Can finasteride or dutasteride cause gynecomastia?

Summary

The video script discusses the use of finasteride as a treatment for male pattern baldness, addressing concerns over its potential side effects, particularly gynecomastia. It clarifies the difference between actual gynecomastia and pseudogynecomastia, reviews the incidence rates from clinical trials, and dispels myths about the drug's side effects. The speaker advocates for a balanced view, suggesting that the benefits of finasteride often outweigh the rare risks, and offers advice for those who may不幸地, experience side effects.

Takeaways

• 💊 Finasteride is a medication that has been used since 1992 to treat male pattern baldness by inhibiting the conversion of testosterone to dihydrotestosterone (DHT).
• 👤 Millions of men have benefited from finasteride with a very small, acceptable risk of side effects, which can often be mitigated through dosage adjustments.
• 📉 The fear of prolonged side effects from finasteride is unfounded as these have not been medically verified, and side effects typically resolve with discontinuation of the drug.
• 🤔 The perception of baldness as a cosmetic defect can negatively impact self-esteem, but finasteride offers a solution to hair loss concerns.
• 🎥 A video from a British dating show illustrates the societal impact of hair loss, where initial impressions can be heavily influenced by a person's hair or lack thereof.
• 🚫 The script discourages the idea that shaving one's head as a solution to baldness will result in an appealing look, suggesting it may not be as universally flattering as some believe.
• 🤷‍♂️ It emphasizes that even attractive bald men could potentially look better with a full head of hair, highlighting the aesthetic value of hair in framing a face.
• 🔬 The script delves into the medical aspects of finasteride, explaining its mechanism of action and its impact on hormone levels, particularly testosterone and estrogen.
• 🤰 The concern of gynecomastia (male breast tissue development) as a side effect of finasteride is addressed, distinguishing between actual gynecomastia and pseudogynecomastia (fat distribution).
• 📊 Clinical data is presented to show that the incidence of gynecomastia from finasteride is very low, especially when compared to the benefits of hair loss prevention.
• ⚠️ The rarity of gynecomastia as a side effect is underscored, with the script suggesting that the fear surrounding it is disproportionate to the actual risk.

Q & A

What is the primary purpose of finasteride as discussed in the script?

The primary purpose of finasteride, as discussed in the script, is to treat male pattern baldness by inhibiting the conversion of testosterone to dihydrotestosterone (DHT), which is responsible for hair loss.

Why might some people be hesitant to take finasteride according to the script?

Some people might be hesitant to take finasteride due to fear of side effects, such as prolonged side effects or gynecomastia, despite these being medically unverified or statistically rare.

What is the script's stance on the belief that finasteride side effects can be prolonged?

The script refutes the belief that finasteride side effects can be prolonged, stating that this idea has never been medically verified.

What is the difference between actual gynecomastia and pseudogynecomastia as mentioned in the script?

Actual gynecomastia involves the development of breast tissue in men, while pseudogynecomastia is simply fat distribution to the chest area that can be resolved by weight loss or liposuction.

How does the script address the concern of developing gynecomastia from finasteride?

The script addresses the concern by explaining the mechanism behind finasteride and the actual incidence rates from clinical trials, emphasizing that the risk is extremely low and often reversible.

What does the script suggest about the impact of hair loss on first impressions?

The script suggests that hair loss, particularly when resulting in a shaved ring of hair, can leave a negative first impression, potentially leading to dismissal by others.

According to the script, what is the incidence rate of gynecomastia with the use of 5 milligrams of finasteride daily?

The incidence rate of gynecomastia with the use of 5 milligrams of finasteride daily is reported to be only 0.3 percent in the largest study involving over 14,000 patients.

What alternative treatments are mentioned in the script for individuals who develop gynecomastia from finasteride?

The script mentions prescription aromatase inhibitors like Arimidex or Letrozole, and tamoxifen (Nolvadex) as alternative treatments, but also highlights the potential side effects and risks associated with these drugs.

What does the script suggest as a potential solution for individuals who cannot tolerate the side effects of finasteride?

The script suggests that for individuals who cannot tolerate the side effects of finasteride, surgery (gynecomastia surgery) might be a safer and more definitive solution than trying to counteract the side effects with other drugs.

