Have Decided to have a HT, Wish to Avoid Finasteride

[JeffC45]

Hello. Long-time lurker, first time poster.

 

Quick re-cap of my history. In about 2007, at about 30 years old, I had some noticeable thinning at my temples and front third. As a preventative measure, I got some generic 5 mg Proscar (Dr. Reddy) online and began taking one-quarter (1.25 mg) daily. I didn't really notice any change (like I said, I was taking it preventatively and my loss was concentrated to my temples and frontal third-- the area least likely to be improved with finasteride).

 

However, about 2-3 months into taking the pills I experienced a pretty severe sexual side effect. I am someone who has never had the slightest issue in "that department" yet suddenly, I found myself having a very difficult time getting an erection. I had actually just started dating a girl, so this was majorly stressful to me. I was sufficiently enough freaked out to go to my doctor over the issue. To be honest, at this stage I had no idea that finasteride was associated with this type of side effect, so didn't even realize this was the cause until my doctor told me that he suspected the finasteride was the issue. He told me to stop taking them immediately, which I did.

 

Thank heavens, within weeks of ceasing the Proscar, my sexual function returned in its entirety. I have since read nightmare stories of people who have become permanently impotent even after they stop taking the finasteride. I actually consider myself quite lucky to have had the side effects cease.

 

Now, fast forward to 2016. I have been on 2/day Rogaine foam for ~5 yrs but my MPB has steadily continued. I now have significantly more thinning in my frontal third and a bit on the crown. I probably have transitioned from a NW2 to a NW3 in the past year and I am reaching the critical point where I will no longer be able to hide my hair loss much longer.

 

I have consultations scheduled and have decided that I definitely want to take the plunge and go for a HT this year. I have researched it for a long time and am firm in my desire for a HT. However, based on my past experience with finasteride I am EXTREMELY reluctant to ever try it again. I would, frankly, prefer to never touch it.

 

I understand that surgeons certainly prefer that the patient hold onto any native crown and vortex hair with finasteride. But I'm still terrified of the stuff.

 

Does anyone have any take on doing an HT with Rogaine only and no finasteride? I understand that I will likely shed more from the crown and need further procedures down the road.

 

My other question is, since I took online, generic Proscar and my side effects ceased when I cut it off, should I give name brand Propecia another try and hope for the best? I am 99.9% against touching it again, but there is a small part of me that is so stressed about my hair loss that I may try to take a smaller amount of it, if I really need it.

[Melvin- Admin]

Hey Jeff,

It's crazy your story sounds identical to mine check out my story, except I I was 22 in 2007 you were 30. I don't take finasteride, I've had two procedures, I think finasteride can be great if you don't get side effects but if you do, then it's not worth it in my opinion, given the fact that you're almost 40 and still only a Norwood 3, I think it's safe to say your hairloss is not very aggressive. I don't see a problem with getting a procedure now and sticking with minoxidil, you know may want to add nizoral and a dermaroller too, I'm also considering buying a capillus laser hat, just for maintenance of my native hair.

[JeffC45]

HTsoon, thanks for the encouraging reply. I was actually starting to become discouraged based on how much I've read doctors on this forum stress the importance of finasteride. I should have also mentioned I also use Nizoral 2% shampoo 2-3x/ week and have for about 5 years. For a long time the Minoxidil + Nizoral really slowed the pace of my hair loss, but unfortunately over about the past year, I feel like the party is over. The loss has either accelerated or has simply reached that critical point when it has become quite noticeable.

 

How satisfied with your procedures have you been? Did you do FUT or FUE? At what ages did you have the HT's?

 

Thanks so much for your response.

[Melvin- Admin]

HTsoon, thanks for the encouraging reply. I was actually starting to become discouraged based on how much I've read doctors on this forum stress the importance of finasteride. I should have also mentioned I also use Nizoral 2% shampoo 2-3x/ week and have for about 5 years. For a long time the Minoxidil + Nizoral really slowed the pace of my hair loss, but unfortunately over about the past year, I feel like the party is over. The loss has either accelerated or has simply reached that critical point when it has become quite noticeable.

 

How satisfied with your procedures have you been? Did you do FUT or FUE? At what ages did you have the HT's?

 

Thanks so much for your response.

