EVERYONE Will Get Finasteride Side-Effects Eventually

Pigeon

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Also, in the study you posted regarding infertility, just to make sure we're on the same page..

The summarized results section is poorly worded, but it states "There was no change in hormone parameters, sperm motility, or sperm morphology." It shouldn't be misinterpreted that these parameters were reduced and then did not change after finasteride was discontinued. They could only assess this if semen parameters were measured prior to finasteride administration, and they weren't. The correct interpretation, which is very clear in the results section, is that these parameters were not effected by finasteride. The only parameters that were effected is sperm concentration/counts which resolved in the majority of men that discontinued finasteride.

Another nitpick; "There were 14 men who had a semen analysis while taking and after discontinuation of finasteride. Twelve of 14 men had a single semen analysis after finasteride discontinuation. Two of 14 men had two semen analyses after discontinuation; for these men, the two analyses were averaged". So the sample size was effectively 14, which is very low.

Regardless, I think there's enough evidence floating around that you should discontinue finasteride when you're trying to conceive.
I agree with most of your critique, as stated many times before we need bigger and more thorough studies. But even studies with a small sample size are indicative and serve as a warning there's more going on. Also purely anecdotally but many men on finasteride experience "watery sperm" or reduced loads, it's a common side effect as far as I've read over the many years.

Just playing devil's advocate here, but this tweet...

"1. Long-term benefits of finasteride 1 mg for baldness are uncertain.
2. LT risks in younger men are unknown, esp. effects on fertility.
3. Risk-benefit analysis for LT therapy cannot be made at this time.

Decision: APPROVED"

Isn't this literally every medication that gets approved? Good luck getting funding and a statistically relevant sample size when you're trying to study a medication for 20+ years. I mean, what's the alternative to this statement? I guess it depends on what you consider "long-term". Are we talking 5 years, 10 years? More?
The shocking part is that the FDA actually admitted in their offical approval letter of 97 that they just do not know if finasteride is safe or not. It's quite crazy, I did not know this. Even more concerning then that some doctors (dermatologists) still prescribe this and tell patients it's "safe" when the official medical control organ of the USA admits not knowing if this is the case or not... Luckily it seems more doctors are aware now about the risks but this was not the case X years ago.

But you're right, if we want new medication we'll have to compromise on trial length but for some medication like finasteride that messes with hormones, neurosteroids, etc one can make the case we should have had much longer studies to assess safety.
 

Pigeon

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Interesting chart I found:

Role of 5ar in hormones conversion and other exogenous influence​

1627039717589.png
 

Baldingat188

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Wow just found this thread and it has me a bit freaked out.. I’m a 23 year old who has been taking finasteride for 4.5 years. Honestly my sex drive has been so low latley it’s basically eunuch levels. I never wanted to blame the finasteride but I do feel like that is affecting me sexually. What can I even do at this point? If I quit finasteride I will risk getting PFS and also losing my hair. I honestly feel like I may be better off with hair and no sexual ability rather than the other way around. At least with hair I can go into public and function ( although I’m depressed). Without hair I think I may be worse off.
 

Stating facts

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I think you are young and naive (in a positive way) to think that keeping hair is a trade off for better. Believe me, in the long run you will start valuing your personality, confidence and maybe companionship without hair as well.

The decision is hard, and should be only made by you, but I am just sharing through experience.

Cheers!
 

Baldingat188

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Thanks for your opinion. I don’t consider myself a vain person so I do value other things but the problem is I would look terrible without hair. I know everyone says that but I truly don’t think I would be able to function in society. I would have to go the hair piece route and that seems like a large burden to maintain. I guess I probably do need to quit finasteride at some point just to see if my sex drive comes back. Cause currently I just feel asexual and it makes me depressed because I still want companionship.
 