How does the script characterize the fear and paranoia surrounding finasteride's side effects?

The script characterizes the fear and paranoia surrounding finasteride's side effects as being out of proportion to the reality of the situation, emphasizing that the actual incidence of side effects is very low.

What advice does the script give regarding the use of finasteride and the fear of side effects?

The script advises that if the fear of side effects like gynecomastia is too great, individuals should consider the potential consequences of not taking finasteride, such as the impact of hair loss on their appearance and self-esteem.

Outlines

00:00

💊 Finasteride: The Solution to Male Pattern Baldness

This paragraph discusses the use of finasteride as a medication for treating male pattern baldness. It highlights the drug's effectiveness since its introduction in 1992 and addresses common misconceptions about its side effects. The speaker emphasizes that finasteride's side effects are rare, mild, and often temporary, and that fears about prolonged effects are unfounded. The paragraph also touches on societal perceptions of baldness and the importance of hair in physical attractiveness, using a British dating show example to illustrate the point. It concludes by encouraging men to consider finasteride to avoid the negative impacts of hair loss.

05:01

🤔 Debunking Finasteride Hysteria and Gynecomastia Concerns

The speaker delves into the hysteria surrounding finasteride, particularly the fear of developing gynecomastia, or male breast tissue. They clarify the difference between actual gynecomastia and pseudogynecomastia, which is fat distribution. The paragraph explains the mechanism of finasteride, its impact on hormone levels, and the extremely low incidence of gynecomastia associated with its use. The speaker cites studies and statistics to show that the risk of gynecomastia from finasteride is minimal, even at higher doses, and that most reported cases are based on anecdotal evidence rather than clinical trials.

10:02

📊 Analyzing the Incidence of Gynecomastia with Finasteride Use

This paragraph presents a detailed analysis of the incidence of gynecomastia in patients using finasteride, comparing it with another drug, dutasteride. The speaker reviews various studies, including a large one with over 14,000 patients, which reported a gynecomastia incidence of only 0.3 percent. They also discuss case reports of gynecomastia with finasteride at the standard dosage for hair loss, noting that these are rare and often resolve after treatment cessation. The paragraph emphasizes that the risk of gynecomastia is low and that fear of this side effect is disproportionate to the actual data.

15:02

🛑 Addressing Gynecomastia and Finasteride: Solutions and Perspective

The final paragraph addresses what to do if someone develops gynecomastia from finasteride, suggesting titration adjustments and the possibility of using prescription medications like aromatase inhibitors or tamoxifen. The speaker also mentions over-the-counter supplements, though they note the lack of proven effectiveness. They propose surgery as a definitive solution for gynecomastia. The paragraph concludes by urging individuals not to let fear of a rare side effect deter them from using finasteride, reminding them of the potential social consequences of hair loss and suggesting that surgery for gynecomastia is a more affordable and permanent solution than other hair restoration methods.

Keywords

💡Finasteride

Finasteride is a medication primarily used to treat male pattern baldness by inhibiting the conversion of testosterone to dihydrotestosterone (DHT), which is responsible for hair loss in men. In the video's context, it is presented as a simple pill that has been a solution for many men's hair loss problems since 1992. The script discusses the benefits and side effects of finasteride, emphasizing its effectiveness and the rarity of side effects.

💡Male Pattern Baldness

Male pattern baldness, also known as androgenetic alopecia, is a common type of hair loss in men where hair thins and falls out in a characteristic pattern. The script uses this term to describe the condition that finasteride is intended to treat, highlighting the impact of hair loss on men's self-esteem and the importance of finding a solution like finasteride.

💡Side Effects

In the context of the video, side effects refer to the potential negative impacts or unintended consequences of taking finasteride. The script mentions that while side effects are rare and often mild, they are a point of concern for some men considering the medication. It also addresses the fear-mongering around prolonged side effects, which the script argues are not medically verified.

💡Gynecomastia

Gynecomastia is a condition in which male breast tissue develops. The video discusses this as a potential, albeit rare, side effect of finasteride. It differentiates between actual gynecomastia and pseudogynecomastia (fat distribution in the chest area) and provides data on the incidence of gynecomastia in patients taking finasteride, emphasizing its rarity.

