Hello, I am a 23 year old male and have been taking propecia on and off for about 3 years, I recently began taking it every day and am hopping to see some new results. It has worked well until recently I have noticed some thinning on top, with little to no receding in front. Is it losing its effectiveness and will the new dose plan have any positive effect? Before i was taking it every couple of days.

I am considering adding avodart to my plan and am wondering if by taking a dose maybe once a week or so I would see any benefit and hopefully reduce some of the side effects, Will the long halflife of avodart make this possible?

In theory, you are correct. Nobody, however, really knows the real answer to the question on the dosing for Avodart (considering that it has a 5 week half life). The experience with Avodart is with older men (usually over 55) and the focus on sex is often less than in a 23 year old. There are significant sexual side effects on the 55 year old men taking Avodart and amongst the doctors who are recommending it in the ‘hair’ circle, there are reports of more sexual side effects with Avodart in the young man. As the drug is not FDA approved for hair loss use, there is really only anecdotal information and opinions on the subject available. You seem to want to be your own doctor. I always was told that a person who treats himself, may have a fool for a doctor. Your call.

I take 1/2 Propecia once every other day and this seems to have completely halted hair loss and it will not cause the permanent side effects documented at www.propeciasideeffects.com and the forum at www.propeciahelp.com

Another strategy might be to take just 1/4 a table every day based on the pre-approval data submitted to the FDA which shows no statistical difference between .25 mg and 1 mg in the actual level of DHT at the scalp.

The bottom line is that although the Merck studies only cite a 2% occurance of side effects that were observed, this drug does cause change and damage to the penis itself if taken long enough.

So I think one should try to find a balance between the minimum amount of propecia needed to halt hair loss and then use other compounds to stimulate regrowth.

If you look at the placebo comparisons with finasteride, you will see that they are relatively close, but when people talk about drops in libido, the placebo data is rarely discussed. We offer finasteride (Propecia) at doses lower than 1mg per day to our patients (take a 1mg pill and cut it in half) if they have a drop in libido with the medication. In some patients, the side effects go away with lower doses of finasteride. In many patients who get the side effect of decreased libido, the side effect goes away in a month or two without changing doses. There is no research to support that lower doses of finasteride causes less side effects and this is only suggested on rare times by us based on logic. There is also no proof to show that lower doses of finasteride can provide the same results on prevention of hair loss in balding patients, in fact, the clinical tests show that the 1mg dose is the best dose for effectiveness against hair loss. There are some studies on effectiveness of lower doses of finasteride on animals, but before we see more results from human studies, we can not recommend a lower dose hair loss treatment.

DHT is crucial for growth and development of male genital organs before puberty, but there is no report of any changes in size and shape of male genitalia in adults who take finasteride for a long time. I have to emphasize that finasteride is contraindicated in children and pregnant women, and may adversely affect development of genitalia in male children or unborn babies.