Stating facts

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Thanks for your opinion. I don’t consider myself a vain person so I do value other things but the problem is I would look terrible without hair. I know everyone says that but I truly don’t think I would be able to function in society. I would have to go the hair piece route and that seems like a large burden to maintain. I guess I probably do need to quit finasteride at some point just to see if my sex drive comes back. Cause currently I just feel asexual and it makes me depressed because I still want companionship.
Everyone, trust me everyone thinks when they start losing it that they will look terrible without hair. But once they lose it to a stage that buzz cut or shave is the only option, then comes the peace of mind by buzzing or shaving it. It's a process and don't go through it unless you are ready.
I personally took oral dutasteride as I was afraid as well, but eventually made the decision of not letting hair loss medications ruin my entire life ahead.
 

user394587

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Thanks for your opinion. I don’t consider myself a vain person so I do value other things but the problem is I would look terrible without hair. I know everyone says that but I truly don’t think I would be able to function in society. I would have to go the hair piece route and that seems like a large burden to maintain. I guess I probably do need to quit finasteride at some point just to see if my sex drive comes back. Cause currently I just feel asexual and it makes me depressed because I still want companionship.
It's a difficult decision. You might want to also examine other things in your life as well. IE, are you sedentary, overweight, are you getting enough sleep, are you stressed, are you taking any other medications that can lower your libido (IE SSRIs), what are your testosterone and E2 levels, so on and so forth.

Finasteride is obviously not your friend when it comes to libido, but many other things can lower it. I've found that my libido decreased a lot naturally from when I was 19 to 27, and this was without any medication.

If you don't have any other factors that you could attribute to low libido, you'll need to weigh the pros and cons. You could also get a buzz cut to see how your head shape actually looks like, and this may influence your decision. If you're feeling like an eunuch at 23 years old and there's nothing else you can attribute to such a low libido, you're probably better off without finasteride in your life.
 

Baldingat188

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Everyone, trust me everyone thinks when they start losing it that they will look terrible without hair. But once they lose it to a stage that buzz cut or shave is the only option, then comes the peace of mind by buzzing or shaving it. It's a process and don't go through it unless you are ready.
I personally took oral dutasteride as I was afraid as well, but eventually made the decision of not letting hair loss medications ruin my entire life ahead.
If there was any chance I could even look reasonably presentable with a shaved head I would definitely do that option. I am a pretty extreme case (pale skin, very thin). I would go from about a 5-6/10 to a 2/10 attractiveness wise. I mean that in an objective way also. I know everyone tends to be their own worst critic but I have shown some members on here my picture and that they have confirmed my beleifs.
It's a difficult decision. You might want to also examine other things in your life as well. IE, are you sedentary, overweight, are you getting enough sleep, are you stressed, are you taking any other medications that can lower your libido (IE SSRIs), what are your testosterone and E2 levels, so on and so forth.

Finasteride is obviously not your friend when it comes to libido, but many other things can lower it. I've found that my libido decreased a lot naturally from when I was 19 to 27, and this was without any medication.

If you don't have any other factors that you could attribute to low libido, you'll need to weigh the pros and cons. You could also get a buzz cut to see how your head shape actually looks like, and this may influence your decision. If you're feeling like an eunuch at 23 years old and there's nothing else you can attribute to such a low libido, you're probably better off without finasteride in your life.

I have had my T checked and it was 430 so not great but still in the acceptable range. Other than that I am not over weight , I eat healthy, and get good sleep. I do take a medication for depression but I specifically avoid SSRIS due to the sexual sides. I’m taking a med called Wellbutrin which is supposed to increase sex drive but I haven’t had that benefit.
 

user394587

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If there was any chance I could even look reasonably presentable with a shaved head I would definitely do that option. I am a pretty extreme case (pale skin, very thin). I would go from about a 5-6/10 to a 2/10 attractiveness wise. I mean that in an objective way also. I know everyone tends to be their own worst critic but I have shown some members on here my picture and that they have confirmed my beleifs.


I have had my T checked and it was 430 so not great but still in the acceptable range. Other than that I am not over weight , I eat healthy, and get good sleep. I do take a medication for depression but I specifically avoid SSRIS due to the sexual sides. I’m taking a med called Wellbutrin which is supposed to increase sex drive but I haven’t had that benefit.
You might want to check out your E2 (estradiol) levels. If they're too low or too high, you can encounter similar issues.

