Skip to main content
The first month is mostly about tolerating the treatment, not judging it. On the pathways that build up over time — weight loss, hair growth and the dermatology topicals — the pattern is the same: the starting dose or strength is held low, early effects are at their most noticeable, and the assessment that decides anything comes later. Sexual health medicines are taken on demand and follow a different rhythm, and a single-course consultation such as chlamydia or emergency contraception has no first month in this sense at all.

​
How these medicines work

Weight-loss treatments. Semaglutide (Wegovy) and liraglutide (Saxenda) are GLP-1 receptor agonists. They activate GLP-1 receptors in the hypothalamic arcuate nucleus and other circumventricular regions, directly stimulating pro-opiomelanocortin (POMC) neurons and indirectly inhibiting neuropeptide Y/AgRP neurons. The net effect is reduced appetite and increased satiety. Tirzepatide (Mounjaro) is a dual GLP-1 and GIP receptor agonist, which produces additional weight loss through GIP receptor activation in the area postrema and hypothalamus. (J Clin Invest. 2026; doi:10.1172/JCI194744) Hair-growth treatments. Finasteride selectively inhibits the type 2 isoenzyme of 5α-reductase, while dutasteride inhibits both type 1 and type 2 isoenzymes — the dual inhibition produces more profound suppression of serum dihydrotestosterone (DHT). In the scalp, DHT shortens the anagen (growth) phase of hair follicles in genetically susceptible individuals. By lowering DHT concentration in the scalp, these medicines stabilise hair loss and, over many months, can allow follicular recovery. (PMID 17110217) Minoxidil acts through a different pathway. It is a prodrug: it is converted to its active form, minoxidil sulfate, by the sulfotransferase enzyme SULT1A1 in the hair follicle. The active metabolite opens ATP-sensitive potassium channels (KATP) in vascular smooth muscle, causing vasodilation, and prolongs the anagen phase of the hair cycle. Individual variation in SULT1A1 activity may account for differences in response. (PMID 31184104; PMID 24283387) Sexual health treatments. Sildenafil, tadalafil, vardenafil and avanafil are PDE5 inhibitors. They block the breakdown of cGMP in the corpus cavernosum, amplifying the natural NO–cGMP signal that relaxes penile smooth muscle during sexual stimulation. None of these medicines creates desire or works without stimulation.

​
Before anything starts

An EU-licensed doctor reads your questionnaire and answers within 24 hours. If the doctor decides it is not safe to prescribe, the consultation fee is refunded in full — see pricing. Follow-up happens in the private chat inside your account, under GDPR. No WhatsApp, no SMS. That thread is where you report anything unexpected.

​
Weight-loss treatment

The first four weeks follow the same order for everyone, whichever pen you are on.
1

Weeks 1–4 — the starting dose is held

The published schedules keep the lowest dose for the first four weeks and do not increase during that period: 0.25 mg once weekly for Wegovy, 2.5 mg once weekly for Mounjaro. Saxenda is the exception — it is a daily pen and steps up week by week from 0.6 mg.
2

Early side effects arrive first, benefit arrives second

Nausea is very common in the first weeks and usually improves within 1–2 weeks. Some people feel tired in the first weeks; this usually passes. See side effects of weight-loss medicines.
3

Reduced appetite, typically at 2–4 weeks

Most patients notice reduced appetite within 2–4 weeks. Effects build gradually and vary from person to person.
4

The real assessment is at 3 months

Weight loss is assessed at 3 months. A loss of 5% or more of your starting weight is considered a good response. The doctor reviews progress and adjusts the plan as needed, and reassesses every 3 months thereafter.
The medicine is prescribed alongside changes to diet and activity, as part of a medically supervised plan — not on its own. Semaglutide is not a substitute for lifestyle change, and neither is anything else in this group.

​
Hair-growth treatment

Month one is the quietest month. Nothing visible is supposed to have happened yet.
Daily 1 mg; changes build silently. In the first 3–6 months you may notice shedding. Hair stabilisation and visible regrowth become noticeable for many patients between 6 and 12 months. Consistent daily use for 6–12 months is needed before judging effectiveness.
Some people experience a temporary increase in shedding. New hair growth becomes visible around 3–6 months and may look thin or fuzzy at first; maximum visible results come at 6–12 months. Topical minoxidil is reviewed after at least 4 months.
One capsule daily. Early changes may be subtle, and temporary shedding does not by itself show whether treatment will help. Hair-loss use is off-label in the EU.
Photographs taken in the same light are more useful than day-to-day checking. Do not increase a dose to speed results. Full detail in side effects of hair-loss medicines.

​
Sexual health treatment

These are on-demand medicines, so the first month is a series of individual attempts rather than a build-up.
  • Sildenafil acts in 30–60 minutes and lasts around 4–6 hours. If the first dose does not work well, the doctor may adjust the strength.
  • Tadalafil has an effect window of up to 36 hours; the low daily dose reaches a steady effect in a few days.
  • Never more than one dose in 24 hours, for any of them.
  • Record dose, timing, food, stimulation, response and side effects. Do not increase the dose yourself after one unsuccessful attempt — message the doctor to adjust the regimen.
Sexual stimulation is still required. These medicines do not create desire.

​
Dermatology treatment

Dermatology at Hi-Doctor is topical only — creams and gels applied to the skin. The first month is about letting your skin get used to the product, not about watching it clear.
  • Retinoids such as tretinoin and adapalene irritate before they help. Dryness, flaking, redness and stinging in the first weeks are expected and are not a reason to stop. A doctor may start you on alternate nights and build up from there.
  • Acne can look worse before it looks better, while lesions that were already forming come to the surface.
  • Benzoyl peroxide bleaches fabric. Use white towels and pillowcases.
  • Tretinoin and hydroquinone both leave skin more sensitive to sunlight. Daily sun protection is part of the treatment, not an optional extra.
Do not add another active on top without asking, and do not raise the strength or the frequency yourself. If irritation breaks the skin barrier — burning, swelling or weeping — stop and message the doctor.

​
What the doctor is watching for

Report a suspected side effect through your message thread even if you are not sure the treatment caused it. Contact the medical team if a symptom prevents you eating or drinking, does not go away, or simply worries you.
For severe, sudden or unexpected symptoms, call your local emergency number or go to the nearest emergency department, then let your doctor know through your account chat. See Safety.
Related: missed or late doses · injection sites and sharps · how Hi-Doctor works

​
Start a consultation

Weight loss

Weekly pens and daily tablets for weight management.

Hair growth

Daily tablets and scalp applications.

Sexual health

On-demand and daily tablets.
This page is reference information, not medical advice and not a prescription. Whether a medicine is appropriate for you is decided by a registered doctor after reviewing your consultation.