What is the longest someone has been on meds then quit? And why?

[follically challenged]

I have heard a few times that 'if you haven't experienced side effects after 1 year of being on meds, then you most likely will not'.

Just wondered if anyone has gained ground with Fin / Dut then suddenly experienced negative sides after a number of years..?

[JDEE0]

You hear stories or anecdotes online related to this if you spend enough time on forums etc., but it really makes little sense to me that you would chronically inhibit the 5-ar enzyme for years on end and then suddenly one day start experiencing side effects out of the blue. 

What people need to remember is that all common finasteride related side effects also occur extremely commonly within the general population. Look up the incidence rates for ED, loss of libido, anxiety, depression and so on for any given person in your country/globally.... they spontaneously develop in hundreds and hundreds of millions of people each and every year around the world (who aren't on finasteride or any other medications at all for that matter).

It is far more likely for whatever is going on with someone to be completely unrelated to fin if they suddenly come down with X symptoms/issues after years on the drug with no problems and is realistically fairly ridiculous to blame it on fin with absolute conviction in this scenario imo. 

 

[Mike10]

Sides can appear even after 10 years plus. Or the med can lose efficiency. I do not think it is unrealistic or ridiculoous at all. Even if it works well, it will only slow down and not completely stop the loss over the long term in most cases

Edited October 18, 2021 by Mike10

[JDEE0]

54 minutes ago, Mike10 said:

Sides can appear even after 10 years plus. Or the med can lose efficiency. I do not think it is unrealistic or ridiculoous at all. Even if it works well, it will only slow down and not completely stop the loss over the long term in most cases

I never said they outright can't, I wouldn't be able to make such a claim. I merely said it makes very little sense that they would spontaneously appear out of nowhere after years and years of inhibiting 5-ar (and having the resultantly altered hormonal profile for the same period of time) without any issues at all. Compound this with the fact that, in the U.S. alone every year millions of men who aren't on fin are diagnosed with erectile dysfunction (as an example) without any apparent cause, it becomes ridiculous to state that finasteride MUST be the cause. The incidence of these fin related/type side effects are by no means rare within the general population, and so I think it's certainly fair to say it's ridiculous for someone to unequivocally blame their sudden ED on finasteride after 10 years on the drug when taking this into account. 

This is also something that is backed up by research; side effects generally take on the opposite trend whereby their incidence rate usually decreases over time according to pretty much all clinical data. This study (https://pubmed.ncbi.nlm.nih.gov/11809594/) for example followed over 1500 men for 5+ years and demonstrated exactly this with the below findings in relation to each listed adverse effect:

- Reduction in libido (1.8% in the finasteride group and 1.3% in the placebo group during the first year. In the fifth year these figures became 0.3 vs. 0 respectively).

- Erectile dysfunction (1.4% against 0.6% after a year and 0.3 vs. 0 respectively in the fifth year)

- Reduction in the volume ejaculated (1.4% against 0.9% which in the fifth year became 0% in both groups).

Also, the med does not lose efficacy, this is something commonly regurgitated online for some reason with no evidence to support the claim. It doesn't even make any sense. The issue is, as you say, it doesn't completely stop the balding process. Only a maximum of 70 percent of DHT is reduced, and all other androgens are left over and actually increased by virtue of the downstream effects of blocking 5-ar in the first place. Loss will still happen in most very slowly and accumulate over time as a result, of course. There are still androgens circulating and imposing their regulation of gene expression etc upon the hair follicles. Besides, if they did lose effect over time, this essentially means they no longer work at effectively blocking 5-ar and would logically mean that sides are far less likely to occur as time goes on. Regardless, that wasn't the point of this post, so I'm not sure how it's really relevant to the discussion here overall anyway.

The only way I could potentially imagine it would make any sense for very sudden and noticeable sides to be caused after years on the drug would be age related. Maybe with a lot less androgenic activity active in the body at 50 than 20 due to ageing, the additional reduction from the finasteride on top could cause some sort of low androgen/high estrogen symptoms. Playing devils advocate really, but I suppose it could make sense on paper maybe. 

 

Edited October 18, 2021 by JDEE0

[Al - Moderator]

Sexual side effects probably don't happen suddenly, but as you get older the minor effects that you didn't even notice when you were young and always horny start to make a noticeable difference 15 or 20 years later. Some guys may feel like it happened suddenly because you don't notice until you really need it to work.

[Al - Moderator]

To try to answer the original question, I was on finisteride for about 11 years from roughly 1998 to 2009. I had some side effects, but was able to manage it, but after some years went by, the side effects were getting worse and my hair was once again noticeably falling out, so for me it made no sense to continue staying on finisteride. Once I stopped the side effects went away. My hair probably started falling out faster afterwards, so technically the finsiteride was still working, but it didn't matter to me as I was a NW 7 either way, just a bit more of a NW 7 after I stopped using it.  To me it was more important to have good erections and increase my body hair in order to use beard and chest hair.

