Finasteride: Uses, Benefits, and Side Effects

Published February 1st, 2021 by Erik Rivera
Fact Checked by
Camille Freking
Updated Date: Mar 10th, 2021

Two of the most common conditions affecting men as they age are benign prostatic hyperplasia (BPH), or enlarged prostate, and androgenetic alopecia, also known as male pattern baldness.  

Benign prostatic hyperplasia is a medical condition that can cause uncomfortable urinary symptoms and sexual dysfunction. Benign prostatic hyperplasia is estimated to affect approximately 50 percent of all men between the ages of 51 and 60 and an estimated 90 percent of men over the age of 80. The symptoms typically worsen with age and are known to be inconvenient and embarrassing. 

Male pattern baldness is estimated to cause up to 95 percent of hair loss in men, according to the American Hair Loss Association. Male pattern baldness is a hereditary condition that is typically characterized by a receding hairline, lack of new hair growth, and thinning hair on the crown of the head. Although many men experience male pattern baldness as they age, hair loss can start as early as the teenage years. Men who are prone to male pattern baldness have about a 25 percent chance of experiencing significant hair loss before the age of 21 and a 67 percent chance of losing their hair by the age of 35. By 50 years of age, 85 percent of men who are prone to male pattern baldness will have experienced significant hair loss. Despite how common the condition is, many men with male pattern baldness are embarrassed about their hair loss and seek out treatment options to help promote hair regrowth.

Finasteride is a prescription medication that is FDA-approved for the treatment of male pattern hair loss and benign prostatic hyperplasia. To help you understand if finasteride might be right for you, we’ll discuss finasteride uses, benefits, and side effects. 

Finasteride Uses

Finasteride is a generic prescription medication that is available in the form of an oral tablet. The medication is used for the treatment of benign prostatic hyperplasia and male pattern baldness. When sold under the brand name Proscar, finasteride is used for the treatment of benign prostatic hyperplasia, while the brand name Propecia is intended to treat hair loss caused by male pattern baldness.

Because benign prostatic hyperplasia and male pattern baldness are so commonly experienced by men as they age, many men will experience both conditions simultaneously and can treat both conditions with one medication. Finasteride was originally developed for the treatment of an enlarged prostate gland, but during clinical trials, many of the study participants treated with finasteride who were experiencing male pattern hair loss found that their hair loss stopped and new hair began growing in as a side effect of the medication. Since then, many more studies have confirmed that finasteride is an effective treatment for male pattern baldness.

How Finasteride Works

Finasteride belongs to a class of drugs called 5-alpha-reductase inhibitors, which also includes Avodart (dutasteride). Medications in this class diminish the activity of 5α-reductase, an enzyme that is used by the body for the conversion of testosterone into a hormone called androgen dihydrotestosterone (DHT). 

DHT is responsible for a number of different effects on the body. As men age, the amount of DHT in their bodies typically increases. When this occurs, rising levels of DHT in the scalp cause the hair follicles to shrink, which pushes out existing hair and prevents new hair from growing in. When DHT levels rise in the body, the prostate becomes enlarged and begins to cause the urinary symptoms commonly associated with benign prostatic hyperplasia. 

Lowering the levels of DHT in the body with the use of medications like finasteride is currently the only clinically proven way to reduce hair loss caused by male pattern baldness and reduce the size of the prostate. Finasteride has been found to lower the amount of DHT in the scalp by up to 60 percent, and often works well when paired with minoxidil and hair regrowth shampoo to tackle MPB from multiple angles.

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Finasteride Benefits

Finasteride is associated with numerous benefits for use. The medication is inexpensive and costs approximately 30 dollars for a monthly prescription of 1 mg tablets (the dosing typically prescribed for hair loss) and approximately 10 dollars per month for a monthly prescription of 5 mg tablets (the dose typically prescribed for treatment of benign prostatic hyperplasia).

Finasteride is associated with physical benefits associated with the treatment of benign prostatic hyperplasia and male pattern baldness. Depending on which condition is being treated with finasteride, patients may experience the following physical benefits:

  • Reduced urge to urinate
  • Decreased nighttime urination
  • Increased ability to empty the bladder
  • Improved urine flow
  • Stopping of hair loss
  • Hair regrowth

Finasteride is well tolerated by most patients and has a fairly low risk of side effects among men using the drug.

