Advantages and Disadvantages of Finasteride
Overview of AGA and Finasteride
Androgenetic Alopecia (AGA), the most prevalent form of alopecia in males, affects almost 50% of them. It is brought on by hereditary factors linked to a higher rate of testosterone conversion to dihydrotestosterone (DHT) which involves type II 5α-reductase [4].
Finasteride is a medication that blocks the action of an enzyme called 5-alpha-reductase. By doing so, it reduces the conversion of testosterone into dihydrotestosterone (DHT), a hormone linked to hair loss, leading to significantly lower DHT levels in the body [5].
Types of Finasteride
1-Oral Use
Finasteride is available in both 1 mg and 5 mg oral tablet forms, each prescribed for different medical purposes. When used for hair loss, it often takes 6 to 12 months of consistent treatment to see noticeable results [7].
2-Topical Finasteride
Topical finasteride is another formulation designed to treat AGA by delivering the active ingredient directly to the scalp, while aiming to reduce systemic absorption and potential side effects [2].
Advantages of Finasteride
1-Effectiveness in Reducing Hair Loss
Finasteride has been clinically shown to slow down and even reverse male pattern hair loss by lowering levels of DHT. Many patients notice reduced shedding and improved hair density with consistent use over several months.
2-Approved by FDA and EMA
Finasteride is one of the few treatments for AGA that has been approved by both the U.S. Food and Drug Administration (FDA) and the European Medicines Agency (EMA). Its regulatory approval reflects strong clinical evidence supporting its safety and effectiveness in treating male pattern hair loss. This makes it a trusted option for patients seeking a medically validated solution.
3-Potential for Combination Therapy
Finasteride can be combined with other treatments, such as minoxidil for a more comprehensive approach to hair restoration [2].
Disadvantages of Finasteride
1-Sexual Side Effects
Some men may experience sexual side effects while taking finasteride, such as reduced libido, difficulty with erections, or a decrease in ejaculatory volume. These effects are thought to be linked to changes in hormone levels, particularly the reduced conversion of testosterone to DHT. In most cases, these symptoms are mild and may resolve after discontinuing the medication [3].
2-Hormonal Findings
Some studies suggest that finasteride may act as an endocrine disruptor, potentially interfering with the body’s natural hormone balance. It can affect the production or regulation of certain hormones, which may lead to hormonal shifts or deficiencies in some individuals [1].
3-Mood Shifts
While finasteride is generally well tolerated, some individuals have reported psychological side effects. These may include mood changes such as anxiety, depression, or decreased motivation. Emerging research continues to explore a potential link between finasteride and mood disorders, often referred to as post-finasteride syndrome. Patients experiencing changes in mood or mental health while on finasteride should speak with a medical doctor provider to determine whether continuing the medication is appropriate [6].
4-Patient Considerations
Finasteride may not be appropriate for everyone, especially individuals with certain underlying health conditions. Patients with a history of disease or hormonal sensitivities should consult a medical doctor before starting treatment. Medical evaluation is important to ensure the medication is safe and appropriate for individual use.
Conclusion
Finasteride is option for managing AGA, particularly in its early stages. Its ability to reduce DHT levels has made it one of the most widely studied and prescribed medications for slowing hair loss and preserving existing hair. However, despite its advantages, finasteride is not without limitations—ranging from potential side effects to the need for long-term, continuous use to maintain results.
For individuals seeking a more permanent solution, especially those with advanced hair loss or unsatisfactory results from medication alone, hair transplantation is a reliable alternative. Modern surgical techniques, such as Follicular Unit Extraction (FUE), provide high precision, minimal downtime, and lasting outcomes. For personalized plan and expert evaluation, we invite you to schedule a consultation at our clinic.
References
- Chen, X., Feng, H., El-kott, A.F., Abd-Ella, E.M., 2020. Origanum vulgare L. leaves extract alleviates testis and sperm damages induced by finasteride: biochemical, immunohistological and apoptosis genes based evidence. Andrologia 52 (11). https://doi.org/10.1111/and.13823.
- Lee SW, Juhasz M, Mobasher P, Ekelem C, Mesinkovska NA. A Systematic Review of Topical Finasteride in the Treatment of Androgenetic Alopecia in Men and Women. J Drugs Dermatol. 2018;17(4):457-463.
- Pereira, A.F.J.R., Coelho, T.O.A., 2020. Post-finasteride syndrome. An. Bras. Dermatol. 95 (3), 271–277. https://doi.org/10.1016/j.abd.2020.02.001.
- Randall, V.A., 2008. Androgens and hair growth. Dermatol. Ther. 21 (5), 314–328. https://doi.org/10.1111/j.1529-8019.2008.00214.x.
- Santana FFV, Lozi AA, Gonçalves RV, Da Silva J, Da Matta SLP. Comparative effects of finasteride and minoxidil on the male reproductive organs: A systematic review of in vitro and in vivo evidence. Toxicol Appl Pharmacol. 2023;478:116710. doi:10.1016/j.taap.2023.116710
- Walf AA, Kaurejo S, Frye CA. Research Brief: Self-Reports of a Constellation of Persistent Antiandrogenic, Estrogenic, Physical, and Psychological Effects of Finasteride Usage Among Men. Am J Mens Health. 2018;12(4):900-906. doi:10.1177/1557988317750989
- Zito PM, Bistas KG, Patel P, Syed K. Finasteride. In: StatPearls. Treasure Island (FL): StatPearls Publishing; February 28, 2024.
