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Girls just wanna have fun, ya know? We want to get in the guys’ club, too, and enjoy the same perks. One club we don’t want to be a part of? The balding club. But 50 percent of women will experience female pattern hair loss in their lifetime.
If you think you might be experiencing hair thinning, you can learn more about the signs of female pattern baldness in our guide. But if you know you are losing hair, you’re in the right place to find out what you can do to treat it.
There are several hair loss treatments available, finasteride being one of them.
But is it right for you? Read on to learn more about what finasteride is used for, if women can use finasteride and how it works.
Commonly sold under the brand name Propecia®, finasteride is a medication often prescribed for treating male pattern baldness.
How does finasteride work? This selective 5-alpha reductase inhibitor decreases the conversion of testosterone into the hormone dihydrotestosterone (DHT). Some people are more sensitive to DHT than others.
We know what you’re thinking: Why does DHT matter for hair loss? DHT is thought to bind to receptors in your scalp. In turn, it prevents hair follicles from producing new hairs, resulting in hair thinning or overall balding. The relationship between DHT and male pattern baldness is clearly linked, but the connection is a little murkier with female pattern hair loss (FPHL).
While finasteride has been well-studied for male pattern baldness, there isn’t as much research on females. Due to its potential teratogenic effects, clinical studies on the use of finasteride for FPHL are limited.
So we can’t yet confidently state whether or not finasteride is completely safe for women to use. But studies have shown that women have used finasteride with success, as you can see from some findings below.
Data on 3,500 women with androgenetic alopecia treated with 1.25 milligrams of oral finasteride showed a significant increase in hair thickness over a three-year period.
A review of 65 studies involving finasteride use in women published between January 1997 and July 2017 concluded that it may improve hair loss in women with female pattern hair loss or frontal fibrosing alopecia. Doses of oral finasteride ranged from 0.5 to 5 milligrams per day in females aged 6 to 88 over a duration of six to 12 months.
Another study tested the efficacy and safety of a 5-milligram dosage of finasteride in normoandrogenic postmenopausal women. Though the study was only done on 40 women, they were monitored for 18 months. More than half of participants saw significant improvements in hair regrowth, while another third showed moderate improvement.
The dosage of finasteride for female pattern hair loss can vary, as noted in these studies.
In one small study, 37 premenopausal women took a 2.5-milligram oral dose of finasteride daily for a year. Sixty-two percent of the women saw some improvements in hair loss and hair density. But there’s one caveat: These women also took birth control pills (since finasteride is classified as a teratogenic), making it tough to solely attribute the hair growth to finasteride.
This is where we’re going to note that dosage may play a really critical role in the results you’ll see.
Another one-year, double-blind, placebo-controlled study tested 137 postmenopausal women with androgenetic alopecia, giving them a placebo or 1 milligram daily of finasteride. After one year, there was no significant difference between the placebo group and the finasteride group. Looking at these findings, it seems like higher doses might be more effective.
Our article on the side effects of finasteride in women is a great resource to learn more about finasteride.
Luckily, we now also have topical finasteride. It could be a safer option for some women and has shown promise in preliminary research. A 2020 review of 33 scientific articles published in the Journal of Dermatological Treatment concluded that topical finasteride “showed positive results with a favorable safety profile,” and the authors called for further research.
The findings are pretty promising, but more trials need to be done for further evidence.
It’s important to remember there are various factors at play when it comes to hair loss. So how finasteride specifically affects you and your hair count will really depend on your medical condition, genetics, lifestyle and other factors.
Right now, finasteride is only approved by the FDA for use in men. However, thanks to the emergence of topical finasteride, there’s hope for women looking for the benefits of finasteride.
Some preliminary research suggests that topical finasteride may be safe for use in women. But due to its pregnancy rating, there haven’t been any large-scale trials.
While topical finasteride doesn’t have FDA approval, it’s gaining popularity in postmenopausal women who take it off-label for hair loss. You’ll need to speak with your healthcare provider to determine if finasteride is for you.
Finasteride is not safe during pregnancy. It’s classified as pregnancy Category X. This means it’s contraindicated in women who are or may become pregnant, as it may cause birth defects in a male fetus.
Finasteride is also prohibited in lactating women because of its potential risks in male infants, despite the unavailability of data on its excretion in human milk. We imagine it's probably pretty difficult to find folks willing to participate in a study like that, which may — at least partly — explain why data is so limited.
Finasteride can interfere with estrogen and testosterone balance, leading to a potential risk of estrogen-mediated malignant transformation. So those with a family history of breast cancer will want to look into other hair loss treatments (more on that below).
You want finasteride, but you can’t use it? If not, don’t be too bummed because other options have shown to be effective in promoting new hair growth.
Figuring out your root cause of hair loss can help determine the right course of action, no matter what’s going on up there. Dive into our guide on female hair loss to start figuring out what may be going on with your mane.
Here are some science-backed hair loss treatments to consider:
Minoxidil drops. Commonly sold under the brand name Rogaine®, topical minoxidil is the only FDA-approved medication for hair loss in women. These over-the-counter drops at 2% strength encourage your hair follicles to enter into the anagen (growth) phase of the hair growth cycle so new hairs can sprout up.
Oral minoxidil. This is a great option for someone who may not want to change up their hair styling routine or can’t tolerate topical minoxidil. In one study, 1 milligram of oral minoxidil had comparable results to 5% topical minoxidil.
Hair growth spray with finasteride. Topical finasteride and minoxidil meet in this spray. Ideal for postmenopausal hair loss, it helps reduce DHT on the scalp to activate dormant hair follicles.
Spironolactone. This once-a-day pill slows the production of DHT, which can weaken follicles and increase shedding.
Hair loss is kind of like dating. There’s no clear-cut answer for what’s right for you. Still, you continue to date around and hope to find your soul — er, hair — mate.
Finasteride could be a lucky match, but remember the following:
A topical form of finasteride may be the safest bet. Speak to your healthcare provider to find the right solution for you.
Stay in it for the long run, as studies show improvements can take up to a year.
Other hair loss treatments are also effective if finasteride isn’t right for you. From minoxidil to spironolactone, you have options.
Now you know it all — you’re a bonafide finasteride aficionado. From knowing that women can take finasteride to knowing what finasteride is used for, you’re ready for a pop quiz. Just kidding!
If you want to dive deeper, you can learn more about female pattern baldness, helpful supplements and other treatment options in our comprehensive guide.
And if you’re ready to make the next move, you can find a healthcare-recommended treatment by taking — yes— an easy quiz.
Kristin Hall is a board-certified Family Nurse Practitioner with decades of experience in clinical practice and leadership.
She has an extensive background in Family Medicine as both a front-line healthcare provider and clinical leader through her work as a primary care provider, retail health clinician and as Principal Investigator with the NIH.
Certified through the American Nurses Credentialing Center, she brings her expertise in Family Medicine into your home by helping people improve their health and actively participate in their own healthcare.
Kristin is a St. Louis native and earned her master’s degree in Nursing from St. Louis University, and is also a member of the American Academy of Nurse Practitioners. You can find Kristin on LinkedIn for more information.
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