Regardless, if you go off the drug for a few weeks up until 2 months, you very likely won't lose any ground. Might be a good idea to see how you feel off of it for a bit.
 

ihatebackstabbers

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If you are a good responder to finasteride than you can halt your hair loss and regrow your recently miniaturized hair which will grow back stronger. Most people halt their hair loss soon after starting the med. Others will still lose hair but at a much slower pace than they would have if they didn't start taking it. The vast majority of people that take finasteride don't have any side effects. If you do then you could try lowering the dosage or skip days before stopping completely. My older brother didn't want to take finasteride when I starting taking it because of all the fear mongering about it. He started taking finasteride last year at 5 times the dose that I take because of his prostate. How ironic is that?
 

Stating facts

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This thread is about discussing the under research done on 5ari, largely finasteride. 90% of people consider just the sexual sides as the only sides while being on that drug, and many easily do a trade off with it just because of hair. The sides on other body functions, example liver (ALT, AST levels in the long run) , are largely overlooked by majority, and here we present studies that showcase it.

Agreed that it is the only drug available in the market but it is not God send which people highly claim about.
 

Norwoody

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I will say that there are definitely some people out there with minor levels of hair loss that could suffice on regimens that include minoxidil, needling, and topical AAs. Finasteride might be overkill for some of the lower Norwood guys on here, and they probably wouldn't need to take that risk. One of the issues is the matter of convenience of taking a pill versus having the discipline to stick to a mainly topical regimen. Sure, some people will continue to lose on minoxidil alone, but why not at least use it as a starting point, especially if you are a low Norwood? Some will say that the problem is that you can never get off minoxidil, you'll lose all your gains, etc. Well, no matter how you treat it, if you do have progressive hair loss, you have to stay on those treatments in order for them to keep working regardless of the medication - this is not exclusive to minoxidil. If you gained hair on keto shampoo, you have to keep taking it to maintain those gains, so the treatment doesn't matter. At the end of the day, the goal is to help restore blood and nutrients so that the follicle can continue to live, and there are a few ways of accomplishing this. Being on both finasteride and minoxidil obviously addresses two ways of doing this, reinforces the chances for maintenance, and usually results in at least some minor regrowth for the average user. But a few guys out there might maintain for a long time by only using one pathway. I am not saying that this will work for everyone, or that this will work forever. I am saying that it is worth a shot, and often many guys throw the kitchen sink at everything when they could be just fine if they began with a more conservative approach.
 

user394587

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I will say that there are definitely some people out there with minor levels of hair loss that could suffice on regimens that include minoxidil, needling, and topical AAs. Finasteride might be overkill for some of the lower Norwood guys on here, and they probably wouldn't need to take that risk. One of the issues is the matter of convenience of taking a pill versus having the discipline to stick to a mainly topical regimen. Sure, some people will continue to lose on minoxidil alone, but why not at least use it as a starting point, especially if you are a low Norwood? Some will say that the problem is that you can never get off minoxidil, you'll lose all your gains, etc. Well, no matter how you treat it, if you do have progressive hair loss, you have to stay on those treatments in order for them to keep working regardless of the medication - this is not exclusive to minoxidil. If you gained hair on keto shampoo, you have to keep taking it to maintain those gains, so the treatment doesn't matter. At the end of the day, the goal is to help restore blood and nutrients so that the follicle can continue to live, and there are a few ways of accomplishing this. Being on both finasteride and minoxidil obviously addresses two ways of doing this, reinforces the chances for maintenance, and usually results in at least some minor regrowth for the average user. But a few guys out there might maintain for a long time by only using one pathway. I am not saying that this will work for everyone, or that this will work forever. I am saying that it is worth a shot, and often many guys throw the kitchen sink at everything when they could be just fine if they began with a more conservative approach.
The problem with minoxidil is that there's no evidence that anyone with even moderately aggressive hair loss can maintain on it in the long term. In fact, there's evidence to the contrary. We have several studies on finasteride that examine maintenance in the majority of men taking it over the span of 10 years.

