5 years on propecia - here come the sides. crap.

[mooman80]

This is my first post, but I have been reading these forums for a long time.

I've been using propecia 1mg fairly successfully for the last 5 years (maintaining, some regrowth on aggressive diffuse thinning), starting when I was 20. In the last year, I have suddenly noticed a major drop in libido, impotence problems when I'm with the girlfriend (no shes not a dog ), and a general disconnected feeling down below. Its just weird that it took so long to manifest. I read a lot about sexual problems around the 6 month mark, but I don't see as much information about long term sides.

Has anyone else experienced a similar change after such a long duration using finasteride? Anyone find a solution that works other than dropping finasteride?

My girlfriend lives out of state now, and if I stop taking the propecia a week before visiting, I am back to my normal self, so the sides aren't a permanent change. However, I just don't like messing around with my sexual health.

Has anyone had success with any other dht inhibitors? I ordered a 3 mo supply of fluridil, so I'm going to give it a whirl. I'm going to try dropping my finasteride dose too, but in the past, i noticed an increase in fallout. Hopefully the fluridil will compensate.

argh. frustrating.

 

[The Rock]

hey outta eveyrone curiousity what how well has it been working, and what is the problem areas u had before taking it.....im 19 so i wanan see if im in the same boat as u

 

[tohair]

hey guy - i've been on finasteride for almost 10 years, and I didn't have your reaction to the drug at all. I would propose that you speak to a qualified doctor about this issue. I think it's HIGHLY unusual for a drug to cause side-effects at this stage, and you may be experiencing an inter-reaction with another med.

It may, of course, be something else entirely, and the psychosematic play of getting off finasteride 7 days before may be masking. Talk to your doctor.

 

[mooman80]

I'm a diffuse thinner, top and sides. At the time, the problem was most noticeable at the crown of my head, where i was starting developing a nice bald patch. The propecia filled it in pretty nicely, but my hair has stayed fairly thin. The scalp is visible under bright lights, but its not that noticeable. I have dark hair which doesn't help since i'm nice and pasty white.

i guess i should feel fortunate that propecia worked ok for me for as long as it did. My new approach will be to limit the propecia dosage to 0.5 mg/day and see if that helps. i'm going to keep lowering until i feel the side effects are diminished to an acceptable level. This is in addition to fluridil, and now minoxidil 5% 2x's a day.

i've been taking pictures, so i'll try to post my results. lets hope they are good results 8)

 

[ropcat]

Moonman- I agree that you might want to ask a doctor about this. There are a variety of factors that could be playing into your erectile difficulties, so it might not be the finasteride. I've never heard of anyone having a problem that far into treatment. Whether or not it turns out to be the finasteride, I'd be careful about stopping it and starting it repeatedly. One thing that surely can't be good for your libido and your hair is having hormonal levels skyrocketing and then plunging on a regular basis.

 

[mooman80]

I have an appointment with the dermatologist this thursday, so i plan on mentioning my problem.

it strikes me as strange too that it would happen at this stage of the game. I'm wondering if perhaps my hormones have finally leveled off. I hit puberty late (almost 18 when i finally grew).

I don't really think its anything psych related, though i've thought about that. It is a noticeable physical change when i get off of the propecia. I wake up with morning wood again, I'm interested in looking at p**rn, no problems down below.

no new medications or life changes/stresses in the last year either.

 

[Trent]

someone on it that long, it would probably be okay for you to down the dose to maybe .5mg. that may help you out, and finasteride is just as effective at this dose.

 

[ropcat]

someone on it that long, it would probably be okay for you to down the dose to maybe .5mg. that may help you out, and finasteride is just as effective at this dose.

Trent, that's an interesting suggestion. I've often read suggestions to cut finasteride dosage as a way of reducing side effects, and I'm a little bit confused about this. As we know, the amount by which DHT is lowered in the bloodstream is almost the same whether one takes 0.2 or 5.0 mg/day. This is why it isn't very effective to boost the finasteride dosage as a way to promote greater hair growth. But this leads me to think that a reduced dosage, by lowering serum DHT almost as much as the higher dose, would also create almost the same side effects as the higher dose.

This supposition, though, seems to run counter to the "lower-the-dose" advice I frequently see on these boards. It's true that the Proscar test subjects had greater side effects (at 5mg) than the Propecia test subjects (at 1mg) -- but then again, the Proscar group was comprised of much older men, who would be more likely to have impotence problems anyway.

I feel like I'm missing something here. If you or anyone else could explain, it would be great. Thanks!

 

[The Rock]

I dunno ropcat, maybe its like using a little bit of bleach on a wood (no pun intended) surface, and then using a lot and damaging the wood itself......maybe its just lik eoverkill to ur body

 

[lossing my hair]

maybe this is a little of topic but why don't merck make lower dosages of propecia for those who experience sides. since it lowers the same amount of dht in lower dosages like, .2 mg and .5 mg? i know people cut them or skip days, but to me it's not the same.

 

[ropcat]

Hi LosingMyHair-

For one thing, I think they'd have to repeat the (enormously expensive) clinical trials in order to make the same claims about the drug at a different dosage.

You can't cut Propecia; they're capsules. Proscar is the one you can cut. I understand you'd prefer not to cut pills, but if you're taking finasteride, you'll save so much money over taking Propecia.

 

[Fallout Boy]

Hi LosingMyHair-

For one thing, I think they'd have to repeat the (enormously expensive) clinical trials in order to make the same claims about the drug at a different dosage.

