Finasteride for Women: Can Finasteride Help For Female Pattern Hair Loss

Life gets really tough when various illnesses take a toll on a person’s body. And when the illness compromises your physical beauty, that’s when things get hard and embarrassing. Such is the Hair Loss disorder Androgenetic Alopecia. While men and women both suffer from the same problem at some point in their lives, it becomes really distressing for women as they don’t feel confident socializing with other people. Also known as Female Pattern Hair Loss (FPHL), it affects 21 million women in the US. While the symptoms of this problem are similar to male pattern hair loss, the prevalence of this disorder increases with age. 

It is completely normal to shed 50 to 100 hairs in a day. However, if a woman sheds significantly more hair a day, it may be a sign of an underlying health condition. Although the prevalence of this disorder increases with age, women in their 20s and 30s can suffer from this problem too. Up to two-thirds of postmenopausal women are likely to suffer from this disorder. Several treatment options are available that can slow down the rate of hair fall and promote hair regrowth.

There’s one surprising drug that has shown tremendous results when tested on various premenopausal and postmenopausal women. Finasteride, sold under the names Finpecia and Fincar, is an oral drug prescribed for the treatment of hair loss in men. While it hasn’t been approved for use in women, various studies suggest that it can be helpful for the treatment of female pattern baldness. But before we talk about how Finasteride can work for women with hair loss, let’s discuss a bit about Female Pattern Hair Loss and its occurrence.

What is Female Pattern Hair Loss, and How does it Occur?

Female Pattern Baldness or Female Pattern Hair Loss (FPHL) is a progressive condition that causes women to lose most of their hair gradually. Unlike men who can go completely bald, women do not lose all of their hair. Their part gets wider instead. The distinctive features of FPHL have been classified into three grades of severity known as Ludwig Grades I, II, and III.

Grade I – Minimal thinning on the crown, limited in the front by a line situated 1-3 cm behind the frontal hairline. It can be camouflaged with various hairstyling techniques.

Grade II – Reduction in the density of the hair on the crown within the area seen in Grade I.

Grade III – Full baldness within the area seen in Grades I and II.

The follicular changes seen in FPHL are somewhat similar to male pattern hair loss. However, the distribution of hair loss is different. While men experience central thinning with a frontal and temporal recession, known as Hamilton Patterns, women experience diffuse central thinning with preservation of the frontal hairline, or hair thinning that is prominent at the front, known as Ludwig Patterns and Christmas Tree Patterns, respectively. The Hamilton patterns are less common in women. However, women with Ludwig patterns can develop a Hamilton pattern after menopause.

How does Female Pattern Hair Loss occur?

Genetics plays a key role in contributing to female pattern baldness. Women can inherit the genes for hair loss from either of the parents. While it is largely thought to occur due to genetics, certain hormonal changes can also be a contributing factor. 

If you suffer from a health condition that affects the production of the hormone androgen, you are likely to suffer from FPHL. Androgen is a hormone that is produced in the ovaries, adrenal glands, and fat cells. Androgens are necessary for estrogen synthesis and play a key role in stimulating hair growth in pubic and underarm areas at the time of puberty. High androgen levels can pose a problem resulting in conditions such as hirsutism (excessive hair growth in places like the chin and upper lip) and female pattern hair loss.

Some other causes of FPHL include:

1. An autoimmune disorder such as Alopecia Areata causes the immune system to attack the hair follicles leading to hair loss.
2. Various cancer treatments, such as chemotherapy or radiation therapy, and other medications used to treat cancer can also cause hair loss.
3. If you are recovering from an illness or having an operation, hair loss can occur.
4. If you seldom color or perm your hair, you may damage your hair which can lead to hair loss.
5. Traction alopecia occurs due to wearing hair tightly pulled back. It can also lead to hair loss.
6. Sexually transmitted diseases such as Syphilis can cause patchy hair loss on the scalp, eyebrows, and other areas of the body.
7. Low levels of nutrients such as biotin, protein, iron, and zinc in the body can also lead to hair loss.
8. Stress can also be one of the contributing factors toward female pattern hair loss. 

