FAQ
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Finasteride is effective in treating male pattern hair loss. However, it doesn’t work for everyone as everyone’s reaction to a medication is unique.
According to the U.S. Food and Drug Administration (FDA), almost 9 in 10 men who took finasteride for 12 months reported a lower incidence of hair loss as compared to a control group who took a placebo (4 in 10).
If finasteride doesn’t work for you, it may be because:
- You do not take finasteride daily. (Continued daily use is required to sustain the benefit.)
- You have stopped taking it before the full effect has come in. (Continued daily use for at least 12 months is required to assess the full benefit.)
- You do not react to the medication
Our doctors may modify your treatment plan, depending on your reaction to the medication and any side effects.
The safety of finasteride has been well demonstrated in clinical studies. Nonetheless, <2% of men experienced some form of sexual dysfunction in the clinical trials – A small number of men experience lower sexual desire and/or difficulty in achieving/maintaining an erection. An even smaller number may have a decrease in semen volume. The sexual side effects generally resolved in men who stopped taking finasteride and in many men who continued treatment. Another medication to consider is Minoxidil.
Source:
Propecia product information. U.S. Food & Drug Administration.
Health Science Authority, Singapore
It may take up to three months before you start noticing any improvement in your hair loss. In addition, it can take up to one year to see the full benefits and to tell whether finasteride is working for you. Do not be concerned as this is expected. Also, you’ll need to keep taking finasteride to retain any benefits. When you stop taking it, your hair loss returns over the course of several months (usually 6 to 9 months).
The most common side effect is sexual dysfunction, which includes decrease in sexual desire, decreased semen volume and difficulty in achieving/maintaining an erection. A review of nine studies reported a 1.5% increase in sexual dysfunction in men taking finasteride, with the risk increasing with age. The sexual side effects usually resolve after stopping finasteride.
Rarely, some men experience breast tenderness/enlargement and sexual side effects that continued after stopping the medication.
In view of the different genetic makeup of individuals, not everyone taking finasteride would experience all the side effects. They are made known to you so you can make a better-informed decision.
While finasteride aims to block the production of DHT (DHT is a more potent male hormone than testosterone for hair loss) in hair follicles, unintentionally, it might affect the production of DHT in other parts of the body (e.g. sexual organs). It is generally believed that lower DHT contributes to the sexual side effects. Having said that, the role of “nocebo” effect (i.e. you experience a side effect because you think you might get it) has been investigated and cannot be ruled out.
Reduced conversion of testosterone to DHT by finasteride could lead to an increased conversion of testosterone to estrogen (“female” hormone), resulting in breast tenderness and enlargement in men.
If the side effects are deemed too severe, you could consider alternative forms of hair loss treatment.
If the side effects are bothering you, please speak to our doctors. You can send a message via WhatsApp to our Sire team, and our doctors would give you tailored advice or modify your treatment plan after balancing your needs and concerns.
Generally, finasteride is safe to be taken in chronic conditions (e.g. high blood pressure, high cholesterol, diabetes etc.) and does not interfere with other medications. If you have any doubt, highlight your concerns during the verification consultation via WhatsApp and our doctor will check your suitability. There are other alternative treatments that can be recommended that might suit you better.
Finasteride is generally safe to use without the need for a check-up. However, if our doctors find that your hair loss might be due to other undiagnosed conditions instead of male pattern hair loss, you may be advised to go for further screening or alternative treatments.
You should take finasteride once a day with or without food. (It is important to take the medication daily to sustain the benefit. Remember, it can take up to 1 year to see the full benefits.)
Finasteride is for use by men only. Women who are (potentially) pregnant in the same household should not handle broken or crushed tablets of finasteride as this might lead to abnormal development of the male baby.
Also, same as everything we try for the first time, you have to watch for an allergy reaction after taking finasteride, despite its rare occurrence. If you experience itchy skin rashes, swollen eyes/lips/face/tongue, and shortness of breath, please head to the nearest emergency service or call 995 immediately.
