I need advice on 3 year post-op medication changes

[alopie]

I have been on finasteride for 5 years and I had my HT 3 years ago. After my HT, I was prescribed a combination of 5mg oral finasteride and 1mg oral dutasteride weekly, so I actually went from 7mg oral fin to this: 5mg oral fin + 1mg oral dut.

During the first year post-op, I did not have any side-effects. However, during the second year I started experiencing some testicular discomfort (pain at times) so I stopped dutasteride and I went back to my 7mg oral fin weekly, the pain went away after 3 weeks.

This year, after 12 months from my last testicular discomfort, I started feeling the same discomfort and pain while on oral finasteride 7mg weekly. I went to urologists, was told that everything is fine, and that it might be unrelated to finasteride, as it looked like it was position dependant. I stopped finasteride for 1 month and then I switched to topical 0.1% 1ml daily.

For a good 2 weeks, discomfort went away, but now I have also started feeling something really small again.

My assumption is that finasteride accumulated and there was in abundance on my tissues, but also topical is likely absorbed to a great extent.

Now I am slowly stopping topical and going back to a low dose oral finasteride at 0.5mg every other day or 0.25mg daily which I can better control. I am on 2mg oral minoxidil, ketoconazole 2% and dermaroller. I apply topical minoxidil 3x week on some weak spots, too. 
 

Is 0.25mg oral finasteride daily + 2mg oral minoxidil daily enough for maintenance for a month or two? I am planing on increasing to 0.5mg oral finasteride daily + 2.5mg oral minoxidil daily, which is viewed as an overall good protocol for maintenance.

[Gatsby]

1 hour ago, alopie said:

Is 0.25mg oral finasteride daily + 2mg oral minoxidil daily enough for maintenance for a month or two? I am planing on increasing to 0.5mg oral finasteride daily + 2.5mg oral minoxidil daily, which is viewed as an overall good protocol for maintenance.

My dermatologist has prescribed this before. 0.25mg of oral finasteride is not too low. It will still be effective. If you are not having side effects from oral minoxidil you could ask to raise it to 5mg per day also. All the best!

[hairman4321]

2 hours ago, alopie said:

I have been on finasteride for 5 years and I had my HT 3 years ago. After my HT, I was prescribed a combination of 5mg oral finasteride and 1mg oral dutasteride weekly, so I actually went from 7mg oral fin to this: 5mg oral fin + 1mg oral dut.

During the first year post-op, I did not have any side-effects. However, during the second year I started experiencing some testicular discomfort (pain at times) so I stopped dutasteride and I went back to my 7mg oral fin weekly, the pain went away after 3 weeks.

This year, after 12 months from my last testicular discomfort, I started feeling the same discomfort and pain while on oral finasteride 7mg weekly. I went to urologists, was told that everything is fine, and that it might be unrelated to finasteride, as it looked like it was position dependant. I stopped finasteride for 1 month and then I switched to topical 0.1% 1ml daily.

For a good 2 weeks, discomfort went away, but now I have also started feeling something really small again.

My assumption is that finasteride accumulated and there was in abundance on my tissues, but also topical is likely absorbed to a great extent.

Now I am slowly stopping topical and going back to a low dose oral finasteride at 0.5mg every other day or 0.25mg daily which I can better control. I am on 2mg oral minoxidil, ketoconazole 2% and dermaroller. I apply topical minoxidil 3x week on some weak spots, too. 
 

Is 0.25mg oral finasteride daily + 2mg oral minoxidil daily enough for maintenance for a month or two? I am planing on increasing to 0.5mg oral finasteride daily + 2.5mg oral minoxidil daily, which is viewed as an overall good protocol for maintenance.

some people have found benefit using very very low dose topical dutasteride - it is supposed to be less absorbable systemically than topical finasteride.
urologists said everything is fine and its unrelated to finasteride - how did they explain the pain then? can you look into it further?

[gillenator]

Do you have or do you feel any small or tiny lumps in your testicals at all?

[alopie]

10 hours ago, hairman4321 said:

some people have found benefit using very very low dose topical dutasteride - it is supposed to be less absorbable systemically than topical finasteride.
urologists said everything is fine and its unrelated to finasteride - how did they explain the pain then? can you look into it further?

Hypermobile testicles and sensitivity in the area due to lifestyle choices (I seat many hours throughout the day for work).  I want to avoid topicals because they are difficult to apply and mess with the appearance of my hair. When I used topical finasteride, I felt like I could not control how much of it I am applying, and if I am applying it correctly, let alone the fact that it might be absorbed to a good extent.

