I'm sure you read this before but....

kincade · Oct 28, 2014

....I can't go through all the threads here.

So to be short-been on finasteride 1mg a day for several years-all the sudden I can't get hard-if I do I pop in a second. I decide to cut back a bit or change my overall plan so 2 questions.

Can two doses a week be effective?

Any alternatives to finasteride at all? (I'm aware of saw palmetto but from what I read on here it sounds useless)

Thanks guys. I'm starting to think the stress of figuring out what would work is not worth it in the end.

zzzzz · Oct 28, 2014

There are no alternatives besides MAYBE RU. Stop the finasteride for like a month maybe, if your erections come back you will know its from the finasteride. If they don't its from just some other cause like aging. Men tend to get ED problems as they get older. If you find that it isn't from the finasteride the goodnews is you will be able to start finasteride again knowing it isn't the cause. You will have to find something to treat your ED if this is the case

ham373 · Oct 30, 2014

If you want to reduce your dose of finasteride you have to be aware of how potent small doses can be as seen in the following graph.This graph shows daily dosing of different doses of finasteride (from 0.04mg up to 1mg) for 14 days achieve nearly the same level of DHT inhibition. You can see 0.04 mg (open circles) and 0.12mg (black sqaures) get down to about 80% of the level of inhibition of 1mg. (In fact, given that the graphs are still heading down a little at day 14 (when the drug was stopped) it is possible that they may get all the way there if given a little longer.

This graph shows you how long a SINGLE dose of finasteride (from 0.04 mg to 1mg inhibits DHT for). Basically 0.04mg has a small effect (remember this is only taking one dose) and tails off over 4-5 days. 0.5 mg has almost two-thirds the effect of 1mg and tails off over about 7 days. 1mg has a bigger effects and tails off over more than seven days.

The punchline is that if you want to have say a steady half of the effect of a full dose of finasteride to see if side effects diminish, you need to get down to a dose of about 0.5 mg every 4 or 5 days. 0.2 mg every 2-3 days would probably achieve about the same. Of course, there are individual differences in all this but these are approximate values.

One issue to keep in mind is that because side effects are likely linked to reduced steroid levels (that is, DHT and all the other steroids that are metabolised by 5-AR) that if you reduce to a dose that improves side effects you will probably affect the desired effect of the drug. (that is, there is probably no magic dose that saves your hair but avoids side effects. That's not to discourage you from trying of course).