Hi, great article. I have an aggressive form of MPB. I am 23 year old with a NW2 hairline, diffuse thinning over the top and crown. Been on 5% Minoxidil and 2% Keto for about 9 months. Went through a period of shedding which has reduced somewhat in the last couple of months. I don’t see any appreciable increase in density anywhere but I do see plenty of thin vellus hair at my hairline. I am waiting for the 1 year mark to see the full effect of this regime. Is there like a test you can do to assess hairfall? Or do we just have to count the hair lost in the shower? Do you reckon I should start the Fin to hold on the the hair I have? Like most guys (actually a bit more than most guys seeing that I am young) I worry a lot about being in the 2% who experience disastrous sides from Fin. I do plan to check my DHT levels before I start, if I do at all, to see if I naturally have high/low DHT. That should tell me what to expect, to an extent.
Women with androgenic alopecia may consider trying prescription ketoconazole at a strength of 2 percent. This drug comes in the form of a shampoo and also goes by the name Nizoral. It’s an antifungal agent and may help reduce the body’s production of testosterone and other androgens that lead to hair loss. You can also find 1 percent strength at your local pharmacy, but it may not be as effective.

Since birth control pills decrease the production of ovarian androgens, they can be used to treat women's androgenetic alopecia. Keep in mind, however, that the same cautions must be followed whether a woman takes contraceptive pills solely to prevent contraception or to treat female pattern baldness. For example, smokers age 35 and older who take the Pill are at higher risk for blood clots and other serious conditions.
Thanks for your response and awesome article! Do you recommend sticking with minoxidil for a period of time (i.e. 6 months) before starting finasteride or do it all at once? I would be on finasteride now if I wasn’t nervous about the potential side effects so my plan was to wait to see if minoxidal does anything for me over the next 3 months or so (at that point I will have been on it ~ 6 months). My shedding has certainly reduced so hopefully it is starting to work. I’m in the very early stages of hair loss. No one would notice (except me and my wife). Just looks my hair part on the top of my head even though it really is thinning.
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Minoxidil (Rogaine, generic versions). This drug was introduced as a treatment for high blood pressure, but people who took it noticed that they were growing hair in places where they had lost it. Research confirmed that a 2% solution of minoxidil applied directly to the scalp could stimulate hair growth. How it works is still not clear. Two double-blind studies of women ages 18 to 45 demonstrated its effectiveness. In one study, 13% of female minoxidil users had moderate hair growth, and 50%, minimal growth (compared with 6% and 33%, respectively, in the placebo group). In the second study, 60% of women in the minoxidil group reported new hair growth, compared with 40% in the placebo group. As a result of these studies and others, over-the-counter 2% minoxidil is FDA-approved for treating androgenetic alopecia in women.
Her hope is that the procedure (she has helped start a company named Rapunzel to develop it) will eventually become another lunchtime cosmetic treatment. Once a patient has had her cells harvested and cultured, they could be stored indefinitely; then, after giving her doctor a month’s notice (the time it takes to grow the million needed), she could pop in for injections. Costs would likely be on par with hair transplants, roughly $10,000 and up.
According to practitioners of traditional Chinese medicine, hair health is tied to two things: kidney energy and the blood, which nourish the hair. The solution: acupuncture and Chinese herbs. While there isn't a lot of hard science to back this up, Maureen Conant, a TCM practitioner at Full Bloom Acupuncture in Seattle, says that she's seen women's hair stop falling out and then gradually regenerate after a few months of weekly treatments.
Men taking Propecia run the risk of sexual side effects, but most experts say that it only affects a small minority. The risks are greater for women, especially those who are pregnant or may become pregnant. Experts warn that so much as handling the tablets can lead to serious birth defects. Like minoxidil, Propecia use must be continued for as long as results are desired.
Cyproterone acetate is not available in the U.S. Doctors consider it one of the last resorts for treating female pattern hair loss because of its possible toxicity and long-term side effects. As with any drug, side effects other than those listed on the package may occur. Contact your doctor if you notice a side effect that is unusual or particularly bothersome.
Thanks for the article with great info. I’ve been taking minoxidil 5% for the last 2 years. I’ve tried a generic minoxidil brand and also Kirkland to no effect. I’ve been hoping it’s maybe slowed the hair loss process. The hair around my crown just keeps getting thinner. Do you think changing to another “better quality” brand like Lipogaine or Rogaine could work? Or does it appear that any minoxidil brand is not going to work?

Thanks for the article with great info. I’ve been taking minoxidil 5% for the last 2 years. I’ve tried a generic minoxidil brand and also Kirkland to no effect. I’ve been hoping it’s maybe slowed the hair loss process. The hair around my crown just keeps getting thinner. Do you think changing to another “better quality” brand like Lipogaine or Rogaine could work? Or does it appear that any minoxidil brand is not going to work?
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