ORAL FINASTERIDE MANUAL
(EVERYTHING you need to know)
(EVERYTHING you need to know)
The information provided in this guide is for general educational purposes only. It is not intended as medical advice and should not be used to diagnose, treat, cure, or prevent any medical condition. Finasteride is a prescription medication that should only be taken under the supervision of a qualified healthcare professional. Individual responses, side effects, and risks may vary. Before starting, changing, or discontinuing Finasteride or any other treatment, consult with your doctor or licensed healthcare provider. I assume no responsibility for any outcome, loss, or damage resulting from reliance on the information contained herein.
WHAT FINASTERIDE ACTUALLY DOES (THE BORING SCIENCE PART)Finasteride blocks 5-alpha reductase type II, the enzyme that converts testosterone into dihydrotestosterone (DHT). DHT is what's murdering your hair follicles if you have androgenetic alopecia (AA).
Your scalp has androgen receptors that DHT loves to bind to. When it does, it miniaturizes hair follicles over time until they stop producing terminal hair and start producing that wispy, pathetic vellus hair that looks like baby fuzz. Finasteride reduces scalp dht by about 70%, giving your follicles a chance to recover and thicken back up.
DOSING: LESS IS OFTEN MORE
Here's where most people fuck up. They think more is better and start popping 1mg daily like it's fucking candy. The standard dose is 1mg daily, but here's what the studies don't emphasize enough: 0.5mg daily gives you about 90% of the DHT suppression that 1mg does. Even 0.25mg every other day can be effective for some people.
Start low. Seriously. Begin with 0.25mg daily or every other day. See how you respond after 3-6 months. you can always increase, but you can't unfuck the psychological impact of jumping straight to 1mg and convincing yourself every random body sensation is a side effect.
Some people respond better to dosing every other day or even three times per week. The half-life is about 6-8 hours, but the enzyme inhibition lasts much longer. Your body doesn't need constant suppression to maintain results.
TIMING AND CONSISTENCY
Take it at the same time daily. Doesn't matter when, just be consistent. With food, without food, whatever works for your routine.
The key is building a habit so you don't forget doses and create fluctuations in your hormone levels.
If you miss a dose, don't double up the next day. Just continue with your regular schedule. Obsessing over perfect compliance will drive you insane and probably cause more stress-related hair loss than the occasional missed pill.
WHAT TO EXPECT (REALISTIC TIMELINE)
| MONTHS | CONDITION |
|---|---|
| MONTHS 1-3 | Possibly some initial shedding. This freaks people out, but it's often a good sign. Weak, miniaturized hairs fall out to make room for stronger ones. Don't panic and quit during this phase. |
| MONTHS 3-6 | Shedding should stabilize. You might notice less hair in the shower drain or on your pillow. This is when you start seeing maintenance effects. |
| MONTHS 6-12 | This is when regrowth typically happens if it's going to happen. Don't expect a full head of hair, but you might see some thickening in areas that weren't completely bald. |
| YEAR 2 AND BEYOND | Continued improvement or stabilization. Some people see continued gains for up to two years. |
THE SIDE EFFECT HYSTERIA (90% BULLSHIT)
The internet has turned finasteride side effects into a boogeyman that's way scarier than the ACTUAL data suggests.
Here's what the clinical trials actually show:
SEXUAL SIDE EFFECTS:
Reported in about 2-4% of men in clinical trials.
1. "Finasteride 5 mg and Sexual Side Effects: How Many Are Related to a Nocebo Phenomenon?"
[1]
Summary:
A randomized clinical trial of 120 men with benign prostatic hyperplasia (all sexually active and on finasteride 5 mg for one year) compared two groups:
Group 1: Not informed of potential sexual side effects.
Group 2: Explicitly informed that finasteride:
Key Result:
Sexual side effects were reported by 43.6% in the informed group vs 15.3% in the uninformed group
This clearly illustrates the nocebo effect. Knowing about possible sexual side effects significantly raises the likelihood of reporting them, even though both groups were taking the same medication.
2. "Incidence and severity of sexual adverse experiences in finasteride and placebo-treated men with benign prostatic hyperplasia"
[2]
Another landmark study (the PLESS trial involving finasteride 5 mg versus placebo over 4 years) showed that:
3. "Finasteride and sexual side effects"
[3]
A literature review noted sexual adverse effects in the range of 2.1% to 3.8%, with rates comparable to placebo and diminishing over time:
[1]
Summary:
A randomized clinical trial of 120 men with benign prostatic hyperplasia (all sexually active and on finasteride 5 mg for one year) compared two groups:
Group 1: Not informed of potential sexual side effects.
Group 2: Explicitly informed that finasteride:
Key Result:
Sexual side effects were reported by 43.6% in the informed group vs 15.3% in the uninformed group
This clearly illustrates the nocebo effect. Knowing about possible sexual side effects significantly raises the likelihood of reporting them, even though both groups were taking the same medication.
2. "Incidence and severity of sexual adverse experiences in finasteride and placebo-treated men with benign prostatic hyperplasia"
[2]
Another landmark study (the PLESS trial involving finasteride 5 mg versus placebo over 4 years) showed that:
3. "Finasteride and sexual side effects"
[3]
A literature review noted sexual adverse effects in the range of 2.1% to 3.8%, with rates comparable to placebo and diminishing over time:
The nocebo effect is real and powerful.
