What is Finasteride (Propecia)?

Finasteride, also commonly known as Propecia or Proscar is an anti-androgen agent used to treat benign prostatic hypertrophy (BPH), which is the enlargement of the prostate gland. It may be used with another medicine (doxazosin) to prevent worsening BPH. It is also used as a treatment for androgenic alopecia or male pattern hair loss, particularly hair loss on the vertex and the anterior mid-scalp area.

Finasteride was approved by the FDA as a treatment for male pattern hair loss in 1997. In a 5 year study, Finasteride 1mg per day was shown to benefit men with mild to moderate hair loss in a 5 year study. Finasteride may also work for some women, although women must not take it if they are pregnant and must not get pregnant while on the drug because of the risk of birth defects in a male fetus. Less than 2 percent of men experience transient sexual side effects including erectile and libido difficulties. In women these side effects do not occur.

How does Finasteride Work?


Type II 5α-reductase is an enzyme, found predominantly in the prostate gland and in hair follicles, that converts testosterone to the more potent dihydrotestosterone.6 Finasteride inhibits type II 5α-reductase, which reduces the formation of dihydrotestosterone and decreases the biological action of testosterone at target tissues.

Finasteride’s hair-raising success is due to its ability to specifically inhibit Type II 5-alpha-reductace, the enzyme that converts testosterone into a more potent androgen dihydrotestosterone (DHT). Propecia’s 1 mg dose of finasteride can effectively lower DHT levels by as much as 60% when taken daily. It is DHT that shrinks or miniaturizes the hair follicle, which eventually leads to baldness. This 60% reduction in DHT has proven to stop the progression of hair loss in 86% of men taking the drug during clinical trials. 65% of trial participants experienced what was considered a substantial increase in hair growth. At this point, the only truly effective medically proven way to arrest the hair loss process is to lower DHT levels.

Finasteride Side Effects


Before you start the treatment, read the manufacturer’s printed information leaflet from inside the pack. It will give you more information about finasteride and will provide you with a full list of the side-effects which you may experience from taking it.

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

The most frequently reported adverse reactions to Propecia affect men’s sexual health. A U.S. Food and Drug Administration (FDA) analysis of adverse event data revealed a wide range of sexual side effects in otherwise healthy Propecia users ages 21 to 46.

– Decreased Libido or reduced desire to have sex

– Erectile Dysfunction or inability to get an erection

It is worth mentioning that no clear causal links between Propecia use and sexual side effects have been established. The drug’s method of action, however, makes the connection highly plausible. Finasteride, the active ingredient in Propecia, suppresses the body’s level of DHT, an androgen hormone that plays a major role in sexuality and sexual development.

Other less common side effects of Propecia include:

– Allergic reactions, including rash, itching, hives and swelling of the lips and face.

– Depression

– Testicular pain

– Male breast cancer

If you experience any other symptoms which you think may be due to the tablets, speak with your doctor or pharmacist for further advice.

Finasteride & Women


Hair loss can be distressing for the female patient, with women being twice as likely as men to be very-to-extremely upset and up to 70% of women reporting high levels of distress over their hair loss.1,2 Although there are various types and etiologies of hair loss in women, the most common form is female pattern hair loss (sometimes called androgenetic alopecia), which is estimated to affect 21 million women in the US and accounts for more than 65% of hair loss in women.1 It can develop any time after puberty, and prevalence increases with age.

The role of finasteride in female pattern hair loss is still controversial, with reports of success and occasionally failure continuing to appear. Some women with female pattern hair loss might benefit from finasteride, although better understanding of the condition and more research into optimal finasteride dosing and who might be good candidates for treatment is needed.17,25 Doses used have ranged from 5 mg per week to 5 mg per day, over periods of 6 months to more than 2 years. Finasteride was well tolerated in the various doses used with few treatment-related adverse effects reported. The main caution is that finasteride can cause feminization of male fetuses, so pregnancy must be excluded before beginning finasteride and women of reproductive age must use effective birth control while taking finasteride.

Proper Use & Dosage

Once again, before you start the treatment, read the manufacturer’s printed information leaflet from inside the pack. It will give you more information about finasteride and will provide you with a full list of the side-effects which you may experience from taking it.
Take one (1 mg) tablet each day, exactly as your doctor tells you to. Try to take your doses at the same time of day, as this will help you to remember to take finasteride regularly.

– Swallow the tablet whole (without breaking or crushing it) with a drink of water. You can take the tablet either with or without food.

– If you forget to take a dose on time, take it when you remember.

– If you do not remember until the following day, leave out the missed dose. Do not take two doses together to make up for a forgotten dose.

– Each time you collect a new supply of tablets from your pharmacy, make sure they look to be the same as you have had before. This is because there is a high-dose brand of finasteride tablet available for the treatment of a different condition. If you are unsure that you have the correct tablets, ask your pharmacist to check for you.

– Your hair growth may start to improve within a few months, although it can take up to a year or so for you to notice the full benefit. You will need to continue treatment to maintain this effect, as the balding process returns when you stop.

Getting Finasteride

Finasteride is only available on a prescription from a doctor. It is important that you consult with your physician before taking finasteride.