You can't cut Propecia; they're capsules. Proscar is the one you can cut. I understand you'd prefer not to cut pills, but if you're taking finasteride, you'll save so much money over taking Propecia.

Propecia is in Pill form . . . why wouldnt you be able to cut it? its not liquid gel or anything.

 

[ropcat]

Propecia is in Pill form . . . why wouldnt you be able to cut it? its not liquid gel or anything.

Sorry, my bad. I haven't actually laid eyes on a Propecia pill since 2000, when I took one month's worth before starting Proscar instead. I must have forgotten what they look like!

 

[Trent]

Trent, that's an interesting suggestion. I've often read suggestions to cut finasteride dosage as a way of reducing side effects, and I'm a little bit confused about this. As we know, the amount by which DHT is lowered in the bloodstream is almost the same whether one takes 0.2 or 5.0 mg/day. This is why it isn't very effective to boost the finasteride dosage as a way to promote greater hair growth. But this leads me to think that a reduced dosage, by lowering serum DHT almost as much as the higher dose, would also create almost the same side effects as the higher dose.

here's my interpretation. the truth about any kind of drug, is that the reactions your body has to them are many fold. there's the intended response, then side reactions that occur. The body works on a such a complex level, that trying to create "simple" one enzyme inhibiting solutions are never perfect, because the body just doesn't work on this simple of a level. Its sort of like changing a rubix cube to try and match and fix the colors on one face of the cube, only to screw up another face. with finasteride, the intended effect is certainly reducing the typeII alpha reductase. hairloss is KNOWN to be caused (at least in part) by DHT levels, and the known reaction to counter this is reducing these levels to prevent hairloss. the side effects experienced, like lack of sexual function, however, have not fully been studied because they are merely unpredicted, somewhat unexpected side effects of the drug. the sexual side effects may work on a completely different level/mechanism than the "hair growing" one. I honestly don't know? and i don't know if anyone knows. So basically you can't make that leap and say that reducing finasteride to .2 mg still gives you good hair growth, and still reduces DHT enough for that, so it must still be enough to give you side effects like impotence. The body just isn't that simple unfortunately. I only offer the suggestion of lowering the levels because what i DO know, is that people on this forum have mentioned that this DID help with their side effects. The sexual side effects may work on a completely different level, perhaps a lower dose of finasteride helps you avoid whatever side reaction is going on when there are side effects. maybe not, but its worth a shot if you know you can still get the intended effect of keeping the ol' hair on the head.

don't know if this helps, but it at least explains why I choose to give the advice of lowering the dose as a possible solution.

 

[ropcat]

don't know if this helps, but it at least explains why I choose to give the advice of lowering the dose as a possible solution.

Thanks Trent, that makes a lot of sense. :thumbs_up:

 

[lossing my hair]

Hi LosingMyHair-

For one thing, I think they'd have to repeat the (enormously expensive) clinical trials in order to make the same claims about the drug at a different dosage.

You can't cut Propecia; they're capsules. Proscar is the one you can cut. I understand you'd prefer not to cut pills, but if you're taking finasteride, you'll save so much money over taking Propecia.

whats going on Ropcat. i hear you on the saving part. i see you been on Propecia for a while and you maintained. was your hair loss visible? where? and did it thicken up or you just maintained.

 

[Norwood2.5]

But this leads me to think that a reduced dosage, by lowering serum DHT almost as much as the higher dose, would also create almost the same side effects as the higher dose.

That would be true if the lowering of the DHT serum is what causes the sides instead of an interaction through a different, unknown mechanism that is somewhat more linearly linked to the dosage. Since lowering the dose doesn't seem to have that dramaticeffects towards hair maintenance/regrowth, I'd say it is at least worth a try.

 

[Fallout Boy]

ropcat thats awesome that you've had results for 5 years.... probably been asked before but are you on anything else other than finasteride and nizoral??

 

[ropcat]

i see you been on Propecia for a while and you maintained. was your hair loss visible? where? and did it thicken up or you just maintained.

Hey man. I just maintained; I had very little regrowth. Then again, there wasn't very much to regrow, since I hadn't lost much at all. There was probably a point where my vertex got slightly thicker than it had been, but at year four, it was about how it was when I started finasteride. Then again, I caught this pretty early. It was about three months between my "oh-my-god-i'm-losing-my-hair" moment at age 21 and the moment when I started finasteride. (Still at a stage where people were denying that I was losing my hair; although if I'd been smart, I would have started six months earlier than I did.) I had slight temple recession and a slightly thinning vertex. Right now it's a bit worse than that. The slippage has been very slow, though. finasteride definitely got me through a period where I was experiencing some severe anxiety and depression about hair loss -- even though I freaked out during the shedding (which continued through month seven).

ropcat thats awesome that you've had results for 5 years.... probably been asked before but are you on anything else other than finasteride and nizoral??

Nope, nothing else. I'm taking my time as I consider additions/changes to the regimen, though, because I'm started downhill again. I'm definitely slipping slowly enough that I can think about this over a few months. I just want to figure out the best solution fairly soon. Problem is, I tried topical spironolactone for a couple weeks a while back, and realized that I'm terrible at topicals. So undisciplined, and I really hated the thought of having to apply 2x/day topicals for years and years. It's a character flaw, I guess! I just really prefer popping a daily pill. I wish there weren't all these question marks surrounding dutasteride, because if it weren't for the unknown factor surrounding 5AR-I and the central nervous system, it would be the obvious choice for me right now.

Good luck guys. Feel free to shoot me any other questions about longer-term finasteride usage, although there are people around here who've been on it for a decade!