Finasteride side effects and on-off regimen

[benjt]

Hi everyone,

my story short: started treatment of my Androgenetic Alopecia 2.5 years ago (currently 25, started at 22). Started off with only minoxidil at recommended dose (2 x 1 ml per day), which produced skin-related side effects within 12 months (wrinkles, dark eye bags). Went off minoxidil completely to allow for recovery and successfully restarted minoxidil treatment about 6 months later at a lower dose which was side effect free. First at 0.7 ml once per day, upped to 1 ml once per day, and recently increased to 1.5 ml per day (most days one application instead of 2 x 0.7 ml due to logistics). All of these doses are wrinkle-free so far, the only noticeable side effect are the dark eye bags which I am willing to accept.

However, the minoxidil alone doesn't do the job anymore. I was Norwood 3.5 when I started treatment. minoxidil at its max took me to Norwood 2.5 - 3, but in late August male pattern baldness itch on my crown started (or at least its the first time I noticed it). As I knew what that meant I decided to carefully monitor my crown with photos each week. Two weeks ago I first noticed visible thinning of my crown, i.e. I'm quickly approaching Norwood 4. Went to the pharmacy the next day to get finasteride and started treatment immediately.

I've now been on finasteride for almost two weeks at 0.5 mg EOD and am, unfortunately, experiencing sexual side effects:

• Weak erection
• No pleasure during orgasm
• Takes much more stimulation to get an erection and to maintain it during sex
• Watery semen and reduced volume
• Lowered libido (my urges are highly developed, i.e. it usually doesn't take much to make me think about it during the day or to get me horny - since finasteride, however, no more "dirty thoughts" or the desire to lay girls that I meet)

What I have not experienced is anything psychological, i.e. no mood swings, depression, anxiety, or the like. I am aware that the effects on erection can be due to placebo, but I consider this unlikely because frankly, until I got them, I considered side effects to be non-existant (mostly because of xRedStaRx's expertise explaining why they shouldn't actually happen). Now the big indicator is the complete loss of pleasure during orgasm. This sucks big time and as orgasm is a reflex-like action, it is highly unlikely as well that this is caused by placebo. On top of that, I didn't even know before that this could happen, which completely eliminates placebo as the potential cause. Conclusion: finasteride definitely does cause sexual side effects in my case.

Nonetheless, I would really like staying on finasteride. It is my goal to definitely maintain a Norwood 3.5 state. So, first question:
1) Will the sexual side effects subside because the body adapts to new, lower DHT levels? How long will this process need?

Second question, related to regimen:
2) Is there anything that would speak against an on-off-regimen with finasteride? I am in a long distance relationship. My gf and I spend one week a month together and then three weeks apart. I could time my finasteride usage such that I have no sexual problems for this week, i.e. go off finasteride 4 days before sex according to a paper that studied how long finasteride's effect lasts. That would allow me to block DHT for 2.5 weeks each month while not affecting my sex life. Any potential adverse effects with such a regimen?

Thanks for any replies or user reports in advance.

 

[Wolf Pack]

They say that side effects subside in those who either give up treatment or persist - i read someone taking up to a year to adapt (crazy). However, this is risky as many people end up worse off for trying to ride out side effects. I don't think your sides sound placebo from how you describe them, the choice is yours. Personally I never had those sides at a similar dosage to you for almost 2 months. I am sure you know the importance of finasteride for hair but sexual health is important too. Could consider RU.

I don't think going off finasteride for 4 days is a good idea. You need a consistent regimen. As far as I know looking the graphs you don't want to be without finasteride for more than 2 days. Basically I think you should commit to the medication or not at an appropriate dosage/schedule. Otherwise you may not get much benefit and still have sides on days you taking it.

 

[arvindekrahi]

22 year old guy here who has been on finasteride for 3 years now..

My testesterone levels are at a all time high..but my semen analysis tell a different story.

Also erections should have been harder.

i left finasteride.I am happy with the amount of hair i got.I hope minoxdil will be able to maintain it.

i frankly think you should get a semen analysis test done along with a testesterone test and see whats brewing inside your body.If you can enjoy sex by following the regime you just stated..i dont think stopping finasteride for a week a month would have very drastic effects on your hairline

 

[BalDing!]

Hey buddy. I'm kind of going through the same problem so I can empathize. Are you using generics?

I've heard of a couple of ways to approach finasteride. Firstly try going through with Propecia for a couple of months. I've heard sides are at there worst at the beginning.

Secondly try weening yourself on to propecia to get your body to adapt to the drug ( Week 1 = 1 pill, week 2 = 2 pills etc.)

I am going through the same problems, I personally am going down the second route.

But let me know how it goes for you, and good luck!

 

[benjt]

The plan was not to go off finasteride for 4 days, but 4 days before the one week I spend with my girlfriend each month. I.e., all in all I'd be off finasteride for 11 and on for 20 days.