I was told that the area there is so sensitive that there are many other reasons that could cause this. All the urologists I have seen so far are in unison that low dose finasteride is unlikely to cause testicular pain, or at least nothing irreversible. However, they are more concerned over the long-term use (beyond 10+ years) as there are not many studies regarding the safety profile for long term use. Hormonal imbalances, particular oestrogen abundance may be carcinogenic in men in the long run. They all seem to agree with this.

9 hours ago, gillenator said:

Do you have or do you feel any small or tiny lumps in your testicals at all?

No, nothing that I can feel. I also did 3 ultrasounds, both last year and this year. My ultrasounds included prostate, bladders and lower abdomen. Nothing, apart from a small abundance of bacteria in one of my urine tests, but both sperm and urine tests excluded STDs, and culture bacteria. Again, the urologists were not concerned at all, they prescribed some minor medication for inflammation as well as a kind of orthopedic boxers that can keep my testicles up in place.

I lowered the dose of finasteride and the discomfort has definitely decreased over the last month, I would say it's at a maximum 2-3/10, and it was 6/10. Sometimes, especially when I am standing, I do not feel any discomfort at all, so it looks like it happens when I am seated, that's why I am keeping my small dose finasteride for now (0.5mg every other day). I believe the topical solution was being absorbed and it was contributing to the side effects.

 

[Maorizio]

0.5mg eod and even 0.25mg eod will eventually build up in the tissue and lead to almost near results as 1mg daily, but sides will also might reappear.

[alopie]

On 1/20/2024 at 4:10 PM, Maorizio said:

0.5mg eod and even 0.25mg eod will eventually build up in the tissue and lead to almost near results as 1mg daily, but sides will also might reappear.

That's exactly what I think is happening. My side effects started to appear after 4 years of use, but now it took me 3 weeks and side-effects are still here. I think that tissue binding might take more than a couple of months. Should I take it slow until I have no side effects and then start at 0.25mg eod? What do you think?

[Maorizio]

5 minutes ago, alopie said:

That's exactly what I think is happening. My side effects started to appear after 4 years of use, but now it took me 3 weeks and side-effects are still here. I think that tissue binding might take more than a couple of months. Should I take it slow until I have no side effects and then start at 0.25mg eod? What do you think?

I am not 100% sure but I think there was a study showed users return to baseline DHT levels almost half a year after discontinuation, so this stuff is really strong as it seems.

If 0.25mg EOD will work? I don’t know because all of us are built different, you can try build up the dosing, using something is still better than not using at all.

Edited January 22 by Maorizio

[alopie]

On 1/22/2024 at 8:20 PM, Maorizio said:

I am not 100% sure but I think there was a study showed users return to baseline DHT levels almost half a year after discontinuation, so this stuff is really strong as it seems.

If 0.25mg EOD will work? I don’t know because all of us are built different, you can try build up the dosing, using something is still better than not using at all.

My plan was to use 0.5mg every other day and use topical in between, but I still have some minor testicular discomfort as a leftover, so I guess I can stop the topical and continue with 0.5mg eod. But since it accumulates, maybe I need a longer break from it (more than 3 weeks that I already did) and build up. In the first 3 years I was taking a solid 1mg daily and there was no side effects, not even loss of libido. The testicular discomfort must be either from accumulation or unrelated to finasteride.
I do not want to lose ground, that's why I don't want to take a longer break, pff this stuff is anyone, I thought I won the hair loss war for a long time  

[Gatsby]

6 hours ago, alopie said:

My plan was to use 0.5mg every other day and use topical in between, but I still have some minor testicular discomfort as a leftover, so I guess I can stop the topical and continue with 0.5mg eod. But since it accumulates, maybe I need a longer break from it (more than 3 weeks that I already did) and build up. In the first 3 years I was taking a solid 1mg daily and there was no side effects, not even loss of libido. The testicular discomfort must be either from accumulation or unrelated to finasteride.
I do not want to lose ground, that's why I don't want to take a longer break, pff this stuff is anyone, I thought I won the hair loss war for a long time  

There are some doctors who suggest that people can take a one or two week wash out period every three months. It may benefit you but you really have to try it to find out. I wish you all the best @alopie. 👌

[Petroholic]

@alopie My HT doc suggests a 2 week break every 3 months to prevent sideffects and mentain effectiveness. you can watch on this his video here.

https://www.youtube.com/watch?v=cPWmhkYEiUw

 

I have been taking fin 1 mg for 11 years now. Following his advice, I stopped it for a week. Faced massive shed in just a week. Plan to take a week's break every 6 months from now on.