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Finasteride for Women: Can Women Treat Hair Loss With Off-Label Finasteride?

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Finasteride use for hair loss in women is a complicated subject. 

Basically, some recent studies are showing that there may be some benefit to using this usually-men-only medication off-label in women experiencing hair loss -- but there are a few important details and disclaimers to know about.

Below, we will outline all the details behind finasteride use in women for hair loss. Read on to learn more about the basics of Finasteride, if women can use Finasteride, the potential risks involved in Finasteride use, what the studies have shown us so far, as well as what dosages tend to be used.

What is Finasteride?

Finasteride is a medication that has been FDA-approved for use in men for both prostate enlargement and male pattern hair loss since the 1990s.

Finasteride helps with both of these seemingly dissimilar conditions due to its ability to reduce the amount of DHT in the body when taken. DHT is a hormone that is derived from some of the Testosterone in the body, and can lead to issues like an enlarged prostate or damage to the hair follicles. So, reducing the amount around can help with both of these issues.

Finasteride is not currently FDA-approved for use in children or women at all. In fact, there is a warning about making sure that women who are pregnant or hoping to be pregnant in the near future not use or even handle Finasteride medications due to the risks to a growing male fetus.

Can women use Finasteride for hair loss?

While Finasteride is not currently FDA-approved for use in women’s hair loss, or even for women for any indication, there are some doctors who have seen benefits in using Finasteride off-label.

Some doctors may opt to not consider off-label use of Finasteride in women at all, but others choose to look at the patients on a case-by-case basis to assess the risks vs benefits of treatment. 

For instance, some doctors may consider Finasteride use in women who are post-menopausal or who are strictly adherent to reliable birth control, and are made aware of the importance of not becoming pregnant during treatment. Maybe these female patients are experiencing devastating hair loss which is not responding to Minoxidil or other first-line options, and they are hoping for anything that might help.

So, technically, women can and sometimes do use Finasteride orally or topically for hair loss treatment. But, this is an off-label indication, and the doctor needs to make an informed decision on this usage and provide extra information to women about the potential risks involved.

What are the risks of using Finasteride in women?

Finasteride is considered a category X drug when it comes to use in pregnancy. This means that the risk of use during pregnancy outweighs the benefit, and that it is contraindicated in women who currently are or may become pregnant.

This classification came about due to animal studies in monkeys showing male fetus deformities from Finasteride use including penile birth defects like hypospadias.

Studies on Finasteride use in women

One of the first studies on the subject was a double-blind, placebo-controlled, randomized trial from 2000. In this study, researchers had 137 post-menopausal women take either 1mg of Finasteride by mouth or a placebo tablet every day for 1 year. However, at the end of the trial, no benefits in terms of increased hair growth or slowed hair thinning were noticed in the treatment group.

Later on, in 2004, a smaller trial was conducted with only 5 post-menopausal women that did not have signs of elevated androgen levels. These women were asked to take either 2.5mg or 5mg of oral Finasteride once daily for 18 months. Hair improvements were monitored every 6 months using patient and investigator assessments and photographs reviewed by an expert panel. At the end of the study, all 5 women showed decreased hair loss, increased hair growth, and improved hair appearance. The researchers concluded by saying that oral Finasteride in strengths of 2.5mg or more per day may be effective for female pattern hair loss in postmenopausal women without signs of hyperandrogenism. There were no reported adverse effects in this small group.

In 2006 a study was done using 37 pre-menopausal women with female pattern hair loss. These women all took 2.5mg of Finasteride by mouth once daily along with an oral contraceptive, drospirenone. The oral contraceptive was included to prevent pregnancy from occurring during Finasteride use. And, this specific birth control was chosen due to it having antiandrogenic effects (which may also provide hair benefits). The improvements were measured after 12 months using global photography and a hair density score from videodermoscopy. 62% of the women showed hair loss improvements by the end of the trial, and no adverse reactions were reported. The researchers concluded by saying that it is unclear whether the benefits are from the higher oral Finasteride strength or due to the birth control method selected.

Finasteride dosage for women’s hair loss

In the studies mentioned above, the most common dosages of oral Finasteride used in women tend to be between 1mg-5mg per day, although the higher dosages of 2.5mg-5mg seem to get better responses in the trials. It is possible that oral Finasteride strengths higher than what is normally used for hair loss in men (1mg) may be required for benefits in women.

Since Finasteride is not approved for use in women at the moment, we do not have much guidance from large-scale studies to know exactly what strengths of oral or topical formulations may be best for female hair loss treatment. 

If you are prescribed Finasteride off-label for female hair loss, your doctor will select a strength and dosage for you to the best of their ability based on the current information available, and their professional experience with the treatment.

Finasteride for women: Bottom line

Finasteride has been historically avoided for use in women due to the risk of birth defects in a male fetus. For this reason, Finasteride still should never be used in pregnant women or women who could become pregnant.

However, some doctors do use Finasteride off-label for female hair loss in women who are post-menopausal or who are on reliable forms of birth control. In these situations, the doctor takes care to explain the risks to the patient, and carefully weighs the risks vs benefits of this off-label usage before issuing the prescription.

Some studies have shown promise in Finasteride potentially being of benefit in female pattern hair loss treatment, although the strengths needed may be higher than what is normally used in men.

There is still more research to be done on this topic in order to help gather information on the best route, dosage, frequency, as well as potential side effects to be expected with use in the female population.

Strut Health topical Finasteride formulations for women

Here at Strut, our doctors are well versed in all potential treatment options for male and female pattern hair loss, including off-label indications like Finasteride for women.

If you are interested in seeing if a compounded topical hair loss medication with prescription ingredients is a good option for you, you can have a free online questionnaire and image-based consultation with our U.S. licensed doctors today. 

Our doctors will review your information and hair goals and determine if a customized formula like our Strut Women’s Hair Growth formula is a good fit for you. This formula can contain active ingredients including Minoxidil, Tretinoin, Biotin, Spironolactone, or Finasteride, if appropriate. You can get started today and complete your telemedicine consultation in under 15 minutes, or just learn more about our Strut Women’s Hair Growth Formula on our website.

If you are a good candidate for treatment, your customized formula will be shipped from a U.S. compounding pharmacy to your front door with our free shipping.

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