Finasteride

[regan]

My therapist has referred me to a doctor solely for the purpose of taking finasteride to maintain what he calls my "great hair".  Knowing that there are two different doses of the medication, and I intend to undergo HRT once I am approved, would it be inappropriate for me to ask for the higher dose associated with HRT vs the lower anti-MPB dose, since that's my long term goal anways?

[ClaireA]

Well, it doesn't hurt to ask, does it? What's the worst that could happen? They give you the lower dose? I say suggest it and then defer to their judgment.

[Kay]

I don't think it's inappropriate to question it once the subject is out there.  Though, once you've questioned it, the onus is on you to provide the rationale/evidence to justify the larger doseage vs. any risk factors it may present.   Most of the risks are not considered negatives to trans-women (Though most men would consider them negatives), so you may have a good chance of the doctor complying with your reuqest as long as you're upfront about your future plans.
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Personally, I've been on the higher 'enlarged prostate' dosage level for almost 3 years now.  I've never used the lower doseage.  It hasn't given me any problems, but your doctor may think differently for you depending on your history/chart.  I'm divided about whether I think it's helpful.  I haven't lost any more hair...but whether that would have happened without Fin is impossible to say.  Another positive about the larger doseage is that unlike the MPB doseage, the larger doseage is usually covered by insurance.   (It's the only HRT med I take that isn't completely out-of-pocket)
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Best of Luck,
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Kay

[JennX]

Finasteride (Propecia & Proscar) is only a small part in the whole HRT regimen. A small dose is all that is needed to block DHT and maintain your hair in it's current state and perhaps help with any regrowth needed. Based on it's mechanism of action, I'd actually recommend dutasteride (Avodart) instead of finasteride, as it is more effective in blocking DHT production. A strong androgen blocker like spironolactone will do the majority of T blockage, with a small assist from either finasteride or dutasteride. So a small dosage of either is fine.

[regan]

Personally, I've been on the higher 'enlarged prostate' dosage level for almost 3 years now.  I've never used the lower doseage.  It hasn't given me any problems, but your doctor may think differently for you depending on your history/chart.  I'm divided about whether I think it's helpful.  I haven't lost any more hair...but whether that would have happened without Fin is impossible to say.  Another positive about the larger doseage is that unlike the MPB doseage, the larger doseage is usually covered by insurance.   (It's the only HRT med I take that isn't completely out-of-pocket)

My main argument to the doc so far actually is that my insurance is a pain in the butt about either dose and its going to be a big giant headache for both of us to get it covered.  Or I can get the higher dose cheaply at WalMart (of the HRT drugs I am familiar with WalMart covers them as part of their $4/$10 plan BTW, except for injectible E)  for about the same I would probably pay through my insurance anyways, and save us both the hassle.

According to my therapist, he's worked with the transgender community for 20+ years which is why I would prefer to go to him anyways as opposed to having to make up a story about MPB to my primary care doc and as I told her "just continue the lies I keep telling".