Hair Loss can be caused due to various reasons. Before you undergo any treatment, it becomes essential for you to determine the root cause of the problem. Talk to a certified dermatologist who can run an accurate diagnosis and suggest a suitable treatment for you. 

Before we talk about how Finasteride can be beneficial for hair loss in women, let’s discuss how exactly Finasteride works.

How does Finasteride work?

Finasteride is a 5-alpha Reductase inhibitor that works by preventing the conversion of testosterone into dihydrotestosterone (DHT). Thus, it decreases the amount of DHT in the body and reverses the process of hair loss. After 28 days, it suppresses the scalp DHT levels by 43% and up to 65% after 42 days of treatment in men suffering from Androgenetic Alopecia. 

So, how does it work for women suffering from hair loss? 

Finasteride for Women with Pattern Hair Loss

Various clinical trials conducted on both premenopausal and postmenopausal women have yielded positive results. A 67-year-old woman with an 18-month history of progressive hair thinning was undergoing antiandrogen therapy which wasn’t tolerable for her. After following a daily course of Finasteride 5 mg for 12 months, she reported an increase in hair density and significant hair regrowth. Similar results were achieved by a 51-year-old woman with an 8-month history of progressive hair thinning. She had been using topical Minoxidil 2%, which didn’t have any effect. After following a daily course of Finasteride 1 mg for 8 months, hair loss stabilized, and hair density improved after 12 months. 

A study conducted on premenopausal women showed that 23 out of 37 women who took Finasteride 2.5 mg along with an oral contraceptive tablet (containing drospirenone) for 12 months reported significant improvement in hair growth. 

Due to the teratogenic (disturbing the development of embryo or fetus) effects of Finasteride, it is necessary for women of reproductive age and women who are considering pregnancy to take an oral contraceptive throughout the course of Finasteride.

Another clinical trial conducted on 4 women aged 36, 40, 60, and 66 years old with elevated serum testosterone levels and hyperandrogenism showed positive results. After following a daily course of Finasteride 1.25 mg, hair loss was stabilized within a period of 6 to 12 months, however, hair growth took 6 months to 2.5 years. 

The role of Finasteride in the treatment of Female Pattern Hair Loss is a bit controversial. While a majority of women may benefit from the treatment, some of them may not. A proper diagnosis can help in determining the exact health condition and the kind of treatment a woman should look forward to. The dosage of Finasteride for female pattern hair loss ranges from 5 mg per week to 5 mg per day for a period of 6 months to 2 years. A starting dosage of Finasteride 1 mg per day should be considered for a period of 6 to 12 months. If significant results aren’t achieved, the dosage should be increased after following up with the doctor. 

Is Finasteride Safe for Women?

Since the FDA has not authorized finasteride for treating hair loss in women, there have been no extensive clinical trials to investigate its safety, unlike in men. As a result, it’s still uncertain whether finasteride is entirely safe for women to use.

Most of the present research on finasteride suggests that it is generally safe, with few or no severe side effects. For example, in the previously mentioned studies, researchers discovered that finasteride was mostly safe for women to use.

Similarly, a comprehensive review of finasteride research in women reached a comparable conclusion but acknowledged some cases of sexual side effects and other problems. Specifically, some women who used finasteride for hair loss reported experiencing a reduced sex drive, irregular periods, acne, headaches, dizziness, folliculitis, and increased body hair growth.

It’s important to note that these side effects were mild and improved on their own over the course of treatment.

Dosage of Finasteride for Women

Finasteride is not approved by the FDA for treating hair loss in women and therefore doesn’t have a standardized dosage recommendation. However, research suggests that taking 1.25 mg or 2.5 mg of finasteride daily may be beneficial for women experiencing hair loss.

Nevertheless, healthcare professionals do not generally suggest finasteride as the primary treatment option for women with hair loss. Instead, they recommend using over-the-counter (OTC) Rogaine (minoxidil) 2%, which is applied directly to the affected area of the scalp.

