Men's Health,
Decentralized

How Finasteride Works

Finasteride is a selective inhibitor of Type II 5α-reductase, the enzyme responsible for converting testosterone to dihydrotestosterone (DHT). DHT is the primary androgen responsible for androgenetic alopecia (male pattern hair loss).

By inhibiting this enzyme, Finasteride reduces scalp DHT levels by approximately 70%, which slows or stops the miniaturization of hair follicles.

Clinical Evidence

• 5-Year Pivotal Study (n=1,553): 90% of men taking Finasteride maintained or increased hair count compared to baseline.
• Hair Count Analysis: Average increase of 277 hairs in a 1-inch diameter circle at 5 years.
• Patient Self-Assessment: 65% of men rated their hair growth as improved after 2 years.

Optimal Usage

• Standard Dose: 1mg once daily
• Initial Results: 3-6 months for slowing of hair loss
• Visible Regrowth: 6-12 months for most patients
• Maximum Benefit: 1-2 years of continuous use

Safety Profile

Finasteride has been used by millions of men worldwide since FDA approval in 1997. Side effects are rare (less than 2% of patients) and typically resolve upon discontinuation.

How Oral Minoxidil Works

Minoxidil was originally developed as an oral antihypertensive medication. Its hair growth properties were discovered as a side effect. Oral minoxidil provides superior bioavailability and more consistent results than topical.

• Vasodilation: Opens potassium channels, increasing blood flow to hair follicles
• Growth Factor Stimulation: Upregulates VEGF and promotes angiogenesis around follicles
• Prolonged Anagen Phase: Extends the active growth phase of hair

Clinical Evidence

• 2020 Systematic Review: Oral minoxidil at 2.5-5mg daily showed significantly greater improvement vs topical 5% solution.
• Combination Therapy: 66% of men experienced visible regrowth when combined with Finasteride.
• Dose-Response: 2.5mg daily showed 85% of the efficacy of 5mg with fewer side effects.

Dosing Recommendations

• Starting Dose: 2.5mg once daily
• Initial Shedding: Normal during first 2-8 weeks
• Visible Results: 4-6 months for noticeable improvement
• Best Results: When combined with a DHT blocker

How Dutasteride Works

Dutasteride is a dual 5α-reductase inhibitor, blocking both Type I and Type II isoenzymes. This is the key difference from Finasteride, which only blocks Type II.

• Type I Enzyme: Found in sebaceous glands — blocked by Dutasteride only
• Type II Enzyme: Primary enzyme in hair follicles — blocked by both
• DHT Reduction: Dutasteride reduces serum DHT by >90% vs ~70% with Finasteride

Clinical Evidence

• ARIA Study (n=917): Dutasteride 0.5mg showed 1.5x greater hair count improvement vs Finasteride 1mg.
• Target Area Hair Count: Dutasteride increased count by 109.6 hairs/inch² vs 75.6 for Finasteride.
• Patient Satisfaction: 38% more patients rated improvement as "greatly improved" with Dutasteride.

When to Consider Dutasteride

• Finasteride Non-Responders: Men who have used Finasteride for 12+ months without results
• Aggressive Hair Loss: Rapid progression or significant loss at a young age
• Vertex (Crown) Pattern: Superior efficacy for crown hair loss

How Tadalafil Works

Tadalafil is a PDE5 inhibitor that enhances the natural erectile response to sexual stimulation. Unlike other PDE5 inhibitors, Tadalafil has a 17.5-hour half-life, providing effects for up to 36 hours.

• PDE5 Inhibition: Blocks the enzyme that breaks down cGMP, enhancing blood flow
• Extended Duration: Effects last up to 36 hours — "The Weekend Pill"
• Daily Dosing: 5mg daily maintains steady levels for continuous readiness

Clinical Evidence

• Success Rate: 81% of men achieved successful intercourse vs 35% on placebo.
• Daily Dosing Study: 67% reported "normal" erectile function on 5mg daily.
• Rapid Onset: Effects can begin as early as 16 minutes after dosing.
• Diabetes Patients: 64% success rate in men with diabetes.

Additional Benefits

• BPH Symptoms: FDA-approved to improve urinary symptoms
• Spontaneity: No need to plan — always ready
• Reduced Anxiety: Eliminates performance pressure

How Sildenafil Works

Sildenafil (Viagra) was the first PDE5 inhibitor approved for ED, revolutionizing treatment when it launched in 1998. It was discovered accidentally during angina trials.

• Mechanism: Inhibits PDE5, allowing enhanced blood flow during arousal
• Onset: Works within 30-60 minutes
• Duration: Effects last 4-6 hours
• Food Interaction: Best taken on empty stomach

Clinical Evidence

• Meta-Analysis of 130 Trials: 84% of men achieved erections sufficient for intercourse.
• First-Attempt Success: 74% success rate on the very first dose.
• All Severities: Effective in mild (89%), moderate (81%), and severe (67%) ED.
• 25+ Years: Most extensive safety data of any ED medication.

Dosing Guidelines

• Starting Dose: 50mg taken 1 hour before activity
• Dose Range: Can be adjusted to 25mg or 100mg
• Maximum Frequency: Once per day
• Age Adjustment: Men over 65 may start at 25mg