How can dutasteride not work?

[Johnson40]

My case. Oral dutasteride 2mg daily and later 2.5mg for 9 months. My hair got thinner and flatter less volume slowly and no thickening whatsoever or regrowth. No itch no scalp inflammation no increase in oil on scalp. First 5 months I had severe insomnia on dutasteride that went away eventually, then I got ejaculation disorder from dutasteride sperm struggles to shoot out and get out from my penis so I know it blocked dht alot. And I also used topical dutasteride once weekly with derma stamp and sometimes twice weekly. Nothing works for me. Now I'm on a new regiment topical dutasteride daily with spironolactone and oral minoxidil 10mg daily. Once weekly derma stamp and right after apply the topicals.

What's your type of hair loss?
Typical recession? Local diffusing? How fast is it untreated? Were you diagnosed by a competent dermatologist?

 

[Johnson40]

You did not answer the last two questions.
Because if absolutely nothing work, yet you are still only NW2.5, it is entirely possible you have another conditions going on, especially if by "all over" you mean nape and sides too.

A lot of hair loss conditions can coexist, you should try to see a competent dermatologist, someone who'll examine your scalp under a microscope.

 

[Johnson40]

How long did you tried the medications by the way?

I suspect that a bunch of people who are resistant to most common treatments might have another conditions going on.
Most practicians believe that anisotrichosis and miniaturisation is almost specific to Androgenetic Alopecia, but some hair loss experts have theorized that there is an unknown conditions causing diffuse miniaturization, some believe it's alopecia areata incognita another form of AA, but it's poorly studied.

Point is, if you did not experienced ANY benefits it might be useful to start looking for other possibilities.