 

I'm extremely satisfied, in my thread I have all my updates my last update was a video I made documenting my full journey up until now, you're more than welcome to check it out. I did FUE for both procedures, I started my journey at 29 now ill be 31 in a few months.

 

I think finasteride is really important for guys who are 20-30, but once you reach your late 30's to 40's I think it's not as important because the majority of men who are destined to be Norwood 6/7 reach it by 30 like myself. The problem is when you get a young guy who's 21, dense pack his hairline, he doesn't take finasteride, by the time he's 30, he looks weird with a hairline and a bald head. I don't think that'll be your situation, you'll continue to lose hair, but probably at a much slower rate, you may need another procedure in 10 years. At which point you'll be almost 50 and who knows maybe you'll stabilize by then. Maybe you won't mind hairloss as much.

[JeffC45]

I took a quick stroll through some of your pictures and it looks like you got some excellent results. You should be very pleased.

 

Finasteride is great for anyone lucky enough to have no sides (although the stories of people experiencing PFS 10+ years later would still scare the hell out of me). For me though, the temporary side effects probably scared me off of it for good. Reluctant to ever mess with my body's hormonal balance again. Though if I didn't experience those side effects, I'd probably still be taking it today.

 

Now I just go into my first consult in a few weeks and cross my fingers that my donor hair makes me a candidate.

[gillenator]

Yep, I agree that if your hair loss is not aggressive or you do not have the advanced classes of hair loss in your family history, then it's possible.

 

So if you do not progress beyond say a class 4, and you have a good donor supply, you're in good shape...

[Rashid36]

I wonder if the med should be tried by those already a bit weak in that department due to other reasons?

[Matt27]

HTsoon, thanks for the encouraging reply. I was actually starting to become discouraged based on how much I've read doctors on this forum stress the importance of finasteride. I should have also mentioned I also use Nizoral 2% shampoo 2-3x/ week and have for about 5 years. For a long time the Minoxidil + Nizoral really slowed the pace of my hair loss, but unfortunately over about the past year, I feel like the party is over. The loss has either accelerated or has simply reached that critical point when it has become quite noticeable.

 

How satisfied with your procedures have you been? Did you do FUT or FUE? At what ages did you have the HT's?

 

Thanks so much for your response.

 

There are physicians who don't care if you use finasteride or not. Dr. Lindsey said that only 30% of his patients take it (iirc).

 

I think this forum overstates the necessity of it. It is very common to get a HT and not be on it. But some physicians, like Bisanga, will require that you're on it.

[Matt27]

I'm extremely satisfied, in my thread I have all my updates my last update was a video I made documenting my full journey up until now, you're more than welcome to check it out. I did FUE for both procedures, I started my journey at 29 now ill be 31 in a few months.

 

I think finasteride is really important for guys who are 20-30, but once you reach your late 30's to 40's I think it's not as important because the majority of men who are destined to be Norwood 6/7 reach it by 30 like myself. The problem is when you get a young guy who's 21, dense pack his hairline, he doesn't take finasteride, by the time he's 30, he looks weird with a hairline and a bald head. I don't think that'll be your situation, you'll continue to lose hair, but probably at a much slower rate, you may need another procedure in 10 years. At which point you'll be almost 50 and who knows maybe you'll stabilize by then. Maybe you won't mind hairloss as much.

 

It's comforting to think that, but I get nightmares looking at, eg, Bruce Willis's hair loss progression. Thick NW3 in his mid 30s and went completely bald shortly after.

 

edit: Just checked your thread. Awesome results.

Edited April 6, 2016 by Matt27

[ndubya]

There are physicians who don't care if you use finasteride or not. Dr. Lindsey said that only 30% of his patients take it (iirc).

 

I think this forum overstates the necessity of it. It is very common to get a HT and not be on it. But some physicians, like Bisanga, will require that you're on it.

 

I don't know about that, Dr. Bisanga never even brought it up with me.

He has quite a few cases on here of patients that do not take it.

[Matt27]

I don't know about that, Dr. Bisanga never even brought it up with me.

He has quite a few cases on here of patients that do not take it.

 

That's great news actually. He might be my top doc if he isn't as conservative as I think he is. I thought he wasn't an option.

