Been on Finasteride for 20 years. Recently started noticing some thinning near my temples. Unsure what to do next

As the title says, I’ve been on 1mg Finasteride since I was 14. I’m 35. It has done a great job, It kept me with a full head of hair for 20 years. I have had 0 side effects.

However, I have recently started to notice some recession on my temples. This is the first time I’ve become aware of any change to my hair since starting fin. I want to try and get ahead of this like I did when starting Finasteride, but I’m a bit unsure of what my next step should be.

The rest of my hair is still very thick and full. There’s no thinning or recession anywhere else outside of the temples and the hairline slightly thinning out.

I have read a lot about oral minoxidil, but I’m a bit hesitant. I have a very, very mild case of mitral valve prolapse, something that was randomly discovered during a Dr visit and took them 30 min to get a clear image of using an ultrasound. I’m very healthy, work out 7x week (cardio, lifting, etc) and have no actual heart issues. But I’m concerned about that.

I’m also concerned about the chance of body-wide hair growth. I’m already decently hairy as it is, and I would really prefer not to have any more/thicker/darker hair on parts of my body where hair is my currently mild.

I have a call into my doctor to see if I’d be okay doing 1.25 → 2.5 mg of oral minoxidil, but in the meantime, I’m wondering if anyone else has any similar experiences being on fin for so long and having some

I wish I started finasteride at 14. You should probably use 5% topical minoxidil on those areas, it’s going to be very easy to apply for you, probably less than 30s every day. Oral minoxidil is not worth it for you considering the potential side effects. For more long term retention of hair, start adding dutasterde 0.5mg once/twice per week

starting finasteride at 14 is crazy damn :skull: , your muscle development may have been stunted

Yeah, I was shedding like crazy at 14. Derm recommended to give it a shot and it seems to have done the job for 20 years. My dad lost his hair around that age so it was something they wanted to try and get ahead of and my parents were pretty practice.

I don’t think I have any muscle development issues, I lift 4x a week and all of that - but idk what that would really look like?

Thanks, I’m leaning that route as well. Waiting to chat with my primary dr and see if there’s a hair specialist out here in LA he recommends I see before getting on anything - not someone who promotes anything for the sake of sales but actually wants to help haha

So I spoke with my Dr and he agreed, 5% minoxidil instead of the oral.

Do you recommend only applying it to the temples and thinning areas? How will I know how far down to go on my temples?

Also, any idea why fin seemed to just not hold the line anymore? I’m curious if you have any idea as to why

dht produced through 5ar isn’t particularly significant for muscle building, since it tends to get metabolized into 3a-androstanediol, which is far less androgenic. this is shown in the literature where male pseudohermaphrodites with a natural 5ar deficiency have normal muscular development.

tldr. fin won’t give small muscles

Regarding the dut, would I take that on top of the fin? So I’d be doing fin, min 5%, and dut as my long term plan going forward?