Thanks for the reply.
I have some health problems so feel particularly vulnerable to it plus it just doesn’t seem right to alter systemic testosterone levels.
Is the topical finasteride as good and without side effects? Do you know how it compares to S5?
There is a lot of misinformation surrounding finasteride, especially when it comes to cognitive impairment, anxiety, depression, and even suicidal thoughts. Not only is there no data showing any of these from any of the randomised and placebo controlled trials that have been conducted, all lack biological plausibility as well.
There is well-documented data showing a small number can have either a decreased libido, erectile dysfunction, ejaculation disorders, and/or breast tenderness/enlargement. These tend to be mild and are reversible.
Some studies show it can also increase total testosterone, but this is generally modest.
As for topical (finasteride): ''The main finding of the study was that the change from baseline in hair count was significantly greater with topical finasteride than placebo, and similar to that observed with oral finasteride. This result was achieved with markedly lower systemic exposure to finasteride and less impact on serum DHT concentrations compared with oral finasteride. Topical finasteride was well tolerated and had a safety profile not meaningfully different from that of placebo. As such, topical finasteride appears to be a useful option for treatment of Androgenetic Alopecia in men.''
https://onlinelibrary.wiley.com/doi/10.1111/jdv.17738
Finally, spironolactone can lower testosterone and increase estrogen, resulting in feminising (side) effects.