Finasteride and PCOS: Treatment for Unwanted Hair Growth

How Anti-Androgenic Medication Can Help Unwanted Hair Growth in Women With PCOS

Finasteride can be found in Proscar and Propecia.
Finasteride can be found in Proscar and Propecia. Stephen Chernin/Getty Images

Typically sold under the brand names Proscar and Propecia, Finasteride is a medication usually used to treat benign prostate growths and male pattern baldness in men. Sometimes Finastreride is prescribed as an anti-androgenic compound for women with Polycystic ovary syndrome (PCOS) who are exhibiting unwanted male-pattern hair growth on their face, chest, or back (hirsutism).

How Finasteride Affects PCOS Symptoms

Finasteride works by blocking androgens, which are a group of hormones that play a role in male traits and reproductive activity.

When androgens in the hair follicles are blocked, PCOS-related hair loss and hirsutism lessen.

70-80% of women with excess androgens demonstrate hirsutism. Androgens increase the growth rate of hair and transform short, fine, light-colored, baby hairs (vellus hair) to thick, long, and darker (terminal hair).

When androgens are reduced, new hair growth is reduced and the growth of existing terminal hair is reduced. Hair grows at different times and the growth phase varies according to the area of the body, for full growth, this cycle of growth is approximately 4 months for facial hair. This is why it is recommended to give hormonal therapy more than 6 months to be fully effective.

For most women, androgenic symptoms are hirsutism, but for others it can also be acne or alopecia. Many women have both hirsutism and acne and a few complain of significant acne, hirsutism and alopecia. Those with acne have often tried used topical treatments and oral medications like antibiotics, but the acne usually comes back after stopping medication.

How Finasteride Works

Finasteride inhibits the expression of the type 2 enzyme, 5-alpha reductase. This enzyme regulates the production of dihydrotestosterone (DHT) which has been shown to have a harmful effect on hair follicles. Taking the medication has been shown to decrease DHT levels by up to 70%.

The recommended dosage amount varies from person to person and dosages of 2.5mg or 5mg per day are common. Please follow the instructions given to you by your doctor.

Possible Side Effects of Finasteride

Please notify your physician of any side effects you may be experiencing. Some commonly reported side effects of the drug are:

  • decreased sexual desire
  • pain in the breasts
  • signs of an allergic reaction include hives or other skin reaction and/or difficulty breathing

Testosterone supplements can interact with Finasteride. Please let your doctor know if you are taking any other medications.

Pregnancy and Finasteride

While Finasteride has a low set of side-effects associated with it, the drug does have a feminizing effect on a male fetus.

It is very important that you don't get pregnant while taking finasteride, due to the potential risk to the developing fetus. Make sure to use an effective form of birth control while taking Finasteride.

It is also important for pregnant women to not handle this medication.

Sources:

Azziz R. The evaluation and management of hirsutism. Obstet. Gynecol. 101, 995-1007 (2003).

Dallob AL, Sadick NS, Unger W et al. The effect of finasteride, a 5 ╬▒reductase inhibitor on scalp skin, testosterone and dihydrotestosterone concentrations I patients with male pattern baldness. J. Clin. Endocrinol. Metab. 79, 703-706 (1994).

Lumachi F, Rondinone R. Use of cyproterone acetate, finasteride and spironolactone to treat idiopathic hirsutism.Fertil. Steril. 79, 942-94 (2003).

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