Can you have alcohol with Finasteride?

In brief, it’s recommended to limit alcohol consumption, particularly heavy drinking, which refers to having more than 3 drinks per day for more than 4 days a week.

Although Merck, the manufacturer of Propecia (which contains Finasteride), did not provide any explicit information about the potential interactions between the medication and alcohol, a 2009 study indicated that heavy alcohol consumption may increase the likelihood of developing prostate cancer in men.

The Use of Finasteride

During pregnancy, it’s not safe to use finasteride during pregnancy or if you’re planning to become pregnant soon. Due to its impact on testosterone conversion to DHT, finasteride can lead to abnormalities related to male genital development.

The FDA advises women to avoid handling crushed finasteride tablets while pregnant to minimize the risk of absorption and harm to the fetus. At present, it is unclear whether finasteride is secreted in breast milk. Therefore, if you are pregnant, breastfeeding, or planning to conceive soon, it’s recommended to avoid using finasteride.

Other Treatment Options to Consider for the Treatment of FPHL

Treatment options depend on the extent of hair loss. Dermatologists may use more than one type of hair loss treatment to give optimal results. These include:

1. Minoxidil

Minoxidil is an effective hair loss drug that comes in the form of a topical solution and oral tablets. It increases the blood flow to the hair follicles, and hair growth can be experienced 3-6 months (or even 12 months) after following a daily dosage of the drug. It is the most recommended treatment for Female Pattern Hair Loss. It may also be helpful in eyebrow growth, however, it may take some time to achieve significant results.

2. Oral Medications

Medicines such as Spironolactone that remove excess fluids from the body and also block androgen production can help restore hair regrowth and prevent hair loss from worsening. Your doctor may prescribe you another medication, such as Dutasteride or even Finasteride, along with Spironolactone to treat FPHL.

3. Hair Transplant

A hair transplant involves removing hair from an area with healthy hair growth and transferring it to another spot where the hair is missing. It is a more permanent solution for the treatment of FPHL.

4. Platelet-rich Plasma Therapy

This process involves drawing your blood and injecting it into your scalp to stimulate hair growth. 

5. Laser Treatments

FDA-approved laser combs, helmets, and other devices are available without a prescription to treat hair loss at home. These devices emit a low level of laser light to stimulate new hair growth.

6. Supplements

If your body is deficient in biotin, iron, protein, and zinc, your doctor may prescribe you a supplement. These supplements help to grow and thicken hair. 

While various treatments are available for FPHL, it can certainly not be prevented. With proper treatment, you can stop hair loss and regrow lost hair. If you see any potential signs of hair loss, you should see a dermatologist for a diagnosis. Early diagnosis can be helpful in preventing any further hair loss that may occur.

Final Thoughts

At present, the use of finasteride to treat hair loss in women is not sanctioned. Nevertheless, ongoing studies are being conducted to investigate its efficacy and safety, and we may anticipate some noteworthy results soon.

Meanwhile, we provide a variety of hair loss treatments for women that include minoxidil, which is a secure and effective medication to prevent hair loss and encourage hair regrowth.

References

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2. Iorizzo, M., et al. (2006). Finasteride treatment of female pattern hair loss. Archives of Dermatology.
3. MedlinePlus. (2020). Androgenetic alopecia.
4. Merck Sharp & Dohme. (2021). Propecia [prescribing information].
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6. Phillips, TG., et al. (2017). Hair loss: common causes and treatment. American Family Physician.
7. Shapiro, J., et al. (2003). Use of finasteride in the treatment of men with androgenetic alopecia (male pattern hair loss). Journal of Investigative Dermatology Symposium Proceedings.
8. Skow, DT., et al. (1999). Medical treatments for balding in men. American Family Physician.
9. Thiedke, CC. (2003). Alopecia in women. American Family Physician.
10. Zhihong, G., et. al. (2009). Alcohol consumption, finasteride and prostate cancer risk: Results from the prostate cancer prevention trial. Cancer.