From the Guidelines
Finasteride may be considered in female patients with hidradenitis suppurativa (HS) or hirsutism, as part of a comprehensive treatment plan, under close medical supervision. The use of finasteride in females is supported by recent guidelines, such as those published in the Journal of the American Academy of Dermatology in 2019 1, which recommend considering hormonal agents, including finasteride, in appropriate female patients with HS. Additionally, finasteride has been used off-label to treat hirsutism in women with polycystic ovary syndrome (PCOS), as mentioned in a 2003 guideline published in the American Family Physician 1.
When prescribing finasteride to females, it is essential to carefully weigh the potential benefits against the risks, including the risk of birth defects in male fetuses if the woman becomes pregnant. Women of childbearing age should use reliable contraception while taking finasteride. Potential side effects in women may include decreased libido, breast tenderness, and menstrual irregularities.
The typical dose of finasteride for women, when prescribed, is 2.5 to 5 mg daily. However, the long-term safety data in women is limited, and finasteride's effects and safety profile in women are less well-established compared to men. Before considering finasteride, women should explore other FDA-approved treatments for hair loss or hirsutism and address any underlying hormonal imbalances or nutritional deficiencies that may be contributing to their condition.
Key considerations for the use of finasteride in females include:
- Close medical supervision
- Reliable contraception in women of childbearing age
- Careful weighing of potential benefits against risks
- Exploration of alternative treatments before considering finasteride
- Monitoring for potential side effects, such as decreased libido, breast tenderness, and menstrual irregularities.
From the FDA Drug Label
Finasteride tablets are contraindicated in pregnant females and not indicated for use in females. Finasteride use is contraindicated in females when they are or may potentially be pregnant Finasteride tablets are not indicated for use in females. Females Finasteride tablets are not indicated for use in females.
The use of Finasteride in females is not indicated. The drug is contraindicated in pregnant females due to the potential risk of abnormal development of external genitalia in a male fetus.
- Key points:
From the Research
Use of Finasteride in Females
- Finasteride is used to treat hair loss, hirsutism, and various other dermatologic conditions in women, with most randomized controlled trials evaluating its use in women with hirsutism or female pattern hair loss 3
- The recommended dose of oral finasteride for females ranges from 0.5 to 5 mg/day, with treatment durations of 6-12 months, and is often used as monotherapy 3
- Finasteride may improve hair loss in women with female pattern hair loss or frontal fibrosing alopecia, although more research is needed to fully assess its therapeutic mechanisms and potential consequences 3, 4
Safety and Efficacy
- Finasteride is not currently approved for therapeutic use in females, and its effects on vital organs such as the liver, kidney, and heart are unknown 5
- Maternal use of finasteride during pregnancy may carry the risk of birth defects, especially hypospadias, although one case report found no association between finasteride use and external genitalia abnormalities in a male baby 6
- Finasteride is well-tolerated in women, but may cause adverse effects such as decreased libido, headache, gastrointestinal discomfort, and changes in menstruation, acne, and dizziness 7
Potential Risks and Contraindications
- Finasteride is contraindicated in pregnancy due to known teratogenicity, and women of childbearing potential must adhere to reliable contraception while receiving finasteride 4
- Long-term use of finasteride may induce apoptosis and pathological changes in female mice, highlighting the need for caution in considering its use in females 5