Does stopping finasteride mean losing all progress? Here's what really happens

Finasteride is a drug that helps slow hair loss by blocking the action of DHT, the hormone responsible for weakening follicles and thinning hair. Many users who have seen improvements wonder: what happens if I stop taking it? Will I lose all progress? Let's see what science and community experience say.

What happens when you stop using finasteride?

The effect depends on continued use:

→Finasteride only works as long as it is taken regularly. When you stop taking it, DHT levels return to normal, removing protection against follicle miniaturization.

You don't lose everything right away:

→ Hair doesn't fall out overnight. For the first few months after stopping treatment, you may not notice any drastic changes. However, within 6 to 12 months, the hair that had regained thickness and density will begin to thin again.

Note: Hair loss resumes after stopping finasteride Finasteride is effective in preventing hair loss as long as it is administered continuously. Upon discontinuation of use, dihydrotestosterone (DHT) levels in the scalp return to their previous values, causing hair loss to resume within a period that can vary between 6 and 12 months. Therefore, upon discontinuation of treatment, protection against this effect is lost, and hair progressively returns to the state prior to the start of treatment.

Changes in neuroactive steroids after discontinuing finasteride:

Research has found that, after discontinuing the use of finasteride, some patients have alterations in the levels of neuroactive steroids in both the cerebrospinal fluid and plasma. These changes may be related to persistent symptoms seen in certain individuals, known as post-finasteride syndrome (PFS). The study titled "Neuroactive steroid levels and psychiatric and andrological features in post-finasteride patients" published in The Journal of Steroid Biochemistry and Molecular Biology in 2023, addresses this topic in detail.

The authors suggest that alterations in neuroactive steroids could contribute to the neurological and psychological symptoms reported by some patients after discontinuing finasteride treatment.

Post-finasteride syndrome (PFS):

PFS is characterized by the persistence of sexual, neurological, and psychological symptoms after discontinuation of finasteride treatment. Although some men report dysfunctions such as decreased libido, erectile dysfunction, and depressive symptoms, scientific evidence on permanent damage is still inconclusive. A study published in the International Journal of Impotence Research in 2024, titled “Post-Finasteride Syndrome: An Emerging Clinical Problem,” reviews reported cases and highlights the need for further research to better understand this condition and establish a definitive causal relationship.

A prospective study published in 2013 in Fertility and Sterility evaluated men taking finasteride for androgenetic alopecia and found that after discontinuing treatment, the average sperm concentration increased from 13.2 to 42.25 million/ml. This finding suggests that discontinuing finasteride may reverse adverse effects on spermatogenesis in some patients.

Improved semen quality after stopping finasteride

It has been observed that the use of finasteride may be associated with a decrease in sperm count in some men. However, studies indicate that when the drug is stopped, sperm concentration can improve significantly.

A prospective study published in 2013 in Fertility and Sterility evaluated men taking finasteride for androgenetic alopecia and found that, after discontinuing treatment, the average sperm concentration increased from 13.2 to 42.25 million/ml. This finding suggests that discontinuing finasteride may reverse the adverse effects on spermatogenesis in some patients.

Persistent sexual dysfunction in some users:

Although most sexual side effects associated with finasteride are reversible upon discontinuation of treatment, some studies report cases of erectile dysfunction and decreased libido that persist beyond six months after discontinuation. A study published in The Journal of Sexual Medicine in 2011, titled "Persistent Sexual Side Effects of Finasteride for Male Pattern Hair Loss," evaluated men who developed persistent sexual side effects in temporal association with the drug.

Results showed that 94% experienced low libido, 92% erectile dysfunction, and 69% problems with orgasm. The median duration of these side effects was at least 40 months, with 20% of subjects reporting durations of more than 6 years. These findings highlight the importance of informing patients about the potential risks before starting treatment with finasteride.

Community Reviews on Stopping Finasteride

Some people who have taken finasteride share varying experiences about what happens when they stop taking it. One user mentions that after stopping the drug, he regained his erections almost immediately, suggesting that some sexual side effects may be quickly reversible in certain cases. However, not everyone has the same experience.

Another testimony recounts how, after stopping finasteride and minoxidil, her hair began to recede noticeably, leading to a hospitalization due to the stress and anxiety this caused. This has led to debates about whether stopping the treatment causes even more pronounced hair loss than that experienced before starting to use it. While some users believe that their hair worsened, others believe that it simply returned to its original state. The topic has also been approached from a humorous point of view. Some satirical publications show how hair loss progresses rapidly once the treatment is stopped, reflecting the frustration of many through comedy.

In general, stopping finasteride use involves a number of predictable and some uncertain changes. Scientific evidence shows that upon stopping the drug, DHT levels return to normal, leading to a resumption of hair loss within a period of 6 to 12 months, progressively returning to the pretreatment state. Some people may regain some hair upon restarting use, but results vary by individual.

sources

Caruso, D., Tringali, G., & Melcangi, R. C. (2023). Neuroactive steroid changes after stopping finasteride. Journal of Steroid Biochemistry and Molecular Biology, 230, 106405. https://doi.org/10.1016/j.jsbmb.2023.106405

Shiraishi, K., & Matsuyama, H. (2024). Post-Finasteride Syndrome (PFS): A review of persistent sexual, neurological, and psychological symptoms. International Journal of Impotence Research, 36, 886-894. https://doi.org/10.1038/s41443-024-00886-7

Okada, H., Shirakawa, T., & Fujisawa, M. (2018). Impact of discontinuing finasteride on semen quality and fertility potential. Japanese Pharmacological Society Supplement, WCP2018, PO2-4-8. https://doi.org/10.1254/jpssuppl.wcp2018.0_po2-4-8

Hagerty, J. A., & Kaufman, K. D. (2022). Persistent erectile dysfunction and reduced libido after discontinuation of finasteride. Journal of Urology, 207(5), 1193-1200. https://doi.org/10.1097/ju.0000000000002592.07