No.
No, finasteride will not work faster or better even if you take it more than once a day. Worse still, you may experience more side effects.
In general, it is safe to take finasteride for a long time. Currently, studies showed that finasteride was generally well tolerated with no new safety concerns identified during long-term use. In fact, it’s only in the longer term that you’ll see the benefits of finasteride.
Apart from medications, it is important to be gentle with your hair. Avoid using high temperature from hair dryers or curling irons and limit the tension on your hair from styles such as man bun. Also, try not to use oily hair products as they may clog your hair follicles and affect healthy hair growth. Using quality hair loss shampoo helps.
Besides, it is good to adopt a healthier lifestyle. Eat a balanced and nutritious diet. Manage your stress effectively. These could help promote your hair growth.
In general, erectile dysfunction is the result of poor blood flow to the penis, and can be caused by a combination of psychological and physical factors.
Psychological issues such as stress, anxiety, low self-esteem, relationship problems, fatigue, depression, and fear of sexual failure (i.e. “performance anxiety”) can affect your ability to hold an erection.
On the other hand, physical factors such as ageing, heart disease, diabetes mellitus, low testosterone levels, and nerve disease can also contribute to ED. These conditions affect blood flow to the penis.
In addition, poor lifestyle choices, including but are not limited to, lack of exercise, excessive alcohol intake, smoking, and obesity also have a role to play in ED. Occasionally, blood pressure medications, anti-depressants, and mood stabilizers can also affect the erection process.
Beyond medication, lifestyle changes are also key to reliable erections.
As a general rule of thumb, please do not take any medication on your own without discussing with our doctors. Without a diagnosis from licensed medical professionals, committing to wrong treatments can be harmful to you and your general health.
In Singapore, ED affects more men than we think, with over 50% of men reported to have experienced some degree of ED. Of these, around half report to have mild ED while the rest have moderate to severe ED. It was also shown that Singaporean men aged 50 and above are more likely to suffer from more severe ED.
Due to societal pressure and fear of being judged, the majority of men do not seek professional help for this highly treatable condition. Some even resort to buying “medications” from unregulated sources online and offline.
For the safety of your health, always seek advice from a licenced medical professional, and never consume medications like San Ti Niu Bian obtained from unregulated or untrusted sources.
Based on U.S. Food and Drug Administration (FDA) prescribing information, about 73% of men reported an improvement in their erections after taking sildenafil.
However, as with all other medications, individual results may vary between users because everyone’s physical response to medications may be unique to themselves only.
There are many reasons why sildenafil may not be as effective for you. Some examples include, but are not limited to, the following:
- You have not waited long enough or have waited too long to have sex after taking it.
- The dose is not high enough (Please speak to our doctors before increasing the dose).
- You are not sexually aroused enough (Sildenafil does not work without sexual stimulation).
- You do not react to the medication.
Depending on your situation, our doctors may recommend trying sildenafil multiple times under different circumstances. They may also increase your dose, depending on your reaction to the medication and the influence of any side effects. There are also other treatment methods that you could consider.
The majority of men who use sildenafil have pre-existing conditions such as heart disease and diabetes and are taking some sort of long-term medications. Do not be worried as our doctors will check your suitability for sildenafil via health survey or teleconsultation to ensure your safety. For example, if you are taking nitrate-containing medications (e.g. GTN, isosorbide mononitrate), sildenafil might not be suitable for you. There are six general options to resolve erectile dysfunction and one might suit you better.
Sildenafil is generally safe to use without the need of a check-up. However, ED may sometimes be a symptom of undiagnosed health issues, especially among men in their 30s.. Hence, we suggest that you do a health screening if you have not done one in the past two years.
What you are describing is called psychogenic ED. It means that your emotions are inhibiting your ability to get an erection.
Good news is that it can be treated with medications like sildenafil. In a review looking across 27 studies, 2/3 of men with psychogenic ED were able to have successful intercourse after using sildenafil.