💡Titration

Titration in the context of medication refers to adjusting the dosage to achieve the desired effect while minimizing side effects. The script suggests that finasteride's effectiveness can be maintained at less than the standard dosage, implying that titration could be a strategy to mitigate potential side effects.

💡DHT (Dihydrotestosterone)

Dihydrotestosterone is a hormone that is a more potent androgen than testosterone and is considered the primary culprit for male pattern baldness. The script explains that finasteride works by suppressing the conversion of testosterone into DHT, thus helping to prevent hair loss.

💡Aromatase Pathway

The aromatase pathway is the process by which testosterone is converted into estrogen in the body. The script mentions this pathway to explain how finasteride, by reducing the conversion of testosterone to DHT, may lead to an increase in testosterone levels and subsequently a small increase in estrogen levels, which could potentially cause side effects like gynecomastia.

💡Nocebo Effect

The nocebo effect refers to the phenomenon where a person experiences negative side effects after being told that a treatment may cause them, even if the treatment is inert or not causing the side effects. The script warns against the nocebo effect, suggesting that fear and misinformation about finasteride could lead to individuals experiencing side effects due to their expectations rather than the medication itself.

💡Aromatase Inhibitors

Aromatase inhibitors are a class of drugs that reduce the amount of estrogen in the body by inhibiting the aromatase enzyme. The script briefly mentions these as a potential treatment for gynecomastia caused by finasteride, although it also notes the cardiovascular risks associated with their use.

💡Tamoxifen

Tamoxifen, also known as Nolvadex, is a selective estrogen receptor modulator (SERM) that can be used to treat certain types of breast cancer and gynecomastia. The script mentions tamoxifen as a possible treatment for gynecomastia caused by finasteride, but also notes its side effects, including hair loss.

💡Gynosurgery

Gynosurgery refers to surgical procedures to correct gynecomastia. The script suggests this as a potential solution for individuals who develop gynecomastia as a side effect of finasteride and for whom other treatments are not effective or desirable.

Highlights

Finasteride, introduced in 1992, has been a solution for male pattern baldness, offering millions of men a simple pill to combat hair loss.

For many years, finasteride was taken with minimal side effects, and even those could be mitigated through dosage adjustments.

Finasteride's side effects are generally rare, mild, and reversible upon discontinuation, contrary to common misconceptions.

The fear-mongering around prolonged side effects of finasteride is medically unverified, yet it persists among some individuals.

The societal and dating implications of baldness are highlighted, suggesting that a full head of hair is often perceived more favorably.

Gynecomastia, or male breast tissue development, is a rare side effect of finasteride, often confused with pseudogynecomastia, which is related to fat distribution.

The mechanism of finasteride involves suppressing the 5α-reductase enzyme, leading to less dihydrotestosterone (DHT) and potentially more testosterone converted to estrogen.

Clinical trials and post-marketing surveillance indicate a very low incidence of gynecomastia associated with finasteride use.

Dutasteride, another hair loss treatment, may have a higher incidence of gynecomastia compared to finasteride, suggesting the latter as a safer option.

Case reports of gynecomastia from finasteride are rare and often involve younger men, suggesting a link with higher baseline testosterone levels.

Gynecomastia caused by finasteride is typically reversible upon stopping the medication, with most cases resolving within 10 months.

The fear and paranoia around finasteride's side effects are disproportionate to the actual risks, as evidenced by the lack of a significant increase in reported cases.

There is no predictive test to determine who might be more susceptible to gynecomastia from finasteride, making it a concern for some.

Adjusting the dosage of finasteride or using prescription aromatase inhibitors may help mitigate the risk of gynecomastia.

Surgery is presented as a potential solution for those who develop gynecomastia from finasteride, offering a permanent fix.

The transcript emphasizes the importance of not letting fear of rare side effects deter the use of finasteride, which has helped many combat hair loss.

