Questions on finasteride dosage and side effect mitigation.

[dolfin]

I started finasteride about one month ago. The dermatologist started me with the standard 1 mg per day. I'm not taking any other medications at this time.

However, within the first week of treatment I started experiencing reduced libido. I don't believe that I'm psyching myself out or anything. I'm confident it's happening because I tried paying attention to my sex drive prior to starting the medication, and it definitely appears to be different.

I had to wait 2 months for the appointment, so I tried paying attention to my body during this time. It's an imperfect observation, but I believe I have a general sense of my bodies ebbs and flows prior to finasteride.

Also, I understand that finasteride has a complicated reputation on the internet, so I'm doing my best to be measured here. I'm not trying to fear monger.

So right now I'm not that worried except for the fact that I might not be able to accumulate to this medication.

The prescribing dermatologist did inform me about sexual side effects, which I already knew about, but never mentioned how long I might be feeling them for.

I found one website saying it might take 6 months for the body to adjust and side effects to go away but I'm not sure. There seems to be less info available about side effect duration.

Personal stories in forums seem to claim that people either have no side effects, some minor side effect, or they had side effects and gave up. I never found any story about someone switching dosage and mitigating side effects, although hair loss cafe on YouTube suggests this strategy may work.

The already scheduled a follow up appointment 3 months from my initial visit. So if the side effects are still present, I will definitely mention them.

But now I'm concerned about possible alternatives. If the derm wants me to lower dosage or not take it ever day, how useful would that even be for hair loss or maintaining?

How long should I actually wait for side effects to mitigate before accepting that the drug might just not work with my body?

[Elithair]

You're approaching this thoughtfully and that matters.

On side effect duration. There is no fixed timeline. Some people notice sides in the first few weeks and they resolve within a month or two as the body adjusts. One month is still early and worth giving more time provided the sides are manageable and not severely affecting your quality of life.

On lowered dosage. There is reasonable evidence that 0.5mg or even 0.25mg daily still provides meaningful DHT suppression with a potentially better side effect profile. Alternate day dosing is another option though the pharmacokinetics of finasteride actually support daily dosing better.

On when to accept it is not working for you. If sides are still significantly present at the three month mark and affecting your daily life, that is a reasonable point to reassess. Topical finasteride is worth raising at that appointment. Systemic absorption is meaningfully lower and some patients who cannot tolerate oral do fine on topical.