 

 

[JDEE0]

1 minute ago, BeHappy said:

To try to answer the original question, I was on finisteride for about 11 years from roughly 1998 to 2009. I had some side effects, but was able to manage it, but after some years went by, the side effects were getting worse and my hair was once again noticeably falling out, so for me it made no sense to continue staying on finisteride. Once I stopped the side effects went away. My hair probably started falling out faster afterwards, so technically the finsiteride was still working, but it didn't matter to me as I was a NW 7 either way, just a bit more of a NW 7 after I stopped using it.  To me it was more important to have good erections and increase my body hair in order to use beard and chest hair.

 

 

Yeah, sort of what I was saying could be all I could think of in my last paragraph of my previous response.

But by your own admission you always had some side effects whilst on the drug so it's a different scenario anyways and isn't a case of developing them after a number of years.

[Curious25]

I think @mustang made an interesting hypothesis , that hair loss could be looked at as seasonal , similar to a hair cycle , and medical treatment as such, could be executed in the same mindset. I wonder if that would become a new thought path for patients . .
 

You could potentially commit to taking a course of medication 3 months a year for instance, 

[NARMAK]

8 hours ago, jessieba said:

I had a scary side effect a long time ago, anaphylaxis and retinal hemorrhage. I went to the ER because I had blood in my urine.

That sounds incredibly unusual and way out of the norm. 

Certainly not the common side affects we have labelled about the medication. Hopefully you're fine but did they say whether you had anything else medically that caused this? 

[Rahal Hair Transplant]

Follically challenged,

I can’t speak for everyone nor can I answer your initial question as to the longest someone has been on finasteride and then quit. But personally, I was on finasteride for about four years and even though I did not experience any side effects, I decided to stop using it because I didn’t feel like it was doing anything for me.

I had already lost essentially all the natural hair on top of my head and lost a substantial amount of hair immediately above the occipital ridge and below the crown.

Frankly, I just felt like I’d rather not keep ingesting medication for the rest of my life that may or may not come with the potential for long-term side effects. Not that there’s any proof of it, but it’s still unknown in terms of any potential long-term side effects and since I didn’t feel that finasteride was working for me, I just stopped. I didn’t lose any additional hair after I stopped nor did I gain any hair while I was using it.

Before I went cold turkey however, I did reduce my dose a couple times to see if There was any possibility of losing any additional natural hair below the crown. I know it was a risk regardless however, I strongly felt that it wasn’t doing anything for me and it was a personal decision I made for myself.  I’m not advising this one way or another, but this is my personal experience.

Best wishes,

Rahal Hair Transplant 

[NARMAK]

Just going to hijack this thread a bit. 

So, usually we are told that if we take Finasteride/Dutasteride etc. it helps prevent the DHT converting via 5AR inhibition so that hair follicles are safer for longer 

Hypothetically if a person aged, we are told hair loss tends to slow. Is this because naturally the hair follicles become less sensitive to DHT or the effect of it converting reduces as we age. 

Because kind of like this thread talking about using it for a long time and stopping  hypothetically if a guy used it from say 18 till 45. Once you're in your mid 40s, if the hair loss had become less sensitive to DHT then stopping the medication should hypothetically mean less DHT in your system in your 40s and thus you have much slower hair loss off the medication. 

However, if i'm gonna guess and this is right, the reason hair loss resumes and you end up losing all the hair the Finasteride etc. saved is because your DHT sensitivity on the hair follicles never changes with age. The hair sensitivity is pre-set in that way and when you stop medication it simply resumes and picks up where it left off. 

So as an example, if say my hair was pre-determined to be a Norwood 5 and not really go beyond, if i stopped in my 40s, it would continue losing hair from say Norwood 1 till Norwood 5 over the next few years or at whatever rate i am sensitive to losing hair. 

However, if you're saying destined to be a Norwood 7 but you block well and respond to medication, hypothetically you can stop hair loss in its track at say even a Norwood 1 or Norwood 2 if you intervene quickly enough. However once you stop, it again will hit you to Norwood 7.

I guess the flip side is people who are aggressively impacted and even blocking with Dutasteride merely slows it down. 

[ciaus]

 

These kinds of what-if-<insert worse case scenario> topics just breed more of the same. And I would guesstimate alot of them are created to do precisely that, worrying guys to the point of not even trying or stopping the medication. Ultimately they're worthless because everyone even in the small number of people that reply have unique physiologies, vulnerabilities to hair loss, and responses to the medications. Most of what's online about hairloss is garbage, but there are a few legit sources for knowledge like Derek below. Otherwise stick with your doctors/blood lab work/peer reviewed medical studies/monitoring your progress with photos over the years.