Transcripts

what's up chooms hope everybody had a

prime valentine's day this weekend with

your missus who picked

you to be your significant other largely

in part because you decided to join team

finasteride

instead of team slaphead 100 years ago

who could have imagined that a cosmetic

defect as

horridly aesthetically unappealing as

male pattern baldness

could be solved by just taking a simple

pill like finasteride

since 1992 when finasteride first hit

the market

millions of men have had their minds put

at ease knowing that they can solve all

their hair loss problems

by just taking finasteride for many

years there were no

issues with this drug at all people

would take it knowingly knowing that

there was a very small

yet acceptable risk of side effects and

even if you did get side effects you

could easily mitigate those risks

through titration

as a as it has been shown that

finasteride is effective

even at less than the standard dosage

finasteride side effects

as we all know at this point are rare

mild and will often go away on their own

with continued use

and will always go away with

discontinuation the idea that the side

effects from finasteride can be

prolonged has never been medically

verified

yet people still continue to fear monger

because it helps them cope with being

bald

miserable slap heads who have given up

on life and want to drag everybody else

down with them because remember

misery loves company slap heads will

tell you things they

know are not true like shaving your head

will make you look like jason statham

vin diesel or the rock

when the reality is you'll probably end

up looking more like that albino kid

from the movie powder

or like that guy from the wife's

boyfriend meme and even if your

aesthetics are

top tier enough that you can look good

despite being bald

chances are you still will drop several

points in the aesthetics department

since no matter how good a face may look

you need a good head of hair to frame a

handsome face

that is why even bald men who look good

would still look

better if they had a full head of hair

and that is only in the best case

scenarios

for most people the results of losing

your hair are catastrophic and

life destroying i mean just take a look

at this video from a british dating show

and bring on the boys

[Applause]

[Music]

welcome to the show sir take it away and

give it your best shots

hello lady my name is emmitt and i'm

from roscommon hey

girls that's anna from roscommon but

tell us you turned on or turned off

[Music]

[Laughter]