 

edit: I just checked your profile and you're mid 40s with NW2 level loss. That's completely different from our cases. I'm 28.5 and looking at NW5 eventually.

[Spanker]

So, I'll be a dissenting voice here.

 

The doc I represent does perform HT'S on people not on fin. It is very common. I feel he prefers the pt, in most cases do take fin.

 

Now, my personal opinion is that I rarely recommend transplants for patients not on fin. Exceptions would be traction alopecia with no other loss, or patents that are low NW levels in their late 40s to 50 and older.

 

That is just my personal opinion. Hair loss is generally more agressive and life is generally longer than the average person gauges. Before you know it, you're due for another procedure. Heck, I've been on fin for 6 years and it does not seem that long. Time really flies.

 

I think that the happiest patients, with their results anyway, are positive responders who are dedicated to taking fin regularly. Their results generally last longer. Meaning, they aren't fighting a losing battle, their HT results holds for an extended period of time and they have time to enjoy that. I've seen a lot of guys get 2,3,or 4 procedures trying that keep up with their hair loss over a relatively short period of time not being on meds.

 

Well, that's my thoughts.cheers.

[Matt27]

So, I'll be a dissenting voice here.

 

The doc I represent does perform HT'S on people not on fin. It is very common. I feel he prefers the pt, in most cases do take fin.

 

Now, my personal opinion is that I rarely recommend transplants for patients not on fin. Exceptions would be traction alopecia with no other loss, or patents that are low NW levels in their late 40s to 50 and older.

 

That is just my personal opinion. Hair loss is generally more agressive and life is generally longer than the average person gauges. Before you know it, you're due for another procedure. Heck, I've been on fin for 6 years and it does not seem that long. Time really flies.

 

I think that the happiest patients, with their results anyway, are positive responders who are dedicated to taking fin regularly. Their results generally last longer. Meaning, they aren't fighting a losing battle, their HT results holds for an extended period of time and they have time to enjoy that. I've seen a lot of guys get 2,3,or 4 procedures trying that keep up with their hair loss over a relatively short period of time not being on meds.

 

Well, that's my thoughts.cheers.

 

HTsoon restored a NW6 in 2 procedures (midscalp and then frontal third). So it isn't like he has much to chase unless he progresses to NW7. But that's the risk you take.

 

If you start getting transplants at NW2 and end up a high norwood that's different.

[JON86]

There is no clear answer to this question everyone is different and that is the way it is. Some need meds some don't, some respond, some get sides ,some don't. I have personally gotten sides from meds but they went away when I cut down the dosing. There is a radio show that I can't name here that had on a bunch of well known doctors and they reported that patients that had suffered sides from generic when switching to name brand propecia saw those sides go away. If you are destined to be a low norwood then you might get away without using meds. I know some people simply can't use them due to sides and that sucks. I personally and it's just my opinion would never get a procedure without them. To me it's like paying for braces but never brushing your teeth again. The result will not be good. If you have great donor you can exist without them I think but if not seems like a road I don't ever want to take. Like I said just an opinion and that's all it is.

[Garageland]

I agree with Spanker.

 

Hair loss is unpredictable and the patients who are long term happy with their results are ones that are on medication. There are exceptions to this are they are the patients that have a well defined minimal area of loss and are in their 40's and over.

 

Just because you have reached a NW6 and lost the majority of hair on the top of your scalp at 30-35 does not mean that the crown will not dip down and the sides start to drop further as you get into your 40's. Sure you can feel great in these cases in the first couple of years after a transplant when the hair is growing through but eventually you are going to end up back in the chair.

 

If you have the donor supply and the finances and are made aware of this then you are taking an educated risk with getting surgery.

[Stublue]

Well I had my HT with Dr. Bisanga when I was 31 (3 years ago) and he was aware that I was not taking finasteride. I tried it for a year before the op but the sides (virtually no libido) were not worth it. Plus I was never really comfortable taking the drug but each to their own. I'm now taking nettle root extract as well as using minoxidil (once a day) and nizoral (2-3 times a week). My crown remains fairly strong.

