How to the reduce side effects of Finasteride

What is Finasteride and how does it work?

Finasteride is a commonly prescribed medication for male pattern baldness (androgenetic alopecia) and benign prostatic hyperplasia (BPH).

Finasteride works by blocking the enzyme that converts testosterone into dihydrotestosterone (DHT). DHT causes hair follicles to shrink over time, shortening the hair growth cycle and eventually stopping new hairs from growing.

By reducing DHT levels, finasteride slows hair loss and, in some cases, promotes regrowth. Results are gradual and consistent daily use is needed to maintain the benefit.

It is available as a 1mg tablet for hair loss and a 5mg tablet for BPH. These are different doses for different conditions and should not be confused.

Finasteride 1mg tablets are also available under the brand name Propecia. Both contain the same active ingredient at the same dose. The only differences are the manufacturer and price.

Some manufacturers use slightly different inactive ingredients, so if you want to check what is in your specific tablets, you can read the patient information leaflet that comes with them.

Are Finasteride side effects common?

Most men who take finasteride do not experience side effects. The known side effects are classified as uncommon, meaning they affect fewer than 1 in 100 men.

Side effects of Finasteride

Uncommon side effects (affecting fewer than 1 in 100 men):

• Reduced libido (sex drive).
• Difficulty getting or maintaining an erection (erectile dysfunction).
• Problems with ejaculation, such as a decrease in semen.
• Depression or very low mood.

Other reported side effects (frequency not precisely established from available data):

• Breast tenderness
• Swelling
• Lumps
• Nipple discharge
• Mild allergic reactions such as itching or rash
• Blood in the semen
• Testicular pain
• An increased heart rate
• Anxiety
• Raised liver enzymes (detectable via a blood test).
• Poor quality semen
• Reduced male fertility

Rare side effects:

• Anaphylaxis (a severe allergic reaction) — seek immediate/emergency medical attention
• Swelling of the face, lips, tongue and throat
• Hives
• Difficulty swallowing

Changes in breast tissue, including pain, swelling, lumps, or nipple discharge, should be reported to your doctor straight away. These changes could be a sign of breast cancer.

If you’ve never suffered from depression and find yourself feeling depressed, low or developing suicidal thoughts then stop taking Finasteride immediately and contact your doctor.

There is new evidence that links using finasteride with the risk of suicidal thoughts and behaviours.

If you are concerned about any side effect or it is affecting your daily life, speak to our clinical team or your GP.

Are Finasteride side effects permanent?

Most side effects are not permanent. They typically go away once you stop taking finasteride, or as your body adjusts to the medication.

A small number of men have reported that sexual side effects such as erectile dysfunction, reduced libido, and ejaculation problems, continued after they stopped taking finasteride.

If you experience persistent side effects after stopping treatment, see your GP.

Long-term side effects of Finasteride

Research into long-term finasteride use is reassuring. Finasteride has been prescribed for many years, and the evidence shows it is safe when used over extended periods.

Some studies did find a very small number of men experienced long-term reductions in sex drive or erectile dysfunction, but these side effects did resolve in most cases, whether the men continued taking finasteride or not.

Long-term considerations include:

Cardiovascular health: An increased heart rate is a listed side effect, though uncommon. If you notice persistent changes to your heart rate, speak to your doctor.

Liver function: In rare cases, finasteride can raise liver enzymes. This would be picked up on a blood test. Let your doctor know if you are having any blood tests while on finasteride.

Prostate-specific antigen (PSA) levels: Finasteride lowers PSA levels in the blood. PSA is also used as a marker to screen for prostate cancer, so artificially lowered PSA may affect test results. Always tell your doctor or any clinician ordering blood tests that you are taking finasteride, so they can account for this when interpreting results.

Breast cancer risk: There is a potential association between finasteride and male breast cancer. If you notice any changes in your breast tissue, see your GP without delay.

Mental health: There is evidence of a link between finasteride and depression in some men. If you develop low mood or depression while taking finasteride, stop the medication and seek medical support.

How to reduce the side effects of Finasteride

• Take only the prescribed dose. The dose for hair loss is one 1mg tablet daily. Do not increase or decrease your dose without medical advice.
• Take it at the same time each day and try not to skip doses — a steady routine keeps drug levels stable and gives you the best chance of seeing results.
• Store finasteride at room temperature. Avoid storing in humid environments such as bathrooms, as heat and moisture can affect the medication.
• Tell your pharmacist or doctor about all medications you are taking. Some medicines may interact with finasteride or increase your risk of side effects.
• Tell your doctor about any health conditions. This includes past or current depression, liver conditions, and prostate issues.
• Keep an eye on your mood. If you experience any changes in your mental health, do not dismiss them. Stop taking finasteride and seek support. Counselling or your GP can help.
• Report side effects. If you experience any side effect, let our clinical team know. We can advise whether to adjust your treatment or consider an alternative. You can also report side effects directly to the MHRA using the Yellow Card scheme.

Yellow Card is the UK system for reporting suspected side effects of medicines, and reports help healthcare professionals and regulators better understand medication safety.

Does Finasteride cause hair shedding?

Yes, and this is completely normal. Some men notice increased hair shedding in the first few months of taking finasteride. This can be alarming, but it is a sign the medication is working properly.

Before you used finasteride, high DHT levels were causing hair follicles to remain dormant. When DHT levels drop with finasteride use, hair follicles re-enter the active growth phase, so they must first shed existing hairs to make way for newer, healthier ones.

Finasteride-related shedding typically begins in the first few months of treatment and usually lasts around two weeks. If you notice shedding continuing for more than a month, speak to our clinicians or your GP.

Sexual side effects of Finasteride

Sexual side effects are the most common concerns about finasteride. These include:

• Reduced libido
• Erectile dysfunction
• Ejaculation problems
• Fertility issues in rare cases.

Erectile dysfunction is common in the male population generally and can occur independently of finasteride use. If you notice changes after starting finasteride, speak to your doctor so they can help determine the cause and discuss your options.

Finasteride can affect male fertility. In most cases, fertility returns after stopping treatment. If you are trying to conceive, speak to your doctor before taking finasteride.

It is also important to know that finasteride can be passed through semen and could potentially harm a developing male foetus. Pregnant women should not handle broken or crushed finasteride tablets.

Sexual side effects often improve on their own even without stopping treatment. If they do not improve or are affecting your quality of life, speak to your doctor.

Alternatives to Finasteride

If you find finasteride’s side effects difficult to manage, there are alternatives:

Minoxidil is a topical or oral treatment that works differently to finasteride and does not affect DHT levels. It can be used on its own or alongside finasteride.

Hair transplant is a surgical option for more advanced hair loss if other treatments are not effective or suitable.

Speak to our clinical team about which option is most appropriate for your situation.

When to seek immediate medical help

Call 999 or go to A&E if you experience symptoms of anaphylaxis: difficulty breathing, severe swelling of the face, lips, tongue, or throat, or severe hives.

See your GP as soon as possible if you notice any changes to your breast tissue, experience testicular pain that does not go away, or develop persistent depression or low mood.

Stop taking finasteride and speak to a pharmacist or GP if any side effect is affecting your daily life and does not improve within a few weeks.