If you go into this expecting your dick to stop working, there's a decent chance you'll psychologically manifest some sexual issues.
"POST-FINASTERIDE SYNDROME"
This gets thrown around like it's a established medical condition. It's not recognized by major medical organizations because the evidence for persistent side effects after discontinuation is mostly anecdotal and poorly documented. No, that doesn't mean people aren't experiencing real symptoms, but correlation =/= causation.
DEPRESSION AND BRAIN FOG
Again, reported rates are similar to placebo in most studies. If you're already prone to anxiety or depression, obsessing over potential side effects and constantly monitoring your mood will probably make you feel worse regardless of the medication.
MANAGING THE PSYCHOLOGICAL ASPECT
To be completely real with you, your mental state going into finasteride treatment will largely determine your experience. if you've spent months reading horror stories and convincing yourself you're about to become a sexless zombie, you're setting yourself up for problems.
1. Stop reading finasteride forums.
Seriously. Unsubscribe from r/tressless if it's making you paranoid.
These spaces become echo chambers of anxiety and negative experiences because people having normal, uneventful experiences don't feel compelled to post about it.
2. Track objective metrics
Don't track based on your feelings. Take standardized photos of your hair monthly. Keep a simple log of any side effects with dates and severity. Don't analyze every random mood change or morning wood situation.
OPTIMIZATION STRATEGIES
1. COMBINE WITH TOPICAL TREATMENTS
MINOXIDIL
+
MICRONEEDLE DERMA ROLLER
(Will make a comprehensive guide for both in the near future)
Finasteride works best as part of a comprehensive approach. It should not be a standalone miracle cure.
2. LIFESTYLE FACTORS MATTER
- Stress
- Sleep
- Nutrition
These all affect hair loss.
Finasteride isn't going to save you if you're chronically stressed, sleeping 4 hours a night, and living on energy drinks.
3. REGULAR MONITERING
Get baseline blood work before starting, specifically
- Total testosterone
- Free testosterone
- DHT (if possible)
Check again after 6 months, then annually. This gives you objective data instead of relying on how you "feel."
WHEN TO QUIT (AND WHEN NOT TO)
QUIT:
1. if you experience persistent, documented side effects that negatively impact your quality of life after giving your body time to adjust (at least 3 months).
2. If you're not seeing any benefit after 12-18 months. Some people are non-responders, and that's okay. There are other options.
DON'T QUIT:
1. During the initial shedding phase unless it's TRULY EXCESSIVE.
2. Because of temporary side effects in the first few weeks as your body adjusts.
3. Because you read a scary story online or because you had one off day sexually.
THE COMPLIANCE GAME
Missing doses occasionally won't ruin your results, but chronic inconsistency will.
1. Set phone reminders
2. Use a pill organizer
Whatever it takes to build the habit.
Some people find that taking breaks ("finasteride holidays") helps reset their tolerance and reduce any side effects. This is controversial and not well-studied, but ANECDOTALLY, some guys report success with 5 days on, 2 days off schedules.
ALTERNATIVES AND COMBINATIONS
If 1mg daily doesn't agree with you, try 0.5mg daily, or 1mg every other day, or even 1mg three times per week.
There's no magic about the daily dosing, despite what the prescribing information says.
Topical finasteride is becoming more popular. Theoretically lower systemic absorption, but the data is still limited on effectiveness compared to oral.
(Picture of Dutasteride, sold under the brand name Avodart among others)
Dutasteride is the nuclear option, blocking both type i and type ii 5-alpha reductase.
PROS:
More effective for hair loss
CONS
1. Higher chance of side effects
2. Longer half-life means slower reversal if you do have issues
THE FINANCIAL REALITY
Generic finasteride is cheap as dirt now.
For fucks sake, don't get fooled by expensive "hair restoration" clinics pushing proprietary formulations. The active ingredient is the same whether you pay $10 or $100 per month.
1. Goodrx.com
2. RX.Costco.com
3. CREDIBLE online prescriptions
There are literally tons of ways to get this medication affordably. Don't let cost be a barrier if you want to try it.
Finasteride works for most people who try it. The side effect profile is overblown by reddit horror stories and anxiety.
Start conservative, be patient, track objective results, and don't let the perfect be the enemy of the good.
Of course your hair loss isn't going to reverse overnight, but it will very likely stabilize and possibly improve if you give the medication a fair trial. The biggest risk isn't the medication itself but the psychological torture you put yourself through by overthinking every aspect of the process.
Treat it like any other medication: take it consistently, monitor for real side effects, and don't make it the center of your identity.
It's a tool to help maintain your hair.
Keep it that way.
Start conservative, be patient, track objective results, and don't let the perfect be the enemy of the good.
Of course your hair loss isn't going to reverse overnight, but it will very likely stabilize and possibly improve if you give the medication a fair trial. The biggest risk isn't the medication itself but the psychological torture you put yourself through by overthinking every aspect of the process.
Treat it like any other medication: take it consistently, monitor for real side effects, and don't make it the center of your identity.
It's a tool to help maintain your hair.
Keep it that way.
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