 

By not taking the meds I was fully aware that future HTs would be needed but I was fine with that. I'm actually going back to Dr. Bisanga in Jun. I'm getting around 750 grafts into the area just behind the transplanted hair in the mid-scalp as there is some weakness there. Its not noticeable at all and most would say that I have a full head of hair but I guess hair greed is getting the better of me. Plus I like the idea of having small FUE sessions to maintain the hair rather than waiting a few more years for a larger op. In addition, I probably won't have to shave the recipient area due to the small number of grafts so recovery will be a lot easier. I realise shock loss is a concern but any permanently lost hairs are on their way out anyway.

 

In an ideal world everyone would be on finasteride and sides wouldn't exist but they clearly do (although placebo definitely plays a role too). I am happy to progress with my HT journey without finasteride and am fully aware that I'll likely be back in the chair again in the next 10 years or so. Its more expensive granted but my sexual health is priceless!!

 

I am fortunate in that I have very good hair characteristics (wiry and thick hair) and a pretty good donor supply. I am also realistic and am aware that the crown will probably weaken a lot more over the next few years but the crown isn't really a concern of mine. If I have good coverage in the frontal half (hairline already taken care of) then I'll be a happy man. I can live with a sparse crown! That's my two cents anyway.

[Garageland]

Stublue,

 

Absolutely, you went to an ethical surgeon who made you aware of the facts and that further surgery would be needed to chase your loss. If you have the donor and favorable hair characteristics and are prepared for this then this is not an issue.

 

Having surgery without meds is a consideration that needs to be taken on a patient to patient basis. Being well informed about your situation is the key.

[JeffC45]

Appreciate the feedback. My last two cents would be just to say that all HT patients take the risk that they may someday be without the aid of medication. To me, every HT should be done with the consideration that the patient may someday have to stop taking the medication because being permanently tethered to a pill isn't necessarily realistic for most. So, in some ways, getting a HT with the understanding that the crown will shed further may provide a safer, albeit more conservative result.

 

Secondly, with regard to the placebo effect, while I acknowledge that it is a very real phenomenon in medicine, I am certain that it is not the driving force behind finasteride side effects. I am a classic example of someone who (sort of ignorantly) had no clue about these potential side effects before taking the pill. The side effects came and I had no idea what was causing them. I actually doubted my doctor when he implicated the finasteride. It was not a situation where I anticipated the sides because I had no idea they were even a possibility.

[Dolph1969]

Took generic proscar and couldn't feel a thing in my top end, lost total sensation in the trouser area after three weeks. Stopped taking it and thankfully the sensation returned.

 

IMO, it's not worth taking, with sides like that. Personally, after reading up on it, it's like playing with fire. Good luck to anyone on it with no sides, but it's not for me.

 

I'd rather be receding with a working d...k.

[Matt27]

Took generic proscar and couldn't feel a thing in my top end, lost total sensation in the trouser area after three weeks. Stopped taking it and thankfully the sensation returned.

 

IMO, it's not worth taking, with sides like that. Personally, after reading up on it, it's like playing with fire. Good luck to anyone on it with no sides, but it's not for me.

 

I'd rather be receding with a working d...k.

 

I had that and then some for over a year and I only took it for 4 days. After 15 months, I'm like 80-90% back to normal. Guys saying "everyone should try fin; it's worth a try! :cool:" simply don't understand how dangerous it can be. Or that every pill they pop makes it more likely that they'll develop the same thing.

 

Risking an unnatural looking head of hair > playing Russian roulette with fin every day for the rest of your life.

[MrGio-WHTCClinic]

Hello. Long-time lurker, first time poster.

 

Quick re-cap of my history. In about 2007, at about 30 years old, I had some noticeable thinning at my temples and front third. As a preventative measure, I got some generic 5 mg Proscar (Dr. Reddy) online and began taking one-quarter (1.25 mg) daily. I didn't really notice any change (like I said, I was taking it preventatively and my loss was concentrated to my temples and frontal third-- the area least likely to be improved with finasteride).

 

However, about 2-3 months into taking the pills I experienced a pretty severe sexual side effect. I am someone who has never had the slightest issue in "that department" yet suddenly, I found myself having a very difficult time getting an erection. I had actually just started dating a girl, so this was majorly stressful to me. I was sufficiently enough freaked out to go to my doctor over the issue. To be honest, at this stage I had no idea that finasteride was associated with this type of side effect, so didn't even realize this was the cause until my doctor told me that he suspected the finasteride was the issue. He told me to stop taking them immediately, which I did.

