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self_made_human  amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi  9mo ago (open.substack.com)   2143 thread views

Escaping the Jungles of Norwood: A Rationalist’s Guide to Male Pattern Baldness

open.substack.com

Out of enlightened self-interest, I did a deep dive into the topic of male pattern baldness, and after freshening up on my rather rusty Bayes', I decided that I'd gone to enough effort to justify a proper blog post. Here you go.

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My understanding is that this is a contested finding, but even assuming the usual relative risk of ED while actively taking finasteride (~1.5x baseline), the absolute risk is not so high that you need to run away screaming. That being said, unless my hair falls out by the fistful overnight, I would personally take my chances with minoxidil first.

I am weakly agnostic on this claim, but my primary motive was to explain that the claim by this pharma professor half a decade back was hyperbole.

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https://cks.nice.org.uk/topics/erectile-dysfunction/background-information/prevalence/

Erectile dysfunction is a very common disorder, and the incidence and prevalence increases with age [Hackett, 2018; Muneer, 2014; EAU, 2022]. The Massachusetts Male Aging Study (MMAS) in the USA, a community-based, random sample, prospective observational study of non-institutionalized men in the Boston area, used a self-administered sexual activity questionnaire, and found [Feldman, 1994]: A self-reported overall prevalence of erectile dysfunction in 52% of men aged 40–70 years. The specific prevalence for mild, moderate, and severe cases was 17.2%, 25.2%, and 9.6% respectively. The prevalence increased with increasing age (increasing three-fold between men aged 40 and 70 years).

A large German postal survey (the 'Cologne Male Survey') of men aged 30–80 years (n = 8000) reported [Braun, 2000]: A prevalence of erectile dysfunction of 19.2%. The prevalence of erectile dysfunction increased from 2.3% at 30 years to 53.4% at 80 years of age. Expert opinion in a review article

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