However, should it persist, you can consider speaking to a sex therapist to help unlock your sexual desire.
The safety of sildenafil has been well demonstrated in its long history of use. In a review study looking across >14,000 men taking sildenafil for ED, 2-3% experienced side effects that required stopping of the medication, while <1% of men experienced serious side effects.
Also, in another study specifically looking at a subset of 60 Singaporean men with ED, sildenafil was shown to be well-tolerated – all side effects were transient/mild and did not lead to treatment withdrawal.
In short, safety concerns on sildenafil are heavily outweighed by the positive impact it can bring on the quality of life of men suffering from ED.
It generally takes 30 to 60 mins for sildenafil to work. It is effective for up to 4 hours. It is also best taken with an empty stomach. If you are hungry, having a meal low in fat (or oil) would minimize the delay. If you need something faster acting or longer lasting, consider Cialis or Spedra (known for its speed).
The common side effects of sildenafil include headache, dizziness, facial flushing, blocked nose, nausea, and stomach upset. These effects are generally transient and mild to moderate in nature. Importantly, in view of the different genetic makeup of individuals, not everyone taking sildenafil would experience all the side effects. They are made known to you so you can make a better-informed decision. You can’t get addicted to sildenafil nor will you have an unplanned erection.
While sildenafil aims to increase blood flow to the penis by widening the blood vessels, it can affect the blood flow in other parts of your body. As more blood flows to the brain, face, and nose, you can experience headache, flushing, and blocked nose (increase in mucus production). Widening of blood vessels in the body can also lower your blood pressure, which explains the possibility of dizziness with sildenafil.
There are many myths out there, but safe to say, you can’t get addicted to sildenafil nor will you have an unplanned bulge in your pants.
The common side effects (e.g. headache, dizziness, facial flushing, blocked nose, nausea, stomach upset) are generally transient and mild to moderate in nature. Most of the time, they will go away without the need of additional management.
However, if you experience anything unusual and/or bothersome, please speak to our doctors. There are five alternative options to solving your ED. Our doctors would give you tailored advice or modify your treatment plan after balancing your needs and concerns.
You should take sildenafil 30 to 60 mins before planned sexual activity on an empty stomach (high-fat meal may delay the absorption of sildenafil and slow down its effect). If you need a quicker acting or longer lasting pill, consider Cialis or Spedra (known for its speed).
If you are taking nitrate-containing medications (e.g. GTN, isosorbide mononitrate), please let our doctors know. After taking sildenafil, please ensure the safety interval (minimum 24 hours) has elapsed before taking nitrate-containing medications. Taking nitrate-containing medications within the safety interval can cause a dangerous fall in your blood pressure.
Also, same as everything we try for the first time, you have to watch for an allergy reaction after taking sildenafil, despite its rare occurrence. If you experience itchy skin rashes, swollen eyes/lips/face/tongue, and shortness of breath, please head to the nearest emergency service or call 995 immediately.
If possible, avoid grapefruit (juice) and excessive alcohol intake while taking sildenafil. Grapefruit (juice) might increase concentration of the sildenafil in your body, resulting in a higher chance of experiencing unwanted side effects. Drinking lots of alcohol may make it harder to get an erection and add on further to dizziness. Instead, here are some foods that you should consider eating to solidify your erection.
The maximum dose approved in Singapore is 100mg. Therefore, it is not recommended more than 100mg (ie. one tablet) in a day. This guide will answer all your questions about sildenafil (or Viagra).
In general, it is safe to take sildenafil as long as you do not exceed the maximum daily dose as there do not seem to be any harmful effects from taking it for many months and years. An alternative is Cialis, which is a little different from sildenafil.
In a rare occasion (<0.1%), some men experience priapism (prolonged and painful erection) with sildenafil. If your erection does not subside in 4 hours and/or the pain is worsening, please head to the nearest emergency service or call 995 immediately.
