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I have been getting thinner and thinner. I am a woman age, 34. Any suggestions?

Women with progressive thinning require a trichoscopic examination where the doctor magnifies the hairs on the scalp and looks for miniaturization. Some women just develop premature Age Related Thinning where there will be no miniaturized hairs on the scalp. In ART, the best treatment is to use thickeners iin your shampoo and conditioner which will increase the thickness of the hair shafts as it is forced to absorb water. An alternative is to use either topical concealers (like Tokkik) ot Scalp Micropigmentation (a tattoo of the scalp make to look like cut hairs). If your hairs are miniaturized in some areas, you need a hair specialist to assess that for you.

My ejaculate hasn’t reduced at all really. The only symptom I have is lack of orgasm. I’m 100% sure it’s not psychosomatic as I had a wet dream a few days ago and came in my sleep, and it didn’t wake me up because I literally didn’t feel anything.

You may be right. If you have an ejaculate and no orgasm, it must be psychological as the ejaculation almost always accompanies orgasms. If it occurs during sleep, it is called nocturnal emissions, a common occurrence in young men.

I mean, they’re not really wrong. The only way to stop balding is to never go through puberty. Futhermore, hair loss happens with age, as we slowly slink towards the grave. Minoxidil is a growth stimulant that doesn’t address the mechanisms for why we bald, it simply provides a cosmetic effect, which is what most people care about. Finasteride helps reduce the amount of DHT below a certain threshold that would cause hair loss otherwise, but as you age, the body may become more sensitive to DHT. These both work, and most people are happy enough to go on them, but we’re still balding. Some people have wonderful, Disneyland results, but they’re still losing their hair, and it would go as quickly as it came if they were to cease treatment. It sounds like your derm is just managing your expectations, as we do here; It’s easier to keep what you have than gain anything back.

I always say that when you are 17-18, something happens and the hair loss starts like the gate of a race track. We know that there is a process called Apoptosis (cell death) which occurs with hair follicles that are genetically programmed to shut down. Each hair follicle has a number of cycles that they will have before ‘dying’ and as the typical male has a 3 year growth cycle, if the hair is destined to not come back after 6 cycles, that is 18 years, 7 cycles is 21 years, 8 cycles is 24 years. We see much of the hair loss in those under 24, so it appears that 8 cycles is a magic number. Finasteride, extends the anagen (growth) phase in hair so these loss cycles slow down while on the drug.

Does sleep (or lack of) have a big impact on hair and worsen MPB?

We know that people who do not get adequate sleep are stressed. Stressed people lose their hair (common in women) and accelerate hair loss that is part of the genetic male patterned baldness process.

This question and answer is taken from the College of Family Physicians of Canada and it accurately addresses the question.

QUESTION: A few women have asked me whether Finasteride, taken by their partners for male pattern baldness, will affect their pregnancies. The product monograph is very alarming: it sounds as if even handling the medication could cause harm, especially to a male fetus. Should a man stop taking Finasteride if his partner is planning pregnancy or is pregnant? What is the risk to the fetus if its mother accidentally handles crushed or broken tablets?

ANSWER: To date, there are no reports of adverse pregnancy outcomes among women exposed to Finasteride. Taking 1 mg of Finasteride daily did not have any clinically significant effect on men’s semen. Absorption through the skin while handling tablets is extremely unlikely to cause fetal exposure or harm. There is no reason to discontinue the drug. Motherisk is currently following up women who are pregnant or planning pregnancy and whose partners are taking Finasteride.

Publication: Finasteride. Does it affect spermatogenesis and pregnancy?

Article: https://wjmh.org/DOIx.php?id=10.5534/wjmh.200012

This treatment may result in development of non-alcoholic fatty liver diseases (NAFLD), insulin resistance (IR), type 2 diabetes (T2DM), dry eye disease, potential kidney dysfunction, among other metabolic dysfunctions. We suggest that long-term use of finasteride and dutasteride may be associated with health risks including NAFLD, IR, T2DM, dry eye disease and potential kidney disease.

A recent article here: https://jamanetwork.com/journals/jamadermatology/article-abstract/2772818 suggests that men under 45 who take finasteride, have a higher risk of suicide than control groups.

We have known that there are some complaints of Central Nervous System problems in a few young me who take finasteride. We need a lot more information than is supplied in this article but I have no doubt that if a man is suicidal, then should stop taking finasteride if they are on the drug. It is interesting to note that suicide is the second most common cause of death in men under 45 and that does not include finasteride. How does this information alter the finding in this paper?