Regarding the graphs, you have 100% effect for 48 hours, the following hours (48 to 72) about 80%, and only after 5 to 7 days the effect of finasteride completely wears off. In my opinion, a 0.5 mg pill every three days instead of every two days would still work for the most part.

Yes, I'm using generics.

Any more experiences? Especially of people who successfully rode out the side effects?

 

[BalDing!]

Hmm, I'm not entirely convinced by the generic route. Sure A LOT cheaper, but from what I've read and What I've personally experienced on them they seem to be problematic. I dunno, just a theory. I once switched to Kirkland minoxidil and saw that it wasn't as effective as Regaine.

I never thought of myself as a brand guy untill now haha!

 

[benjt]

I just completed my first on-off-on cycle and wanted to share my experiences for anyone who might be considering taking this route.

Most importantly: No sides stuck around permanently after getting off finasteride. Didn't expect them anyway, but after a few days everything was 100% back to normal.

I knew the time it takes for DHT to fully recover after a single dose (cf. the well-known graphs for single doses), i.e. about 4 days for a single 0.5 mg pill. However, the time it takes for DHT going back to normal after continued use seems to be much higher. In my case, it took me around 6 days to get functionality down there back to a degree such that I could have regular intercourse again, and everything was 100% back to normal after 8 days. Gf agrees on that.

The reason seems to be accumulated effect: If after two days DHT is lowered by 50%, and you lower it again with another pill within a few days, it will actually be much lower than after the original, initial dose, obviously. It was already lowered and is now lowered even more. The effect won't stack linearly I assume, but it will still accumulate/pile up. So even if a single dose of finasteride at 0.5 mg lowers your DHT by 60%, continued use will lower it even more.

For this reason, I'm now trying a 0.5 mg dose every three days instead of every two days, let's see if my body can get adjusted to that quicker. I'd prefer to stay on finasteride permanently instead of an on-off regimen. Still hoping that I can get full sexual functionality on finasteride. Since getting back on finasteride (now 5 days), the situation is the same as before, i.e. side effects.

One last thing: the first orgasm I had after getting off finasteride for the off-phase I had major ball ache, much stronger than when getting on finasteride. Dont know how or why it happened, but at least only once and it was gone after like 1 hour.

Hope someone can profit from this.

 

[OSWALD]

All of these side effects will resolve. Please use drug and continue treatment. When your body adjust to drug, side effects will go.

In 5 mg finasteride treatment, side effects will be similar on 4 years with placebo. Maximum 4 years, your body will adjust it.

 

[bodill32]

If you received such sides at such an early rate with such a low dosage, I would advise against going back on. Your body is telling you it does not take well to the inhibition of the 5ar2 enzyme (metabolite for dht) and controller of other neurological pathways. Continuing to use this drug with such knowledge is asking for permanent damage and or inhibition to the enzyme. Some people do well, others do not. However it is not a chemical risk worth taking.

 

[benjt]

bodill32, many people report initial sides subsiding after a while. Of course, after they set in, I did a great deal of online research and managed to find the raw statistical data of the finasteride sexual side effect trials. During the first year of use of finasteride, above 8% of people reported impotence in the PLESS trials. (source: http://www.rxlist.com/proscar-side-effects-drug-center.htm )
Other sources, though, report up to 18.5% (!) of people suffering from ED/impotence (e.g., http://www.drugs.com/sfx/finasteride-side-effects.html ). So there are studies that report way more.

The interesting thing, though, is that in the PLESS trials, there was no statistical difference in sexual side effects occurence between finasteride users and placebo after minimum one and at most four years of continued treatment. This is why I decided to take my chances, as your body seems indeed to adjust. I just hope it will do so much quicker than 4 years and closer to 1 year.

I am planning on working out regularly now, not to get a buffed look but to boost my androgen levels. Let's see if it helps. As of now I still have the side effects, i.e. while on finasteride "things don't work" so I still have to go off finasteride 7 days before seeing my girlfriend (long-distance relationship).

 

[benjt]

Wanted to report in, with some rather positive news. Four months later, it seems as if my body is adjusting. I can maintain erections much more easily, and I even had morning wood two or three times by now. My dose is at 0.5 mg E3D. My libido is also better, though still not at normal levels, and while maintaining an erection got easier, getting one is still harder. In other words, I cant be aroused as easily it would seem. Orgasms are 100% normal again and at 100% strength, too.

A strange thing I have noticed by now, though, is that my junk is smaller when flaccid (!) sometimes. When this happens and I have to pee, it's difficult to get all drops out. I can't explain it, but as I'm on an on-off regimen I can easily reproduce it. It never happens after 3 days off finasteride, and always only happens while on finasteride.

I hope I will get back to 100% of my sexuality, but as of now it seems it's on a good way.

In case anyone's wondering: For the first three months I saw no signs of recovery; this all happened within the last month.