holy [ __ ] i don't want to be too mean

because you know i've been down that

path before i know how it feels but

you know just looking at this guy you

could tell he has other glaring problems

as well such as being weak

effeminate looking he's a manlet he's a

new male but you'll notice all the

initial criticism from the women

was aimed at this main miss man's lack

of hair

shannon lights off for you as well i'm

doing my best for you here it's just the

hair

the lack of i mean i'm sorry so as you

can see it is hair

or a lack of hair that leaves the first

impression on those who meet

and nothing leaves a worse impression

than when someone sees per a person

who has a shaved ring of hair that looks

like a toilet seat around their head

which is appropriate because in this day

of age you have got to have [ __ ] for

brains to let yourself go bald

it doesn't matter what your other merits

may be if you don't give a good first

impression

people may dismiss you outright and you

leave a terrible first impression

when you are bald so stop fearing

finasteride and

start fearing what will happen to you if

you don't take finasteride

so on that note let's talk about a

common concern many have

many men have before beginning

finasteride and that is the development

of gynecomastia

aka male breast tissue so before i get

into this i think it is important that i

distinguish between

actual gynecomastia and

pseudogynecomastia

actual gynecomastia involves the

development of breast tissue in men

whereas pseudogynecomastia is just fat

distribution to the chest area

and men who get that can solve it by

simply losing weight or maybe getting a

liposuction so

real gynecomastia can happen to men

regardless of their body composition

composition as you often see

in professional bodybuilders who get

gynecomastia even though they're

extremely

lean you'll see some female breast

tissue on them and often this is because

they use supraphysiological levels of

testosterone which can then aromatize

into estrogen

and even though this is an extreme

example of how gynecomastia can happen

in men

the mechanism behind finasteride

possibly causing this side effect

is similar even though as we'll see this

is an extremely rare side effect of

finasteride

so the level of hysteria and concern

people have over this

is way overblown but nevertheless let's

take a look at this

balls deep as we always do so the

mechanism behind finasteride is well

understood at this point

we know it suppresses the type 2 5a

reductase pathway

that converts testosterone into

dihydrotestosterone which is the trash

hormone that makes us go bald and does a

whole bunch of other really horrible

things

um anyone who denies that dht is the

primary culprit for hair loss and men

genetically predisposed to male pattern

baldness at this point

is sprouting complete bro science at a

level equivalent to what we see from the

flat earth society

or from anti-vaccination groups so as

you can see in this figure

testosterone can not only be converted

to dht but also into estrogen via the

aromatase pathway

this seems counterintuitive at first but

you have to understand

men do in fact need some estrogen in

their body for proper joint as well as

proper cardiovascular health

logically when you suppress the 5a

reductase enzyme

that will leave you with more overall

testosterone and that is why finasteride

will raise testosterone by 9 to 15

or so in most people for most of us this

isn't an issue at all

and possibly this could even be

beneficial and may explain why some

people report things like higher libido

while they take finasteride

however some of this extra testosterone

will be converted into a small

amount of estrogen via the aromatase

pathway so estrogen levels can rise

slightly as well

for most of us this is negligible and we

won't even notice it

but this could be why some people do get

side effects from finasteride such as

lower libido as well as gynecomastia

so before anyone freaks out about this

let's discuss the actual

incidence of gynecomastia on finasteride

how common is it really

well if you look at the package insert

for proscar which is the five milligram

tablet of finasteride

as opposed to propecia which is a one

milligram tablet

you can see that they looked not

specifically at gynecomastia as a side

effect

but instead they looked at the incidence

of breast enlargement and breast

tenderness

which are not necessarily equivalent to

gynecomastia in any case

they looked at about fifteen hundred

patients on proscar versus fifteen

hundred patients on placebo

and saw the breast enlargement was seen

in one point eight percent of patients

on finasteride for up to four years

versus one point one percent of patients

on placebo

the incidence of breast tenderness was

up to 0.7 percent on finasteride and 0.3

percent on placebo they also included

data from another study

of a total of about 1500 patients half

on proscar and half on placebo

and they concluded that the incidence of

gynecomastia was 2.2 percent on proscar

and 0.7 with placebo of course we

are talking about proscar here not

propecia propecia has the same active

ingredient which is finasteride

but only at one-fifth the dosage as a

proscar tablet

which has five milligrams of finasteride

whereas again a propecia has just one

milligram

so what does the package insert for

propecia actually say

well we know it has to be rare because

in the initial clinical trials which

involved

thousands of subjects there were no

reported incidences of gynecomastia at

all

in fact the package insert reads quote

in the clinical studies with propecia

the incidences for breast tenderness and

enlargement

hypersensitivity reactions and

testicular pain and finasteride treated

patients

were not different from those in

patients treated with placebo unquote

so in other words they didn't notice

anything in any of the

thousands of subjects initially studied

and keep in mind this is an fda approved

medication we're talking about here

so the standards for approval are the

most vigorous in the entire world

and require hundreds of millions of

dollars worth of research

however based on the post-marketing case