Effectively with minoxidil you're making the gamble that you haven't inherited anything beyond a NW4 and you have at most mildly aggressive hair loss.

There's also another problem with minoxidil in that we don't know how it functions. With finasteride, if a better treatment came along, it would more than likely be possible to switch to that treatment and maintain the hair you've gained on finasteride. I don't think the same thing can be said for minoxidil.

A last point to consider is that the long term (10 years) studies on finasteride clearly show that the earlier you start the drug, the better results you get.
 

Norwoody

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The problem with minoxidil is that there's no evidence that anyone with even moderately aggressive hair loss can maintain on it in the long term. In fact, there's evidence to the contrary. We have several studies on finasteride that examine maintenance in the majority of men taking it over the span of 10 years.

Effectively with minoxidil you're making the gamble that you haven't inherited anything beyond a NW4 and you have at most mildly aggressive hair loss.

There's also another problem with minoxidil in that we don't know how it functions. With finasteride, if a better treatment came along, it would more than likely be possible to switch to that treatment and maintain the hair you've gained on finasteride. I don't think the same thing can be said for minoxidil.

A last point to consider is that the long term (10 years) studies on finasteride clearly show that the earlier you start the drug, the better results you get.
I agree with everything you said. I think it is really is individually dependent, and a prerequisite being a low norwood to start. For example, ElDuterino has been maintaining on CB but he never went much past NW2 to begin with. But if you're NW4+ then yes, you're going to need some sort of 5AR inhibition to maintain for the long haul. The reason that finasteride is still the main solution for most people is that we don't have a topical AA that can effectively compete with DHT.
 

user394587

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I agree with everything you said. I think it is really is individually dependent, and a prerequisite being a low norwood to start. For example, ElDuterino has been maintaining on CB but he never went much past NW2 to begin with. But if you're NW4+ then yes, you're going to need some sort of 5AR inhibition to maintain for the long haul. The reason that finasteride is still the main solution for most people is that we don't have a topical AA that can effectively compete with DHT.

Agreed.

The worst cases to deal with are edge cases. You have some guys that are 21-22 who are NW2. In some cases, they hop on finasteride, but their hair loss could have just stopped there and not progressed further. On the contrary, they could continue to recede all the way to a high norwood.

My own case was similar, I was a NW2 at around 22 years old. I continued to recede until I hit a NW3 at 27.5. Clearly my hair loss isn't as aggressive as some, but I really have no idea where it's going to end up. The worst pattern in my family looks like a NW5a, but it's all over the place in terms of consistency. I have a worse hairline than my father did at 55, for instance. Knowing that I could very well be destined for a NW5 in my mid 30s, I just cut my losses and went on 0.5mg of finasteride.

I think what Kintor has in the pipeline with pyrilutimide is the most promising thing, but I'm not getting my hopes up for it. They also haven't even started phase II trials in the US (though they have been approved), so who knows how long we'll be waiting for it to hit the market. That, and when/if it does hit the market, who knows what sort of side effect profile it's going to have. Anything that binds to androgen receptors has the potential to wreak havoc if it goes systemic and doesn't degrade into some sort of harmless particle once it reaches the blood stream. This is particularly the case if it is strong enough to halt hairloss, as it would have to have a binding affinity that is at least as strong as DHT.
 

Norwoody

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Agreed.

The worst cases to deal with are edge cases. You have some guys that are 21-22 who are NW2. In some cases, they hop on finasteride, but their hair loss could have just stopped there and not progressed further. On the contrary, they could continue to recede all the way to a high norwood.

My own case was similar, I was a NW2 at around 22 years old. I continued to recede until I hit a NW3 at 27.5. Clearly my hair loss isn't as aggressive as some, but I really have no idea where it's going to end up. The worst pattern in my family looks like a NW5a, but it's all over the place in terms of consistency. I have a worse hairline than my father did at 55, for instance. Knowing that I could very well be destined for a NW5 in my mid 30s, I just cut my losses and went on 0.5mg of finasteride.

