I’ve Been Taking Propecia, But HairDX Said I Have a Low Risk for MPB

Hello Dr.,

A little back-story: I’ve been on generic propecia (1.25mg) for the last 9 years. I am a 32 year old male. When i started taking it, I was a Norwood 1.5. Presently, my hairline is the same and i’m still a norwood 1.5. My father is not bald. However, my maternal grandfather was.

Unfortunately, for the last 2 years or so, i’ve noticed a severely lower libido. I suspect that it might be the finasteride, although i am not 100% certain.

Hoping to get off of finasteride by confirming whether i have (or will develop) MPB, i decided to take the HairDX genetic test. My results stated that i was: “Low Risk” (Negative for the “short” CAG allele; CAG >= 24)

In my report, it stated that a score greater than or equal to 24 had approximately a 60% chance of NOT developing male androgenetic alopecia.

Doctor, should i get off finasteride? In your view, am i reasonably safe from developing MPB? I would like to get my libido back. Do you think i need a miniaturization test to truly CONFIRM whether i am at a risk for MPB?

Any thoughts would be greatly appreciated, kind sir!

The HairDX genetic test for balding is not a simple yes/no test. It provides a percentage factor, which is why in my humble opinion, it only confuses patients (as it seems to have done for you).

So basically the HairDX test said you have a 40% chance of developing MPB… and now you’re asking me if that means you should stop taking Propecia. With all due respect, I am not your doctor. You must have a discussion with your prescribing physician before starting or stopping or changing your medication.

Having said that, there is no such thing as a Norwood 1.5 (which I guess means nearly a NW 2?), but for some men that could just be considered a mature hairline. In other words, it isn’t balding. Could it be that you didn’t need the medication to begin with? Or could it be that the medication halted the early loss from progressing? I do not know the reason for the utility of finasteride for a non-balding man, but I will defer that judgment to your doctor.

You took the medication for 9 years, and for 7 of those years you didn’t see any sexual side effects. The libido issue might be unrelated to the finasteride. For example, up to 25% of men in their 30s may experience erectile dysfunction. Lower libido can come with age, or it can also be a sign of other serious medical issues (not related to medication). See your doctor.