1.Why is there hair loss on the top of the head? Male pattern baldness, also called androgenetic alopecia, also called seborrheic alopecia, is common in men and also occurs in women, androgen-dependent autosomal dominant genetic disorder, which occurs at puberty and after puberty (20-30 years old), manifesting as progressive reduction of hair on the top of the head or crown and both temporal areas, and the hairline of the forehead will slowly be “M “M” shape, thinning and greasy hair in the hair loss area. The mechanism is: dihydrotestosterone (converted from androgens), this substance acts on the hair follicles, making them miniaturized and eventually atrophying and disappearing. 2.Hair loss is not very serious, do I need to see a doctor? Male hair loss can be divided into seven grades: (1) Grade 1-2 is mostly seen in young people aged 17-29, with less hair loss not easily noticed. (2) As shedding continues, hair loss reaches grade 3-4 at the age of 30-39, with thinning areas of little or no hair beginning to show at the top. (3) By the age of 40-49, only a few sparse hairs remain in the middle of the top and forehead, which is already level 5, and soon progresses to level 6-7. (4) Grade 6-7, commonly known as “Mediterranean”, leaves thick hair on both sides of the temporal area, around the ears and in the back of the occipital area. It seems that male pattern baldness is progressively aggravated. If we don’t pay attention to it and don’t treat it in time, the hair loss will get worse and worse, and even the hair follicles will disappear completely and can’t be regenerated. Therefore, you should seek medical attention as soon as possible to save the hair follicles in time. A research study shows that the treatment effect is very different between 1 year of hair loss and 5 years of hair loss as the baseline. 3.How to treat hair loss problem? Early treatment of hair loss is more effective. Anti-androgen treatment can not only stop hair loss, but more importantly, regenerate new hair in areas where the hair follicles have not been completely destroyed. Finasteride tablets (trade name Paulownia), an oral drug approved by the U.S. and China’s Food and Drug Administration for the treatment of male pattern baldness, decreases the concentration of dihydrotestosterone in the scalp and serum, which can stop hair follicle miniaturization. This drug is not suitable for the elderly, children and women. For female premature baldness, the anti-androgen cyproterone 100 mg daily by mouth on days 5-14 of the menstrual cycle, often in combination with ethinyl estradiol, which is 100 mg daily on days 5-25 of menstruation, or spironolactone which effectively inhibits androgenic activity and counteracts the activity of dihydrotestosterone, under medical supervision, while topical application of 2% minoxidil solution for 6 months. It can achieve close to 80% of the efficacy of the internal Paulownia. 4.How long does it take for oral medication to work for male pattern baldness? Generally speaking, it takes 3 months to stop hair loss, 6 months to grow new hair, and 1-2 years to get the best effect, if the drug is stopped, the effect may be reversed within 12 months. 5.Does taking finasteride tablets (BUPA) have any effect on sexual function? Finasteride’s mechanism of action: it reduces scalp dihydrotestosterone, not androgens, so it does not affect sexual function. A multicenter clinical study has confirmed that finasteride tablets have no significant effect on male sexual function (erectile function, ejaculation volume, total sperm per ejaculation, sperm concentration, viability and morphology, orgasm, libido, sexual intercourse satisfaction).