I think what Kintor has in the pipeline with pyrilutimide is the most promising thing, but I'm not getting my hopes up for it. They also haven't even started phase II trials in the US (though they have been approved), so who knows how long we'll be waiting for it to hit the market. That, and when/if it does hit the market, who knows what sort of side effect profile it's going to have. Anything that binds to androgen receptors has the potential to wreak havoc if it goes systemic and doesn't degrade into some sort of harmless particle once it reaches the blood stream. This is particularly the case if it is strong enough to halt hairloss, as it would have to have a binding affinity that is at least as strong as DHT.
Yeah that's the thing. It would be super helpful if we could test and predict our fate. Not only could treatments be tailored better, but you could also plan and execute a transplant much more effectively. And yeah, I don't expect any treatment to hit the market any time soon that is as effective as finasteride and minoxidil. Before we even identify a safe, effective AA or modified estrogen powerful enough to combat androgenic alopecia, there really needs to be breakthroughs in dermal carrier technology first, so I think it's going to be quite a while unfortunately. Then again, the cloning stuff might happen before all that so who knows. It's just amazing that it still is pretty much about "the big 3" and unfortunately, aside from a few slight modifications, it is what the average guy with hair loss needs at minimum to battle it.
 

MDL999

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Agreed.

The worst cases to deal with are edge cases. You have some guys that are 21-22 who are NW2. In some cases, they hop on finasteride, but their hair loss could have just stopped there and not progressed further. On the contrary, they could continue to recede all the way to a high norwood.

My own case was similar, I was a NW2 at around 22 years old. I continued to recede until I hit a NW3 at 27.5. Clearly my hair loss isn't as aggressive as some, but I really have no idea where it's going to end up. The worst pattern in my family looks like a NW5a, but it's all over the place in terms of consistency. I have a worse hairline than my father did at 55, for instance. Knowing that I could very well be destined for a NW5 in my mid 30s, I just cut my losses and went on 0.5mg of finasteride.

I think what Kintor has in the pipeline with pyrilutimide is the most promising thing, but I'm not getting my hopes up for it. They also haven't even started phase II trials in the US (though they have been approved), so who knows how long we'll be waiting for it to hit the market. That, and when/if it does hit the market, who knows what sort of side effect profile it's going to have. Anything that binds to androgen receptors has the potential to wreak havoc if it goes systemic and doesn't degrade into some sort of harmless particle once it reaches the blood stream. This is particularly the case if it is strong enough to halt hairloss, as it would have to have a binding affinity that is at least as strong as DHT.
Hey i have a question regarding hair loss stopping at 22. So Im 22 years old and my temples have receded, specially my right temple. But my hair is still thick, seems to be no sign of loss in the crown and i never notice any kind of shedding. For example when i use shampoo i might see 2-3 hairs maximum. So you’re telling me its possible my temples have receded and now my hairloss will halt/slow down? This would be very good news as i didnt tolerate finasteride very well, and cant seem to find a viable alternative to it. Thinking about fluridil though.
 

20YearsOnFin

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I think the Yoda quote ''do or do not there is no try'' some's up my view on finasteride, its up to people to make there own choice what to take and what not to take, people are still discussing this 24 years after its release, and will likely still be discussing it 24years from now, but in the meantime I still intend to take it for the duration unless it becomes obsolete. .
 

user394587

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Hey i have a question regarding hair loss stopping at 22. So Im 22 years old and my temples have receded, specially my right temple. But my hair is still thick, seems to be no sign of loss in the crown and i never notice any kind of shedding. For example when i use shampoo i might see 2-3 hairs maximum. So you’re telling me its possible my temples have receded and now my hairloss will halt/slow down? This would be very good news as i didnt tolerate finasteride very well, and cant seem to find a viable alternative to it. Thinking about fluridil though.
It's possible, it's not uncommon for men to develop what's known as a mature hairline (NW2) and then stop there. Some prominent hair transplant surgeons don't even consider this to be a stage of balding (https://www.bernsteinmedical.com/hair-loss/men/classification/). With that said, it would be a good idea to see a doctor who specializes in this to be sure. They'd need to examine you with a trichoscope to determine if you have active miniaturization.
 
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