Is S5 / Spironolactone effective instead of Finasteride to avoid side effects?
- Thread starter Paul C
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On average, only 2.1-3.8% had side effects from oral finasteride https://pubmed.ncbi.nlm.nih.gov/23130269/
So I wouldn't worry. If you do get sides, you can either push through, limit how often you take it, reduce your dose, or switch to topical finasteride.
So I wouldn't worry. If you do get sides, you can either push through, limit how often you take it, reduce your dose, or switch to topical finasteride.
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.
Thanks again for the reply.
I’m concerned that those side effects are legit enough for me to stay away from oral finasteride. I’d prefer not to mess with my body’s hormones.
So the suggestion is that topical finasteride works almost as well as oral? Then should I just use topical finasteride and minoxidil?
How does topical finasteride compare to topical spironolactone in effectiveness and side effects? Were those spironolactone side effects you mentioned for oral or topical spironolactone?
Thanks again
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Topical goes sytemic too. Lesser degree but it will go systemic.
Topical finasteride has at least one strong RCT showing it works almost as well as oral.
Other data has been published as well. Broadly, it shows that topical finasteride led to reduced hair loss, increased total, and terminal hair counts https://www.tandfonline.com/doi/abs/10.3109/09546639709160517 https://pubmed.ncbi.nlm.nih.gov/19172031/ https://pubmed.ncbi.nlm.nih.gov/25074865/ https://pubmed.ncbi.nlm.nih.gov/26636418/
So all positive. Based on this, I would suggest you start using one (finasteride or minoxidil) first for at least six months to evaluate efficacy.
As for topical spironolactone, data is limited in men with Androgenetic Alopecia. It has antiandrogenic properties. But there are safer topicals like pyrilutamide. Pyrilutamide has a high affinity for the androgen receptor, selectively blocking it. The clinical data showed that plasma drug levels were very low or below quantifiable limits. There were no changes in serum hormone levels compared to placebo, and no androgen deprivation-related side-effects (e.g., loss of libido, erectile dysfunction, or gynecomastia).
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