October 5, 2010

About Finasteride

A week on Finasteride, and no unpleasant side effects. The nice thing about Finasteride is that it's not a diuretic, nor meant for blood pressure, so the extra peeing and the possibility of dizziness are no longer there. Neither is the risk of potassium build-up.

So, I wanted to do a post about the drug, and as always, this is for general information purposes only. Never try to self medicate; always speak to your doctor and get a prescription.

Finsteride (aka Proscar, Propecia, Finast, Fincar, etc.) was first designed for men with benign prostatic hyperplasia (enlarged prostate), and a few years later was approved for male pattern baldness. Like Spironolactone, it affects the male hormones in the body which cause these concerns. But it does it in a different way.

Spiro in the body competes with androgens for spots on the androgen receptors in the body. When Spiro attaches itself to the receptors on the skin and hair follicles, the androgens can't get in there to stimulate the cells to produce dark, terminal hair.

Finasteride in the body inhibits an enzyme called 5-alpha reductase which hangs out in places like the skin and turns testosterone into the much stronger dihydrotestosterone (or DHT) which really goes to work on the androgen receptors, causing hair growth on the body (and hair loss on the scalp). So rather than block the hormones themselves, it works to prevent their conversion. But like Spiro, this is not a cure. About the same amount of women find it works as they do with Spiro, and men who have stopped taking it usually find their symptoms return.

As with most things to do with hormones, it takes months to see results. Most of the reported side effects are for men, regarding reduced sexual desire and performance. Some drug sites report that this effect is the opposite in women. However, this drug is definitely not recommended for women who are pregnant, breastfeeding, or who may become pregnant, as it can harm a male fetus. I'd heard that with Spiro, too, but they even go so far as to tell pregnant women not to handle broken or crushed Finasteride pills. People on Finasteride cannot donate blood, and as with many drugs, there is a slight chance of liver toxicity. I'm going in for a blood test to monitor that at the end of the month.

Your doctor may prescribe you 1 to 5 mg of Finasteride. I'm on 5 mg a day, and the pill is very little. And blue. Which I joke about a lot. Being on a generic brand of the medication, I only noticed a price increase of a few dollars--my insurance covers 80% of the cost of prescriptions. I was paying about $45 for a month's supply of 2 pills a day of Spiro, so a month of Finasteride would have probably been around $55 without insurance.

The endocrinologist warned me I might get a few odd looks at the pharmacy for picking up a drug well-known for "male problems," but when I dropped off the prescription order, a male pharmacist assisted me, and I didn't notice him do a double take. When I returned to pick it up, he asked if I was warned about this drug, and I assured him I had, thinking about the liver toxicity. He didn't look convinced, and said, "Pregnancy? Absolute no-no while on this." When pregnancy is that far from your mind, it kind of takes you aback. I must have looked blankly at him for several seconds before it clicked that yes, I'd been told that, too. Felt a little foolish after that.


It's not easy to find sites that discuss its use in women with hirsutism. Usually, any reference to women is in the category of female hair loss, which sometimes does go hand-in-hand with hirsutism, but isn't well discussed. Some sites say Finasteride doesn't work at all for women. That seems to be because the studies in hair loss were with post menopausal women, so their hormonal make-up would be a little different from a young woman with male pattern hair growth.

Finasteride is mentioned for women with hirsutism on the Hormone Help Center site which I've had on my sidebar for ages. I've actually just bought the doctor's book to see if it can provide anything else enlightening on my situation. (I'll be sure to post a book review.) It's also mentioned on Hirsutism.com. And a study comparing Finasteride and Flutamide in women with PCOS and idiopathic hirsutism is discussed in a paragraph on the European Journal of Endocrinology site.

But in the end, it's never going to help every woman. Let's just see what it does for me. Worth a try, isn't it?

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