Matt27

Like Chrisis, I also developed persistent side effects from using finasteride. They hit me immediately, just a couple days after I began using it. The symptoms of PFS are not merely sexual. In my case, I have widespread muscle tightness and fasciculations and sleep disturbance in addition to sexual dysfunction. I had a thorough hormonal workup done prior to using the drug and there are no appreciable differences now, so I do not believe this is a hormonal disorder. That is also one of the reasons why it is difficult to prove it exists. My symptoms are also less severe than many and I seem to be improving, now 8 months off of the drug. The guys who have had their lives completely destroyed by finasteride won't be on here because they are not worried about their hair. Using finasteride for just a few days is the biggest mistake I have ever made. And it probably always will be.

The guy who posted that video is a shill whose goal is to deny the risks associated with finasteride. He is, for lack of a better term, talking out of his ass to divert blame away from the drug. The sexual symptom profile of PFS actually closely matches a severe form of chronic pelvic pain syndrome/pelvic floor dysfunction. And yes, people do develop similar sexual dysfunction independent of finasteride use.

True; however, med school is only 4 years long and there are way too many things to cover. I spoke with a med student I know and he said they spent like 2 hours on it. I have seen dozens of doctors and their (outside of pain clinics) knowledge on the subject is poor at best. Basically they're aware that it exists and that's it. Tender points are actually associated with fibromyalgia, not myofascial pain. So... yeah. The 'points' associated with myofascial pain are called trigger points. He may very well have neuropathic pain. Sometimes our description of pain can get lost in translation (it can be very difficult to put into words) so I was trying to be open minded despite his mention of sharp shooting pain.

I can't say that it's for sure what you have. But it should be at the forefront of any chronic pain investigation. Generally myofascial pain is triggered by one thing (eg surgery) and perpetuated by something else. If it is myofascial, you'd have to find out why it's being perpetuated.

It can be cured. It's the cause of like 98% of chronic pain. It's just generally unknown to doctors. And I have heard of surgery triggering cases of it.

Honestly a GP isn't likely to know about it. Even neurologists don't. You'd have to see a chronic pain physician (who are normally trained as physiatrists or anesthesiologists). In my experience, myofascial pain can feel like "tingling" and can be sharp. The sure fire ways to differentiate it from neuropathic pain are whether you have numbness or 'pins and needles.' The latter of which occur only in neuropathic pain.

It is possible that the surgery triggered something called myofascial pain in which trigger points develop in muscles and refer pain around the head. There are a lot of nerves on the sides and back of the head and the donor region also corresponds to the classic "tension headache" pattern because of this. I would look into a muscular cause. If you really do have sharp shooting pains though then that's neurological.

He is completely slick bald on top. I think we would see a gradient if he was going to significantly progress beyond what he already is. He said it has been stable for 8 years. Yes MPB is normally progressive. Not (significantly) in cases like this.

If your hair loss has been stable for 8 years it seems pointless to use drugs. Finasteride, imo, is not worth the health risks. Especially not for someone with stabilized loss. I think that a few users on this forum feel almost bad about taking it and feel better thinking it's mandatory for everyone. Anyway your hair loss pattern makes you an excellent candidate. I think I'll settle into an identical pattern eventually, which is about 4.5A.

Looks good John. This is what most FUE cases I've seen look like shaved down. I don't even read the negative comments made about FUE anymore. It's obvious what their agenda is.

Thanks. I'm a long ways away from a procedure, but I'll make sure to update the forum if/when I do. I'll wait for an evaluation of my donor before I feel too ideal for FUE I personally don't see how I could have 80+ FU per cm^2, but I also think that about every pre-op photo I see. Maybe I'm just terrible at estimating.

Thanks for the responses. Those numbers for top docs seem... ok. Hopefully I get a good result. FUT for some of us just isn't an option. My long term treatment plan involves having a buzz cut. I don't want to be rocking a long hair style with thin coverage and a balding crown. And I like having short hair. I haven't had higher than a grade 2 on the sides/back (from the initial cut) since I was 11 years old. That's why we demand FUE. If FUE didn't exist, I wouldn't get a HT. FUT may as well not exist to me.

There are lots. Keep in mind that the "you must use finasteride with a HT" is largely internet forum culture. It needs to be judged on an individual basis.

You do get scar tissue with needles but it has to build up to become visible. FUE creates scars, but I don't think they would generally be 0.8 mm like the size of a punch which is fairly large.

The scars aren't necessarily the size of the punch. Poke yourself with a needle - it doesn't create a scar. Poke yourself with a needle 100 times... 100 times zero is still zero. You don't create scar tissue the size of the needle diameter.

Exactly. Especially for me, since I plan to keep my hair short. A thinner donor will avoid a horse shoe appearance when cut all to the same length. I was thinking about it. Imagine if you could evenly redistribute a NW6s hair all over his scalp. Would it look at all unusual with it cut very short?

You gave another reason why American physicians may not be so enthusiastic about FUE. It is laborious and maybe not overly profitable for them. And they can't increase their rates beyond what they are to make up the difference because they would become completely uncompetitive with FUE docs in Europe. I doubt someone as conservative and forthright as Bisanga would consider FUE a viable practice if he ever lost so many donor grafts.

Thanks for that. That seems highly unethical :eek:

I can understand that but saying it is "beyond the importance of whether the grafts were extracted by techs or docs" makes it sound like skill level doesn't matter. Especially considering the context of the post he was replying to in which the user was asking whether we should avoid FUE clinic who use techs for extractons.

Wouldn't 6k completely deplete someone's FUE donor? There are countless 3k FUE cases posted on this website. Can you point me to an example where it looks like 6-7k grafts were extracted to get 3k grafts suitable for implantation?

First, he states that the problem is especially apparent when FUE is performed by technicians. Later, he claims that the problem lies not with skill level, but is inherent to the technique itself. Shocking posts indeed. I do not think that the exaggeration was added to strengthen any point. We're all adults and benefit most from accurate information. It seems like he is doing whatever he can to discredit FUE. Having said that, he is a HT surgeon and I am not. And maybe he is privy to information that we aren't. Maybe what he said is common even with top surgeons. I would like him to clarify this as well.

I would like to know how common 35% yield (2-3k of 6-7k) is with FUE. That definitely doesn't sound like something common with top physicians, especially those who perform exclusively FUE.

Mitigating the problem of hair loss without disrupting your hormones is an ideal scenario imo. And for some, it's the only option they have left. I respect Dr. Lindsey a lot after reading many of his posts on this forum and I'm glad that a surgeon like him has gained a perspective many prospective patients have due to their experiences with finasteride. Dr. Lindsey, how old is this patient?

that's a huge area to cover for 3k grafts. he even did the side triangles with it.

I have found that my beard is creeping upwards toward my eyes in recent months/years, but I think that the lower hairs on and below the jawline have stayed the same for a long time. I would only expect your beard to thicken at 30 if you can see non-mature hairs already formed.