Question 1

Will finasteride cause sexual side effects?

Accepted Answer

A small percentage of men (~2–4% in the registration trials) report decreased libido, erectile dysfunction, or ejaculatory issues. These effects are typically dose-related and reverse upon discontinuation. Side-effect rates in real-world use may be modestly higher than in the trials. If you experience symptoms, your provider can switch you to topical finasteride (lower systemic exposure) or discontinue.

Question 2

What's post-finasteride syndrome?

Accepted Answer

Post-finasteride syndrome (PFS) describes persistent sexual, neurologic, and cognitive symptoms that some men report continuing after discontinuing finasteride. Its existence as a distinct medical entity is debated; prevalence — if real — appears very low. Take patient reports seriously without dismissing them. If you have concerns, discuss them with your provider before starting; topical finasteride or alternative protocols (e.g., dutasteride at low dose, ketoconazole shampoo, PRP) are options.

Question 3

Is topical finasteride safer than oral?

Accepted Answer

Likely yes for systemic side effects. Topical formulations achieve scalp DHT suppression comparable to oral but with markedly lower serum DHT changes — which is plausibly why sexual side effects appear less common with topical. Topical finasteride is still off-label in the US (must be compounded). Quality depends on the compounding pharmacy. The trade-off is potentially lower side-effect rates with a less standardized supply chain.

Question 4

Will I lose all my hair if I stop?

Accepted Answer

You'll return to your "baseline trajectory" — the rate of loss you would have had without treatment. Hair you regrew on finasteride will gradually shed back to your pre-treatment density over 6–12 months. This isn't a "rebound" effect; it's simply that the underlying DHT-driven loss resumes when the inhibitor is removed. Long-term maintenance of finasteride results requires long-term use.

Question 5

How long until I see results?

Accepted Answer

Reduced shedding typically at 3 months. Visible regrowth at 6 months. Peak benefit at 12 months. The 5-year Kaufman trial showed 90% of men had no further hair loss vs. 25% on placebo, with ~65% showing visible regrowth. Don't judge effectiveness before 6 months. Hair grows slowly and the early phase of treatment can include a temporary shed as miniaturized follicles cycle into a stronger growth phase.

Finasteride (oral) in Albany, NY

Benefits

Stops the loss

Real regrowth

Decades of evidence

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