 

Thank heavens, within weeks of ceasing the Proscar, my sexual function returned in its entirety. I have since read nightmare stories of people who have become permanently impotent even after they stop taking the finasteride. I actually consider myself quite lucky to have had the side effects cease.

 

Now, fast forward to 2016. I have been on 2/day Rogaine foam for ~5 yrs but my MPB has steadily continued. I now have significantly more thinning in my frontal third and a bit on the crown. I probably have transitioned from a NW2 to a NW3 in the past year and I am reaching the critical point where I will no longer be able to hide my hair loss much longer.

 

I have consultations scheduled and have decided that I definitely want to take the plunge and go for a HT this year. I have researched it for a long time and am firm in my desire for a HT. However, based on my past experience with finasteride I am EXTREMELY reluctant to ever try it again. I would, frankly, prefer to never touch it.

 

I understand that surgeons certainly prefer that the patient hold onto any native crown and vortex hair with finasteride. But I'm still terrified of the stuff.

 

Does anyone have any take on doing an HT with Rogaine only and no finasteride? I understand that I will likely shed more from the crown and need further procedures down the road.

 

My other question is, since I took online, generic Proscar and my side effects ceased when I cut it off, should I give name brand Propecia another try and hope for the best? I am 99.9% against touching it again, but there is a small part of me that is so stressed about my hair loss that I may try to take a smaller amount of it, if I really need it.

 

 

Sounds like you would need to plan on conservatively approaching surgery. Strong donor resources and hair characteristics can influence your goals as you chase the loss with surgery and minoxidil.

 

Unfortunately, not every manufacturer of finasteride is reputable. However, you may now have a good source of generics. How long of a trial has it been with your current generic supply generic Proscar?

[gillenator]

I have been using a generic form of Proscar for well over a decade or so with consistent results...

[Rashid36]

Took generic proscar and couldn't feel a thing in my top end, lost total sensation in the trouser area after three weeks. Stopped taking it and thankfully the sensation returned.

 

IMO, it's not worth taking, with sides like that. Personally, after reading up on it, it's like playing with fire. Good luck to anyone on it with no sides, but it's not for me.

 

I'd rather be receding with a working d...k.

 

 

There is a similar discussion under hair loss drugs http://www.hairrestorationnetwork.com/eve/183074-thinking-about-quiting-propecia%3B-erection-problems.html

 

Today i decided not to start med due to the fear of sides.

I might start taking it if / after i have a ht!

Edited April 8, 2016 by Rashid35

[Melvin- Admin]

There is a similar discussion under hair loss drugs http://www.hairrestorationnetwork.com/eve/183074-thinking-about-quiting-propecia%3B-erection-problems.html

 

Today i decided not to start med due to the fear of sides.

I might start taking it if / after i have a ht!

 

Rashid in my opinion,

You should not take that med until after you've consulted with a physician, I would also get blood work done prior to your consultation so the doctor could go over it, I think we forget this is a prescription, this should always be prescribed by a physician. It might not be necessary in your situation IMO. You are advanced enough where I wouldn't risk the potential side effects for the small amount of hair you have left. I know there are plenty of Norwood 6 guys who use finasteride for preventative measures. My opinion is I'd rather risk becoming Norwood 7 then potentially becoming impotent. Of course, everyone values things differently. Plenty of guys don't mind having to use cialis so long as they have hair, I'm not one of those guys so again this is just my opinion and my take on it. I know this is a tough personal decision to make and I respect everyone's choice regardless.

[Rashid36]

Yes, that's what i was thinking so i cancelled my doctor appointment today.

 

As with everything regarding my hair loss I have had different opinion if i should take it or not at this stage from top doctors.

 

Everyone is different and i read many do benefit from the med.

 

I took it when i was around 25 years old for about 1 year. I had a lot of stress at the time so not sure if it or the stress affected my libido and perhaps many have issues for other reasons and not because of the med. I cannot say for sure but to this day (10years) my libido has not been the same as it was before the med but then again i have gone thru alot of things which could equally be to blame.

 

I totally agree with you but if i had a ht then i don't know maybe I will try it again.