Finasteride Side Effects

The side effects caused by finasteride are the same regardless of whether the medication is being used for benign prostatic hyperplasia or male pattern baldness, but patients are more likely to experience side effects at the higher doses used for treatment of enlarged prostate. Most people tolerate finasteride well when taking the recommended dose of 1 mg per day for hair loss, but some people do experience side effects. 

Mild side effects associated with finasteride include:

  • Skin rash
  • Trouble getting or keeping an erection (erectile dysfunction)
  • Sexual side effects such as ejaculation disorder or reduced ejaculate
  • Decreased sex drive (sexual dysfunction)
  • Breast enlargement and breast tenderness to the touch

Most people adjust to the medication over the course of several days or weeks and find that their side effects diminish or disappear as their bodies adapt to the lower levels of DHT. 

However, some patients may experience severe side effects or side effects that last for a prolonged period of time. If this occurs, it’s important to consult with your doctor about your options. 

Some patients may stop taking the medication due to the side effects they experience. In most cases, side effects associated with finasteride, especially those related to sexual function, will subside with discontinuation of the medication. However, some patients may continue to experience these side effects after stopping their use of the drug. 

Most of the side effects associated with finasteride are mild, but in rare cases, they can be serious and potentially life threatening. Patients experiencing any of the following side effects should contact a doctor right away and should contact 911 if their symptoms feel life threatening.

  • Nipple discharge
  • Swelling of your lips, tongue, throat, or face
  • Depression
  • Lumps or pain in your breasts

Finasteride decreases prostate-specific antigen (PSA) by half during the first year of use. This reduction in PSA levels can make it harder to detect high-grade prostate cancer as part of routine cancer prevention screenings. Those with an increased risk of high-grade prostate cancer should discuss whether finasteride is right for them with their healthcare provider. Men who have had prostate cancer or breast cancer or who currently have prostate cancer or breast cancer should not use finasteride, and the medication is not recommended for use in women. You should additionally seek medical advice if you're worried about drug interactions between finasteride tablets and other over-the-counter or prescription drugs you may be taking, or if you're experiencing an allergic reaction such as hives.  

Finasteride Effectiveness

Finasteride was first developed for the treatment of benign prostatic hyperplasia, and numerous studies have confirmed its effectiveness. 

Studies examining the effectiveness of finasteride for the treatment of benign prostatic hyperplasia typically treat study participants with a dose of 5 mg of the medication. A literature review of available studies found that treatment at this dose with finasteride reduces prostate volume by more than 20 percent when used on its own for the treatment of benign prostatic hyperplasia. The combination of finasteride with other medications for the treatment of enlarged prostate may reduce prostate size by an even greater amount, but more research is needed. 

Finasteride is also effective for the treatment of male pattern baldness despite originally being developed for a different purpose. In fact, finasteride is the only prescription medication approved by the Food and Drug Administration (FDA) for the treatment of hair loss. 

Finasteride is clinically proven to be effective in stopping hair loss and encouraging hair regrowth in men suffering from male pattern baldness, as confirmed by numerous studies. These studies typically treat participants with a dose of 1 mg of finasteride per day. One of  the most significant studies, conducted in 1999, concluded that taking  this dose of finasteride once per day promoted the growth of new hair in approximately 48 percent of study participants in one year and up to 66 percent in two years. After two years, 83 percent of participants receiving finasteride showed no further hair loss compared to 28 percent of those receiving the placebo.  

Summary

Finasteride is used for the treatment of benign prostatic hyperplasia and male pattern baldness in adult men. Depending on which medical condition is being treated with the medication, finasteride provides numerous benefits, including a low cost, reduced urinary symptoms, reduction in hair loss, and promotion of hair regrowth. Most men tolerate the medication well, and few have serious side effects. 

Both brand name and generic forms of finasteride are available, and you can purchase the medication at any pharmacy with a doctor’s prescription.

Sources:
https://pubmed.ncbi.nlm.nih.gov/11050579/ 
https://pubmed.ncbi.nlm.nih.gov/29464847/ 
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5803857/ 
https://www.webmd.com/skin-problems-and-treatments/hair-loss/hair-loss-treatments-men#1 
https://pubmed.ncbi.nlm.nih.gov/9951956/ 
https://www.healthline.com/health/finasteride-oral-tablet#side-effects 
https://www.americanhairloss.org/men_hair_loss/introduction.htm

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