Because sometimes continuing a medication (even one as great as finasteride) may not be advised.
I spend a lot of time singing the praises of finasteride. And why wouldn’t I? It’s a fantastic, first-line of defense for people experiencing androgenic alopecia. Not only is it a potent DHT blocker, but it also has a great safety profile. And, if you’re pursuing hair loss surgery, I stand by the statement that finasteride is an important step to consider to create a solid starting foundation.
But, despite finasteride’s many accolades, I don’t talk enough about when you should stop taking this medication. The simple fact is that medical therapy isn’t magic or a miracle – it’s a medication and not all medications are appropriate for everyone.
So, below are my top 6 reasons for stopping your finasteride.
Finasteride is a fantastic medication, but there are good reasons to stop treatment. The first? If it isn’t working. Image by Freepik.
1. You’ve been on finasteride for a while but are still experiencing hair loss.
Finasteride will control hair loss in about 90-95% of men, meaning that 5-10 % of men don’t respond fully. When that happens, it’s worth considering stopping and switching to finasteride’s stronger, more potent DHT blocking cousin, dutasteride. Up to 2.5 mg dutasteride daily can be prescribed to control hair loss, and people who don’t respond to finasteride often will respond to this medication. The caveat of course is that with a more potent DHT blocker comes an increased potential for side effects. The incidence of sexual dysfunction side effects is about double (4-6% versus 2-3% with finasteride) and though still relatively low, it’s the reason we keep dutasteride in reserve.
2. You suspect an allergic reaction. A severe allergic reaction – a rash, hives, difficulty breathing, facial/mouth/throat swelling – is rare but can occur quickly and be extreme. An allergy is distinct from a side effect (they’re not the same thing) and can also build up over time – beginning with mild hives and progressing to more serious symptoms. If one of these reactions occurs when starting a new medication? Stop, seek emergency services if needed, and always let your doctor know.
3. You experience one of finasteride’s known side effects. The main side effect most men fear when it comes to finasteride is sexual dysfunction – a medically polite way of saying libido (desire) decreases and the plumbing doesn’t quite work as it used to. First off if you’re considering finasteride, be aware that this side effect is rare (2-3%) and usually happens within the first few weeks. What to do if this occurs? Stop the medication, wait for the side effect to resolve, and (with your doctor!) try a lower dose - sometimes even a topical preparation. Side effects with finasteride tend to be dose dependent and resolve soon after stopping the medication.
Some people who experience side effects might decide to stop completely – but keep in mind that there’s no substitution for finasteride when it comes to preserving the hair you still have.
Another reason to stop finasteride (albeit temporarily)? If you and a partner are planning to start a family, ceasing finasteride 3 months before trying is advised. Image by Freepik.
4. You’re planning a pregnancy. Finasteride can affect semen in a few key ways that might impact fertility: it can lower the volume, sperm count, and reduce sperm motility. Keep in mind that finasteride won’t permanently cause infertility. Semen quality and quantity typically return to normal levels 3-4 months after stopping medication, and the studies out there support this.
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If you and a partner are considering a pregnancy? Let your doctor know, stop finasteride 3 months before trying to conceive and, once a pregnancy is confirmed, you can resume. It takes about 6 months for hair fall to continue after stopping a medication so a 3-6 month break from finasteride should be safe.
Another fantastic reason to stop finasteride? If you’re no longer attached to your hair and are ready to embrace a bald look. Image by pch.vector for Freepik.
5. You’re no longer attached to your hair. Some men, in their 20s especially, aren’t ready to lose their hair, but afterwards? Into their 30s or 40s? Finasteride is a great way to build confidence in men self-conscious over losing their hair, but if that resolves? Then there’s no reason not to stop.
6. You think your hair loss has resolved and stabilized. Hair loss can be age dependent, in the sense that as men get older, the active androgenic alopecia they experienced in their youth can stabilize (though not always). Men past the age where testosterone typically depletes (~50+) sometimes find that they can stop their finasteride and their hair loss has stabilized, but there is absolutely no need to stop past a certain age. Also, it’s not a reason to avoid prescribing finasteride later in life if that’s when their hair loss begins
So those are some of the reasons to consider stopping the use of finasteride. Keep in mind, finasteride is a safe, effective drug that’s unmatched in its ability to preserve the hair you have. If you’re losing hair and would feel more confident keeping it, then finasteride (and its hair loss partner minoxidil) is a fantastic place to start. And, if you’re considering a hair transplant in your future? It behooves you to explore medical therapy as an option.
It’s also a generic, inexpensive drug that can be shipped to your door at an affordable price. Head to feelconfident.com to explore whether these prescription hair loss medications are for you.
