Huge News: Finasteride Works for Hair Loss in Women – Yes, Women!

Dr. Sharon Orrange
Dr. Orrange is an Associate Professor of Clinical Medicine in the Division of Geriatric, Hospitalist and General Internal Medicine at the Keck School of Medicine of USC.
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It has been known for more than 15 years that Propecia (finasteride) at 1 mg/day is an effective treatment for male pattern hair loss. The huge bummer was that 12 years ago Propecia was found to be ineffective for female pattern hair loss. Well, some researchers didn’t give up on finasteride. As mentioned in my previous blog ( the trick here is that Propecia is really just finasteride, a medication that has been around forever as a generic used for benign prostatic hypertrophy at 5 mg/day. So how would finasteride 5 mg work on women with hair loss? Well, apparently really well.

These recent exciting results showed that oral finasteride at 5 mg/day proved safe and effective for the treatment of female pattern hair loss in 43 premenopausal women in an 18-month study. Treatment effectiveness was assessed in two ways: patient satisfaction and investigators’ evaluation of photographs. Women participating in this study had to be on oral contraceptives so they wouldn’t become pregnant.

Because finasteride works by blocking the conversion of testosterone to DHT (dihydrotestosterone), which decreases the amount of DHT in the body, you certainly couldn’t be on it if you were thinking about conceiving.

Did it really work? At 6 months, 58% of patients characterized their improvement as “huge” and 33% as “moderate.” What is also great is that results were stable after 12-18 months. There were a few downsides: diminished libido was reported by 8 patients out of 43, and 4 had nausea or headaches that did resolve.

The current choices for female hair loss are quite dismal—topical 2% minoxidil (Rogaine) and spironolactone pills—so the fact that this pill has been around forever and is cheap, safe, and effective . . . well that’s all good. Stay tuned.

Dr. O.

Finasteride can be found for under $10 per month, and is included in many pharmacies’ discount generic programs. Most insurance plans consider finasteride a Tier 1 medication, meaning you’ll pay only your lowest copay if it is covered.

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