Finasteride, known by brand name Propecia,  was originally used to treat enlarged prostate glands due to its ability to work as a type-II alpha reductase inhibitor.

The milligram dosage for enlarged prostate hovers around 5 mg. For hair growth, the dosage can be decreased to 1 mg.  Finasteride works by decreasing the conversion of testosterone to DHT.  Since DHT is found in the hair follicles it can help decrease their miniaturization.   Side effects often cease after 6 months, but there are some patients with permanent sequelae.  The generic medication comes in 5mg and a pill cutter can be used to cut the pill.  It will be just as effective as the 1mg.

Most patients will experience shedding for the first 3 months.  It is important to not stop the medication if shedding occurs.  Finasteride takes 1 year to see the results.

Propecia or finasteride found on the internet or made outside the US are not recommended.  There are many examples of patients receiving medications from outside countries with severe adverse side effects.

Side Effects

  • Occur in less than 2% of population
  • Decreased libido
  • Erectile Dysfunction
  • Decreased ejaculate
  • Breast engorgement and tenderness
  • Decreased male fertility

FAQs

Can women take Finasteride?

Women should not take finasteride.  It has not shown to be effective for women in several studies.  Furthermore, finasteride can lead to anatomical defects in fetus (a condition called hypospadias). In postmenopausal women,  it has shown to not help with hair loss.

Does finasteride increase rate of prostate cancer?

Finasteride decreases size of prostate and therefore will make it more difficult to detect prostate cancer. It does not increase incidence of prostate cancer.

Does taking finasteride with Rogaine (minoxidil) work better?

Yes, the two medications can work in synergy.

Do  I have to take Finasteride daily? 

Some patients will half dose Finasteride and take a dose every other day to decrease chance of side effects.  In our office, we prefer full potency and recommend the use of 82F to allow for penetration of the product topically with minimal side effects.

Does Finasteride permanently affect my hormones?

There have been select cases of patients with permanent dysfunction and patients should take the medication with the risks and rewards planned.

Can I take Finasteride if I am planning to have a baby?

Finasteride is an absolute contraindication for women, plus it doesn’t work for hair loss for women.  For men, decreased ejaculate load and potential for side effects should have men waiting until after their significant other is pregnant to start.  Finasteride can reduce spermatogenesis.

Can I have gynecomastia as a result of this treatment?

About 2% of men taking oral finasteride will develop gynecomastia.  The incidence of male breast cancer rises about 200x based out of one study by Dr. Khera.  Preliminary evidence suggests that the rise in breast cancer is low despite this report.

Does Dr. Shah or Dr. Chughtai prescribe this medication?

Both prescribe the medication.  Dr. Chughtai specializes in hormonal medicine and can do further testing in select patients.