reports of gynecomastia from finasteride

and because of the incidence of

gynecomastia on proscar

breast tenderness and enlargement were

eventually added to the list of possible

adverse reactions from taking propecia

and that's why it's on the package

insert today so reports of gynecomastia

on low-dose finasteride are only based

on crace reports which are the weakest

form of

evidence as we all know as they just

involve one or two subjects so let's

look at a paper describing two such case

reports

the first case report involved a 21 year

old man with antridic alopecia

who developed gynecomastia four months

after starting treatment

and he was on the standard dose of one

milligram per day upon cessation

the gyno did not resolve even after 10

minutes off the drug

now normally i'd say any reports of

prolonged

side effects from finasteride are

completely bogus but in this case

we're talking about tissue development

so it is true that if you do get kind of

hastily from finasteride

you may need surgery to rectify this so

this young man's case

is rare but it's not completely

implausible since you can't reverse

tissue development without surgery in

most cases so

in the second case report this paper

dealt with an older individual this time

he was 65 years old

and he had andronic alopecia it wasn't

specified how severe it was but he

but he developed gynecomastia after two

months of treatment and his case was

unilateral meaning only one breast was

enlarged fortunately for him though the

side effects did dissipate after two

months off treatment

but he still had some very slight

swelling six years after stopping

treatment

and this was probably as a result of

some press breast tissue development

that never completely resolved

even after he stopped taking the drug so

he probably would need surgery as well

so in this paper they also review the

literature on gynecomastia with

finasteride

in table 1 you can see the incidence of

gynecomastia in patients treated with 5

milligrams per day of finasteride

in the largest study involving over 14

000 patients

the reported incidence of gynecomastia

was only 0.3 percent

namely 42 out of 14 722 patients

and you know i don't know about you guys

but i think i take those odds especially

when you're talking about proscar

not propecia and keep in mind the

standard dose of finasteride for

treating male pattern baldness is only

one-fifth

of what was used in these studies and

furthermore many people report success

on even

smaller doses another thing worth

pointing out was that gynecomastia was

listed as the third most common side

effect in that study

so they were accounting for all the

other reported side effects from

finasteride

so if the third most common side effect

for finasteride only affects 0.3 percent

of patients

that gives you an idea of just how rare

side effects for finasteride are in

general

even at a dose of five milligrams per

day which no men should be using for

hair loss just one milligram or less per

day is totally fine

of the other studies in this table as

you can see though the highest

incidence was 4.5 percent in a study of

9423 patients and the lowest was

0 in a study of 70 patients but again

in the largest study by far the

incidence was only 0.3 percent

they then show a table showing the

incidence of gynecomastia from using

dutasteride which is interesting

dutasteride even though it isn't as well

studied as finasteride for fighting hair

loss

especially long term is still known to

suppress more dht than finasteride so it

may possibly increase estrogen levels

more

since there will be even less

testosterone being converted into dht

and more converted by aromatase into

estrogen compared to finasteride

so if you look at the table you can see

the studies have a

similar but smaller sample size compared

to the finasteride studies

but they seem to show a higher incidence

of gynecomastia

with all the studies except for a small

study involving 68 patients showing zero

cases

which could be a classic argument as to

why having a large sample size is so

important for these kind of studies

the other studies however show an

incidence of gynecomastia ranging from 1

to

2.3 percent which is still small but

nevertheless many times as high as what

the largest finasteride study showed

so personally i think the risk of both

these drugs are

low enough to the point where you

shouldn't be concerned but if you are

really worried about gynecomastia it

would probably be safer to use

finasteride rather than dutasteride

because even though

the incidence of side effects is low

with your testosterone it's many times

lower with finasteride so

both are low but finasteride's chances

are even lower so

anyways we've looked at finasteride at

five milligrams as well as dutasteride

at 0.5 milligrams

but what about finasteride at one

milligram daily as that is the standard

dosage for angenic alopecia well

in this table here you can see that all

we have are case reports and no

large clinical trials showing gyno as a

side effect of propecia

so interestingly all these case reports

show that the gynecomastia was

unilateral meaning again

just one breast was getting gyno for

some reason the age of

onset in the subjects was mostly pretty

early on with with most of them getting

gyno as early as two to six months

with one uh case of just one case of

somebody getting it after 11 months

so if you're already on finasteride and

have been on it for like over a year

let's say

then the chances you'll get gyno seem to

be pretty null fortunately for these

subjects though it looks like most of

their gyno resolved upon stopping

treatment within

at most 10 months or so the other thing

to note is that the age of these

patients was fairly young

ranging from 18 to 29 years old with

only one patient being on the older side

at 53 years of age

now this is speculative but i think this

may have to do with younger men

having higher baseline testosterone

levels to begin with so if someone is

really young and virile

then it could be that the very small

boost in testosterone they get from

finasteride

is enough for it to aromatize to a

greater degree than if an older

