Finasteride and Its Side Effects: What You Need to Know
Quick Summary: Finasteride and Its Side Effects
Finasteride for Hair Loss: Originally developed for prostate enlargement, Finasteride is commonly used to treat male pattern baldness or androgenetic alopecia. By reducing DHT levels, it can slow hair loss and even stimulate regrowth.
Dosage and Administration: Finasteride is most commonly taken as a tablet, once a day at a dose of 1mg.
Side Effects in Men: Include decreased libido, erectile dysfunction, and ejaculation issues, primarily due to hormonal changes. Mood changes and a rise in liver enzymes are less common.
Side Effects in Women: Less researched, but can include hormonal imbalances and risks during pregnancy. Finasteride is not recommended for women who could become pregnant due to its teratogenic nature.
Management and Alternatives: Regular monitoring and consultations with healthcare providers are important to ensure effectiveness and safety. Alternative treatments include Minoxidil, hair transplant surgery, PRP therapy, and LLLT.
Finasteride
Finasteride is one of the most common medications prescribed for androgenic alopecia. It is mostly provided in a pill forn, but patients can also use it topically. It’s main mechanism of action is stopping the enzyme, 5-alpha-reductase, from working. This enzyme changes testosterone into another form, dihydrotestosterone (DHT). DHT is responsible for causing hair follicles to shrink and eventually stop growing back. By preventing the production of DHT, and thus reducing its level in your blood, Finasteride can effectively slow the progression of hair loss, and in some instances even encourage the regrowth of existing hair.
Think of it like this: Finasteride acts like a blocker, stopping the transformation into DHT, and helping to keep hair loss at bay.5
Finasteride Dose and Administration
The recommended dosage for hair loss is a 1 mg tablet taken daily. We advise patients to take it daily at the same time to ensure compliance. Taking Finasteride with or without food is fine.
Finasteride is commonly prescribed as a 1mg tablet once a day for patients. However, some patients we see benefit from a lower dose and this requires careful assessment. Taking it at a lower dose can reduce the risk of side effects and it is something we consult extensively on, in our clinic
Dr Vara, Co-founder and Surgeon at The treatment rooms london
Side Effects of Finasteride
As Finasteride alters the hormone DHT in your body, it has important side effects patients should be aware of.
Difficulties with erections (erectile dysfunction)
Difficulties with ejaculation
Although infrequent, some small-scale studies have indicated a potential link between Finasteride and mood changes, including depression and anxiety. Patients with liver conditions also need to be cautious, as their body might process the drug more slowly. In our experience, most patients find these side effects non-existent or mild and notice they diminish over time.
The research on finasteride’s effects in women is not as comprehensive. The main concerns for female patients, particularly those who could become pregnant, revolve around hormonal balance and the risk during pregnancy. Finasteride falls into a category of substances known as teratogens – substances that can negatively affect foetal development.
Finasteride is rarely prescribed in women as there is a risk that it could affect a developing baby should a woman become pregnant. This doesn’t mean the medication is not prescribed in women who suffer from androgenic alopecia. Under specialist supervision, and careful family planning, women who do suffer from severe androgenic alopecia, may benefit from Finasteride in helping to halt further hair loss. In clinical studies involving women taking Finasteride, the most commonly reported side effects included1:
Decreased libido
Headache
Stomach discomfort
Long-term Research on Finasteride’s Side Effects
It’s also important to be aware of additional rare risks associated with long-term Finasteride use in men. Emerging research highlights the potential for metabolic issues, such as3:
Increased blood sugar levels (hyperglycemia)
Decreased sensitivity to insulin
Higher risk of developing type 2 diabetes
Potential risk of fat buildup in the liver with prolonged use
Other Possible Organ Impacts:
Dry eyes
Changes in liver and kidney function
We advise our patients who are taking Finasteride over a long period of time that they should monitor for these side effects and consult their doctor or prescriber if they are concerned.
Managing Finasteride Side Effects and Knowing When to Stop
If you suffer from side effects whilst taking Finasteide, we advise reaching out to your Doctor immediately. In a consultation, you will want to consider the following 3 options:
Stopping Finasteride entirely
Adjusting the dose of Finasteride to alleviate side effects such as taking it 3 times a week
Switching from oral to topical form to reduce systemic side effects
Patients who do stop taking Finasteride entirely may want to consider alternative treatments such as Minoxidil, PRP or LLLT.
Minoxidil: A medication that stimulates hair growth
PRP (Platelet Rich Plasma) Therapy: Injecting platelet-rich plasma into the scalp to encourage growth
Low-Level Laser Therapy (LLLT): Stimulating hair growth using light4
Patients choosing to have hair transplant surgery who aren’t taking Finasteride because they have had side effects, will need careful counselling around long term hair loss risk and how this would need to be managed with surgery.
Conclusion
Finasteride is an effective medication in treating and preventing hair loss in androgenic alopecia. Side effects of this medication are rare and if they do occur, should be explored with the prescribing Doctor.
References
Hirshburg, J. M., Kelsey, P. A., Therrien, C. A., Gavino, A. C., & Reichenberg, J. S. (2016). Adverse Effects and Safety of 5-alpha Reductase Inhibitors (Finasteride, Dutasteride): A Systematic Review. The Journal of clinical and aesthetic dermatology, 9(7), 56–62. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5023004/
Mysore V. (2012). Finasteride and sexual side effects. Indian dermatology online journal, 3(1), 62–65. doi:10.4103/2229-5178.93496. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3481923/
Traish A. M. (2020). Health Risks Associated with Long-Term Finasteride and Dutasteride Use: It’s Time to Sound the Alarm. The world journal of men’s health, 38(3), 323–337. doi:10.5534/wjmh.200012. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7308241/
Nestor, M. S., Ablon, G., Gade, A., Han, H., & Fischer, D. L. (2021). Treatment options for androgenetic alopecia: Efficacy, side effects, compliance, financial considerations, and ethics. Journal of cosmetic dermatology, 20(12), 3759–3781. doi: 10.1111/jocd.14537. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9298335/
Finasteride’s impact on hair follicles illustrated using BioRender.com
Dr. Roshan Vara is a renowned hair transplant surgeon in London and the Co-Founder of our award winning hair transplant clinic, The Treatment Rooms London.He has over 10 years of experience in hair transplant surgery and is recognised for delivering natural-looking results through ethical, patient-centred care. He is a Full Medical Member of BAHRS and an Associate Member of ISHRS, reflecting his commitment to the highest standards in modern hair restoration.
Dr. Dilan Fernando is regarded as one of the best hair transplant surgeons in London and Co-Founder of The Treatment Rooms London. He has over 10 years of experience in hair transplant surgery and is known for his meticulous technique and commitment to ethical practice. He served on the Executive Committee of BAHRS from 2020 to 2024, helping to shape industry standards for patient safety and quality of care. Dr. Fernando personally performs each surgery, ensuring natural results built on trust and experience.
