half of them on finasteride and the other half not.  All of these men were over 55 in the study. What the study learned was that those men on the drug had a lower incidence of cancer of the prostate by 25% compared to the study group. So the long term effects of finasteride may be good for the prevention of cancer of the prostate. This reported study only went out 7 years, so I would imagine that younger men who took this drug in their 20s through their 60s, would have a much lower incidence of cancer of the prostate, the #1 cancer in men.

 

Many people with side effects who are persistent and stay on the drug often find that their side effects eventually go away. The decision to take this medication is, of course, yours. Without side effects, it is an easier decision, but with such side effect, if they came back, would be a reason to stop the drug in my opinion.

 

I took finasteride 1,25mg daily for a month. After a week or so I started to have gyno symptoms: stabs of pain in my chest, sensitivity in my nipples and general discomfort in my chest. I quit and after a couple of weeks I was fine. Decided with my derm to get back on Fin but this time 1,25mg eod but after a week the gyno symptoms came back. So, is it possible to have symptoms but not growing tits? Or if I have symptoms I will grow tits for sure?

With the return of these symptoms, it is likely that you are not a good candidate for this drug. You can try cutting the dose down to one pill every 4th day and see what happens.

 

I’m about half way through my second month, didn’t experience any of the ball ache associated with the first week. I had about a week near the end of month 1 where I had watery semen but it’s returned to normal since. Throughout this week though I have experienced weaker erections, my libido is still there mentally though. Should I give this another week to see if I get beyond it or should you just get off once you notice sexual sides?

Also, if I do get off of it, should I take a break and try taking it every other day or something?

Most people see a reduction in side effects in 1-2 months. You can reduce the dose to one pill every 4th day and try that for a months and if that work for you, increase it to 1 pill every 3 days, for a months. Doing this you might end up with one pill every other day which is 80% as effective as every day, good enough for most men.

 

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