6LETTERS

Hair loss medication might not just be a matter of hair alone.

by Senior's Know-How | May 25, 2026

At some point, hair becomes a man's pride. 

Every time you look in the mirror, the M-shape widens, 

and looking at the drain after a shower brings a sigh. 

Eventually, you end up searching: 

“Hair loss drug recommendation.” 

“Finasteride review.” 

“Dutasteride side effects.” 

And most people get a prescription within 5 minutes 

through non-face-to-face medical apps. 

It's so convenient. 

The problem is, our bodies are not that simple.

 

 

 

There are different types of hair loss

 

 

People often think of hair loss as a single condition. 

However, in reality, they are quite different. 

Representative types include:

• Alopecia areata (spot baldness)

• Telogen effluvium

• Stress-induced hair loss

• Drug-induced hair loss

• Female pattern hair loss

•  

And the most common: Androgenetic Alopecia. 

Most of what we commonly refer to as "male pattern baldness" is this androgenetic alopecia.

 

The key is DHT

 

 

At the core of androgenetic alopecia is 

DHT (Dihydrotestosterone). 

DHT is a more potent androgen converted from testosterone via the 5α-reductase enzyme. 

The problem is that in specific hair follicles on the scalp, 

this DHT makes the hair thinner and thinner.

Therefore, the core strategy of hair loss medication is simple: 

“Let's block the conversion of Testosterone → DHT.”

 

 

So the drugs that appeared are 5α-reductase inhibitors

 

 

Representative drugs are:

• Finasteride

• Dutasteride

The most widely used hair loss drug. 

Mainly inhibits 5α-reductase type II. 

It is known to reduce blood DHT levels by about 60–70%.

Dutasteride

A bit more powerful. 

Inhibits both type I and II, 

reducing DHT more comprehensively. 

Therefore, some studies suggest that its hair growth effect may be stronger. 

However, strong inhibition sometimes leads to stronger side effect controversies.

 

 

 

The issue is that it doesn't "only" touch the hair

 

 

This is where many people misunderstand. 

“Isn't hair loss medication just for hair?” 

No. 

This drug ultimately intervenes in the male hormone metabolic system itself. 

In other words, it can be linked to systems such as:

• Sexual function

• Mood

• Energy

• Autonomic nervous system

• Neurosteroids

 

 

 

Side effects actually reported

 

 

Side effects repeatedly mentioned in papers include:

• Decreased libido

• Erectile dysfunction

• Decreased ejaculatory volume

• Depressed mood

• Anxiety

• Gynecomastia (male breast enlargement)

• Fatigue

•  

For men, these are quite critical symptoms. 

Of course, they do not happen to everyone. 

Most people take it without major issues. 

However, what's important is: 

Individual variation is very large. 

Some people have no problems at all, 

while others react very sensitively.

 

 

Why does it differ from person to person?

 

 

It hasn't been completely revealed yet. 

However, so far, possibilities are being raised that factors such as:

• Baseline testosterone state

• DHT sensitivity

• Genetic differences

• Changes in neurosteroids

• Sleep

• Stress

• Depressive tendencies

•  

may have an impact. In other words, rather than simply: 

“Taking hair loss pills causes side effects vs. No it doesn't” 

It means that your original bodily state might be what's important.

Yet in reality, it is prescribed too easily

These days, through non-face-to-face medical apps:

• A few photos

• A simple questionnaire

• A 5-minute consultation

is often all it takes to get a prescription. 

Of course, it has the advantage of increasing accessibility to healthcare. 

At the same time, however, questions like these are rarely asked:

• What is the original hormone status?

• How has sleep been recently?

• What is the stress level?

• Is there already a low testosterone tendency?

• How does the body's condition change after taking it?

•  

In other words, 

we often: “Monitor hair, while failing to monitor the whole body.”

Therefore, "continuous observation" becomes more important

 

 

In fact, what matters may not be the binary choice of whether 

or not to take the medication. 

What's more important is knowing: 

“How my body is actually responding.”

For example, changes in:

• Sleep quality

• HRV (Heart Rate Variability, measured on Apple Watch, etc.)

• Fatigue level

• Vitality

• Workout recovery

• Libido changes

• Emotional changes

are things that could potentially be linked to hormonal shifts. 

And these changes might actually be better observed within long-term patterns 

rather than through a single blood test.

 

What is ultimately needed

May be "understanding hormones" beyond "hair loss treatment"

 

 

We want to protect our hair. 

Naturally. 

However, 

at the same time, the balance of the whole body is also important. 

Hair loss drugs are not simple cosmetic pills; 

they affect male hormone metabolism. 

Therefore, what will become more important in the future may not be simply taking hair loss medication, but:

• Understanding my body's rhythm

• Observing patterns of change

• Looking at the long-term balance

•  

Hair is important. 

But in the end, what's even more important is 

“How my whole body is changing.”