While the world of hair loss treatments may focus primarily on men, the fact is that both men and women can and do experience hair loss for many of the same reasons.
Women are just as susceptible to hair loss due to age and other genetic factors, and while it’s more common and pronounced in men, it’s no less of a problem for women.
It’s a serious issue, then, that the treatments designed to help men with male pattern baldness are not all considered safe and effective for women.
Finasteride (sold under the brand name Propecia®) is one such treatment that doesn’t work in a safe and effective way for women, even though it’s one of the most effective and reliable options for men.
Before we get into the big question, it’s important to understand what finasteride is and why it’s so popular.
Studies have shown that finasteride treats male pattern baldness effectively. It does this by inhibiting 5 alpha-reductase — an enzyme that can prevent hair regrowth — and consequently reducing the presence of dihydrotestosterone, also known as DHT, which is a male androgen created by 5 alpha-reductase and associated with hair loss.
Experts don’t fully understand the role of DHT in hair loss, but we know that there’s a firm correlation between increased levels of DHT and male pattern baldness.
Finasteride for hair loss, when taken as an oral medication, has been shown to reduce those reductase levels by about 70 percent.
It’s considered safe and effective for use in men, with generally mild and rare side effects （note: women experience different side effects when taking Finasteride).
Hair loss treatments like finasteride might be unsafe for some women primarily because the way they work (by affecting hormones) presents certain risks for women. These medications are designed to combat hair loss, but offer potential benefits for people suffering from hirsutism (excessive body hair growth) and hypergonadism, and could be used by transgender women for their anti-androgen properties.
There’s not a lot of data currently on the safe use of finasteride for women, but there are some situations in which women should absolutely not use finasteride, and they mostly have to do with pregnancy.
Both pregnant women and expectant mothers should avoid finasteride at all costs because of the risk of adverse events like birth defects and abnormalities. Because finasteride works on a male androgen — because its process is the conversion of testosterone — there are risks that finasteride could create abnormalities in the genitalia of a male fetus, either during or before pregnancy.
Furthermore, it is unknown if children and breastfeeding parents might likewise experience some adverse effects — finasteride has not been thoroughly tested for safety on children, but we do know it has the potential to be excreted in milk.
There are fewer “known” risks for postmenopausal and non-childbearing women, but the clinical efficacy of finasteride still doesn’t offer much of a benefit in the cost-benefit analysis.
Right now, the answer to the “safety” question of finasteride for women is a very firm no. The FDA has not approved oral finasteride for use in women.
A condition called Post Finasteride Syndrome that affects men might also mean that the effects of finasteride in women might persist long after a woman has stopped using finasteride.
There’s also a question about finasteride’s efficacy in women compared to in men.
A 2000 study (one of few in existence) examined the use of finasteride to treat women with androgenic alopecia, commonly known as female pattern hair loss.
They found that a 1mg daily dose like those recommended for men did not show effectiveness — it didn’t increase hair growth or slow the progression of hair thinning in the 137 women tested.
Further studies may indeed show an effective way to employ an androgen-based treatment for female hair loss, and the progress made in research might make this current information irrelevant.
But for the time being, that’s not the case. The FDA has not approved finasteride for use in women, and in the 20+ years since the study we mentioned, there hasn’t been one refuting those findings.
Instead, women experiencing hair loss of any kind should focus on treatment options that do have some scientific support (and approval).
If you’re seeing signs of female pattern hair loss or any kind of hair loss, your first step should be seeking support from a healthcare professional.
They may recommend certain approaches to fighting that hair loss, including the following:
Hair loss in women can be caused by a variety of underlying issues, but stress, poor diet and extreme hairstyles like ponytail are all risk factors that you can do something about.
Eliminating unhealthy processed foods and managing your vitamin intake is a great way to give your hair follicles the stuff they need to perform at their best.
Focus on vitamins A, D and biotin, and wear looser hairstyles whenever possible to reduce the strain on the hair root. And if you’re seeing a lot of stress and it’s feeling unmanageable, talk to a healthcare provider about your concerns.
While finasteride isn’t your friend, medications like minoxidil show great effectiveness for women. Topical minoxidil has been shown in studies to increase total hair count and hair density when used as directed.
As a stand-in for the likes of finasteride, you might consider including a natural supplement like saw palmetto, which can reduce DHT levels. Some benefits have been explored, but experts agree more research is needed to fully understand these benefits.
Saw palmetto is often used as a shampoo ingredient, and it’s just one of many ingredients that might help with the stabilization of hair loss. Check our guide, The Best Shampoo for Women’s Hair Loss guide for more.
If the above options haven’t helped you, tools like scalp massagers and laser combs have shown modest potential in trials.
While we’d consider these tools somewhat gimmicky, they fall into a larger category of potentially useful tools that need further study.
You might also consider some natural products like rosemary oil, pumpkin seed oil, and others that, while promising, have thus far shown limited or inconclusive results.
Finasteride is not worth the unsupported chance of moderate improvement in women’s hair loss, considering the potential risks associated with its use.
Hair loss can be a serious problem for women, for their self-confidence, and for their happiness, so if you’re a woman experiencing hair loss, it’s time to do something about it.
You can start with more research — reading more about female pattern hair loss or androgenetic alopecia is a great way to explore further treatment options. Take a quick look at our guide to DHT and female hair loss if you’re not sure where to start.
But your next step should be talking with a healthcare professional and getting serious medical advice. Protecting your hair follicles from further damage is the only way to stop hair loss. Take action now.
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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