individual gets it since we know that

testosterone drops a little bit as you

get older

again though i must go back to the first

table and emphasize that gynecomastia

was

only reported and 0.3 percent of

patients and a sample size of over

14 000 patients on five milligrams of

finasteride daily

not one milligram so if you are a young

man don't interpret this as a red flag

to not use finasteride

another way to look at this is that this

is just a handful of case reports

and we know that there are millions of

people on finasteride for hair loss so

again it seems the incidence of

gynecomastia on one milligram of

finasteride daily

must be exceptionally low certainly

nothing to panic over

so as you can see from the available

research

gynecomastia like all of finasteride's

reported side effects are dramatically

overblown

because people want to exaggerate their

side effects because they're trying to

sue

merck however that being said i don't

want to come across

as being completely dismissive to the

few people who do in fact get kind of

gynecomastia as a result of taking

finasteride but keep in mind there is no

underlying predictor to find out whether

or not certain people are more apt to

get kynecomastia from finasteride

compared to other people people can

develop gynecomastia during puberty for

instance but the endocrine system in an

adolescent young man still undergoing

development

is not the same as an adult suppressing

their dht through finasteride so just

because you got gyno during puberty

doesn't mean you're going to make it

worse or get it again if you take

finasteride

there are a lot of shifts in the hormone

and endocrine system

levels during puberty before the

hormones finally stabilize in adulthood

so there are a whole plethora of factors

that could cause kaino during

adolescence that wouldn't apply to an

adult taking finasteride

also you don't need blood work before

starting finasteride

if you're already a healthy individual

if you have some pre-existing

endocrinological problem like

hypogonadism

or klein klinefelter syndrome then you

might be at a greater risk but if that

were the case you'd probably already

have

other symptoms in which case you should

be speaking with an endocrinologist

to get those problems resolved to begin

with like going on trt

people who are hypogenatal will almost

always have symptoms

and to screen everyone starting

finasteride for hypogonadism would not

be cost effective

and basically would just be a big waste

of time and money and if you're already

so scared of getting gyno from

finasteride

that you feel that you need to get blood

work even though we've already

established it effects fewer than

0.3 percent of users then chances are

you're at a very high risk to give

yourself a nocebo effect

in which case you probably shouldn't use

finasteride because the last thing we

need in the hair loss community

are more people spreading fear and

misinformation about this drug there's

plenty of that already

so let's assume though the absolute

worst case scenario has happened to you

and you're one of the very few people

who get gyno from finasteride

so what can you do well the first most

obvious thing you can do

is adjust your titration finasteride

standard dose is one milligram

daily but it is common for doctors to

prescribe less than that

and at a lower frequency such as 0.5

milligrams

or 0.25 milligrams daily or every other

day

and patients still report success while

potentially mitigating side effects

being that five milligrams of

finasteride only has a 0.3 percent

chance of causing gyno

then it seems like the chances on just a

fraction of that would be

very low unfathomably oh in fact but

failing that

what else can you do well there are

prescription aromatase inhibitors you

can use like arimidex or letrazole

although these drugs aren't considered

very cardiovascular friendly

meaning they have the tendency to raise

our cholesterol levels

although keep in mind a doctor who would

prescribe you an aromatase inhibitor for

something like gyno

would probably do so at an adjusted

titration which might mitigate these

risks

although none of these drugs are

completely risk-free another drug that

could be prescribed would be something

like tamoxifen

which is also known as novodex which has

a similar outcome but different

mechanism

as it is not an aromatase inhibitor but

rather it is a serum not to be confused

with sarms

serum stands for selective estrogen

receptor modulator

which works as an estrogen receptor

antagonist in the breast tissue

unfortunately novadex isn't very side

effect-friendly either

and one of its reported side effects is

even hair loss which kind of defeats the

purpose of using finasteride to begin

with

so there are also numerous

over-the-counter dietary supplements and

purported natural aromatase inhibitors

but none of these have been proven

effective so if you are an individual

who gets gynecomastia from finasteride

i think the best solution would be to

opt for something like

surgery gynosurgery isn't super

expensive

and you can ask the doctor remove the

gland altogether so that you'll never be

at risk for gynecomastia ever again

frankly i think that is a safer option

than trying to counter one drug side

effects

with another drug especially something

like tamoxifen or arimadex

you know nobody wants to spend a few

thousand dollars for a surgery but

gynosurgery is still cheaper than a hair

transplant

so for some reason you can't get around

the gynoside effects

i think surgery is a good idea so

anyways i don't think there really is

anything more to talk about regarding

this subject

you know gyno from finasteride we know

it's not common and the level of fear

and paranoia

people feel about this extremely rare

side effect is

way out of proportion to reality you

know gyno is rare

it is reversible with surgery and if the

extremely low odds of getting gyno are

still too great for you

just remember what happened to this guy

and ask yourself is that who i want to

be

nadine what happened he kind of looks a

bit old and he's baldy like me da

and no okay

okay folks till next time take care