Medical Review by Jennie Stanford, MD, FAAFP, DipABOM
Summary:
- Finasteride is a 5-alpha-reductase inhibitor that effectively treats male pattern baldness and benign prostatic hyperplasia (BPH) by reducing DHT levels.
- Finasteride was developed in the 1980s. It was FDA-approved for BPH in 1992 and for hair loss in 1997.
- The benefits of finasteride include slowing hair loss, stimulating hair regrowth, reducing prostate size, and improving urinary symptoms.
- Common side effects include decreased libido, erectile dysfunction, and ejaculation disorders. These are usually reversible when the use of finasteride is discontinued.
- Typical finasteride dosages are 1 mg daily for hair loss or 5 mg daily for BPH. Consistent, long-term use is vital for effectiveness.
- Always consult with a healthcare professional when taking finasteride for any reason or length of time.
Finasteride guide: what is finasteride?
Finasteride is well-known as an effective treatment for male pattern baldness. Originally approved for managing prostate enlargement, this medication’s ability to prevent hair loss and even promote hair regrowth in some men has made it a popular solution.
Our US-based medical team at Lemonaid Health can provide online consultations, personalized advice, and prescriptions for people wondering about finasteride. Below, we go into detail about finasteride’s uses, benefits, and possible side effects so that you can make informed choices about whether or not to use it.
Introduction to finasteride
Finasteride belongs to a class of medications called synthetic 5-alpha-reductase inhibitors. These medications block the action of an enzyme called 5-alpha-reductase, which is responsible for converting testosterone into dihydrotestosterone (DHT).
DHT is an androgen that plays a key role in the development of male pattern baldness and the enlargement of the prostate gland. By helping to prevent this conversion, finasteride lowers DHT levels in the scalp and prostate, which helps reduce hair loss and symptoms of benign prostatic hyperplasia (BPH).
A quick history of finasteride
Finasteride was developed by the pharmaceutical company Merck & Co., and it has had a notable history in the years since. Here are a few of the highlights:
- 1992: The U.S. Food and Drug Administration (FDA) approves finasteride (marketed as Proscar) for the treatment of BPH.
- 1997: After clinical trials showing its efficacy in treating male pattern baldness, finasteride is FDA-approved under the brand name Propecia for this new purpose.
- 2000s onwards: Finasteride becomes increasingly popular for its use in preventing hair loss, leading to extensive research into its long-term safety and efficacy.
Uses of finasteride
The two FDA-approved uses of finasteride are for treating male pattern baldness (androgenetic alopecia) and benign prostatic hyperplasia (BPH), commonly known as prostate enlargement.
In both cases, the medication works by helping to prevent the conversion of testosterone to DHT.
Male pattern baldness (androgenetic alopecia)
This condition is largely driven by DHT, which shrinks hair follicles and shortens the hair growth cycle, leading to thinner and shorter hair strands.
By inhibiting the formation of DHT, finasteride effectively slows down this process and can halt the progression of hair loss. In many cases, it can not only prevent further hair loss but also stimulate regrowth, particularly on your crown and in the middle of your scalp.
Benign prostatic hyperplasia (BPH)
BPH is a condition that becomes more likely as you get older, where the enlargement of your prostate gland leads to discomfort and complications when urinating.
By lowering DHT levels, finasteride can help decrease the size of your prostate, which in turn helps to reduce urinary symptoms—like difficulty when starting to urinate, a weak urine stream, and the need to urinate frequently or urgently.
Regularly taking finasteride for BPH can significantly improve these symptoms, making urination easier and reducing your likelihood of needing surgical intervention.
Key benefits of finasteride
- Hair loss prevention and regrowth: Particularly effective in slowing down male pattern baldness, finasteride can also stimulate hair regrowth in some men (see above).
- Prostate size reduction: If you have BPH, finasteride can significantly reduce the size of your prostate gland, which can help make urination easier and more comfortable (see above).
- Long-term efficacy: Continuously using finasteride can maintain its benefits for both hair loss and prostate health over several years.
- Low dosage effectiveness: For hair loss treatment, a lower dose of Finasteride is often effective. This may also make side effects less likely (see below).
Common side effects
Finasteride is generally well-tolerated, but like all medications, it can cause side effects due to the way it changes the hormones produced by your body. Some of the most common ones include sexual side effects:
- Decreased libido
- Erectile dysfunction
- Ejaculation disorders
Some research also suggests that these side effects may persist after discontinuing the medication (commonly called post-finasteride syndrome). It is important to discuss the potential side effects of finasteride in detail with your healthcare provider before starting this medication so that you understand the risks and benefits.
Taking Viagra® (sildenafil) may also help if you’re experiencing sexual side effects from finasteride. Learn more about Viagra® here.
Less common side effects
Another set of concerns revolves around less common side effects like these breast conditions:
- Breast tenderness
- Breast enlargement
These reactions are relatively rare but important to monitor. Breast tenderness, in particular, can be uncomfortable and distressing.
Serious side effects & precautions
While rare, there are some serious side effects and precautions associated with finasteride use. Be aware of the following if you are considering taking finasteride:
- Some users have reported depression and mood changes. If you are taking finasteride, report any mood changes to your healthcare provider.
- Post-finasteride syndrome can sometimes show up in less common ways that include skin rashes, itching, hives, and swelling of the lips or face. Seek immediate medical attention if these symptoms occur.
- Women—particularly pregnant women—should also avoid contact with finasteride. The medication can be absorbed through the skin and may cause birth defects in a male fetus. If you are a woman who is pregnant or may become pregnant, do not handle crushed or broken finasteride tablets.
Who should not take finasteride?
Finasteride is not right for everybody. If you fall into one of the following categories, your healthcare provider may not recommend or prescribe finasteride for you:
- People who are hypersensitive to any of the ingredients in finasteride
- Children
- Pregnant women or women of childbearing age
If you have a personal or family history of prostate cancer, you should also approach finasteride with caution, since it can affect certain antigens that are used to screen for prostate cancer and make accurate screening more difficult.
As with any medication, the decision to use finasteride should only be made in consultation with your healthcare provider. Talk to a qualified healthcare practitioner about any medications or supplements you are taking beforehand to avoid potential interactions, and use finasteride only as directed.
Dosage & Administration
Recommended doses
Finasteride’s effectiveness largely depends on the dosage you take. This will vary depending on why you’re taking the medication, but here are the typical dosages:
- For treating hair loss, the standard dosage is 1 mg per day.
- For managing BPH, a higher dose of 5 mg per day is recommended.
Consistent Daily Use & Duration
The success of finasteride treatment hinges on regular, daily intake and the duration of your treatment.
- You may experience initial benefits in as little as a few months, but it typically takes 6 months to a year for full effects.
- Ongoing use is essential to maintain benefits. Always consult with a healthcare provider before changing or stopping the medication.
Learn More about Finasteride from Lemonaid Health
Finasteride has proven benefits for men struggling with hair loss or BPH, but it also has potential side effects. For this reason, it’s essential to consult a healthcare provider before using finasteride and only take it under their supervision. Only a qualified medical professional can help you determine what amount of finasteride (if any) is right for you and ensure you have the best possible experience.Lemonaid Health’s US-based team of experts can provide online consultations and personalized recommendations based on your individual health history, along with prescriptions for finasteride if it is clinically indicated. Get started with us today.
