I'm 27 and slowly confronting what seems to be male pattern baldness (sped up by massive stress at age 24/25). After attempting all sorts of natural and diet based remedies I have started the propecia prescription I was given over 12 months ago. 

Knowing the sexual and hormonal side effects I really didn't want to take it but thought I would give it a try sooner rather than later while I still have a respectable head of hair and see If I would be lucky and escape the side effects.

After nearly one month of ~0.6mg per day I have noticed less libido and 'weaker' sexual performance. This is at the same time when I have finally hit my stride in life in terms of in meeting and seducing women and am bloody enjoying it as part of a process of personal growth and development. 

So the options are: Keep my hair through finasteride/propecia and try and deal with the side effects ( supplements/diet and more pills to improve sexual performance)

or 

Deal with the ego challenge of going bald before age 30 and avoid having a 'pill-based' lifestyle.

I think I have a pretty whacked bald head so that is a major disincentive to just shaving it all off.

How have other guys dealt with this ego challenge (more internally than physically) and or dealt with the choice of hair vs sex brought on by propecia?

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I started going bald around that age as well - I kept my hair buzzed (1" or 2" guard) and sported a clean shaven face. While on vacation one year I decided to take the razor to my head and was thrilled with the look - dramatic difference over just a buzzed head. I started growing a beard shortly after that and I've had this same look for over 10 years. My point in all that is to say, at least try the shaved head, and as others have suggested, maybe grow a beard as well - these are two easy options that are reversible if you find they don't work for you.

Having a shaved head can actually cause a powerful masculine kinda look You might like it. Sex is too good to give up lol 

Work on having confidence in a bald or near-bald state and err on the side of good sex my friend.  Being a confident and bald young guy will set you apart from the dozens of other guys that hit on a woman in one night.  One of my closest friends started going grey when he was a senior in high school, he embraced it, and he got laid more often than any of the rest of my buddies or myself in our bachelor years.

Sex and wigs.

It's fun, you should try it!

Thanks to all for the pretty unanimous responses. I suppose it was never really much of a choice. Yet the main challenge remains, not even in terms of accepting that you can still look manly/sexy whatever - rather that you just look different.

We spend years accepting an image of a person in our reflection and I was wondering how you can get over the shock of a different image being there as smoothly as possible?

Don't know if you have already tried it or not, but do the drastic thing, shave everything off. In the beggining you will not like it, but stick with it, try it for a month. No matter how bad you think you look, keep shaving (or buzzing) that head. You will hear various comments from the people close to you, probably most of them bad, but once the initial period is over, you will be familiar with your look, and then you can actually decide if you like it or not. I have actually seen this with a friend, he was balding at a much younger age than you, he tried to shave his head but once he did he felt weird about it and went back to semi-long hair. He tried again, and the same happened. Then he commited to it, and now he has been shaving his head for several years, being very happy and never going back to having any hair. 

And I have myself lived a familiar kind of change, I used to have very long hair for several years, then I had to cut it, and I did. I felt terrible about it, and started growing it again, but once it was quite long again I started looking at pictures. By that point I was familiar both with my long and my short hair, and I realized I actually look very better in short hair.

So, what I am trying to say, is get familiar with yourself. Try to shave it, try to have it buzzed, try long but bald, try whatever, but get familiar with it before you reject it. Hair isn't worth feeling bad or insecure about...

After reading your introduction, here's what I think; if you have to choose between sex and male pattern baldness, keep the sex and get rid of the chemicals. Shave your head; you will find your bald head looks a lot worse to you than it does to anyone else; plus you could grow a moustache and goatee or short-well trimmed beard to take attention away from your head. Also, if you are having such a successful time meeting and seducing women; the 20's and 30's are the best years you have, so breed as much as you can NOW! You won't regret it and the hair would be thinning anyway.

If it was me, I can do without hair but no way at your age could I have done without sex. 

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