Finasteride Side Effects and Alternative Treatments

If you deal with pattern hair loss or male-pattern baldness, you’ve likely heard of Finasteride—the main component in Propecia. This prescription medication works well to slow hair loss and even encourage regrowth. Most people don’t experience Finasteride side effects.

While the chance of side effects is low, you should still understand how this treatment might affect you and how often common Propecia side effects occur.

Let’s break down the typical side effects of Finasteride so you know what to expect before starting.

What Finasteride Does for Hair Loss

Doctors prescribe Finasteride as an oral tablet.

You can get it under brand names like Proscar and Propecia, or as a generic version. Generic forms typically cost less than branded ones, though they might not come in all the same doses or formats.

Why Some People Use Finasteride

The condition Finasteride treats depends on which version you use.

• Doctors prescribe Proscar to relieve symptoms of an enlarged prostate (benign prostatic hyperplasia). It’s often part of a combination plan, meaning it’s taken with other medications. For example, it can be paired with doxazosin to lower the risk of worsening prostate symptoms.

• Propecia is used to treat hair thinning in men caused by male-pattern baldness.

Finasteride isn’t recommended for women or children.

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How Finasteride Affects Hair and Hormones

Finasteride lowers the levels of the hormone dihydrotestosterone (DHT) in your body. DHT typically causes the prostate to enlarge.

By reducing DHT, Finasteride helps stop prostate growth. It also promotes scalp hair growth and slows down shedding. Hair in other areas of the body stays unchanged.

6 Common Finasteride Side Effects

Most Finasteride side effects relate to hormone changes, since the drug reduces levels of dihydrotestosterone (DHT) in the body. Side effects tend to appear more often with the higher 5 mg dose used for treating enlarged prostate. The lower 1 mg dose, typically used for hair loss, is mainly linked to sexual side effects.

Frequent side effects (reported by over 1% of people in clinical studies) include:

• Difficulty getting or keeping an erection

• Lowered sex drive

• Fewer sperm produced

• Problems with ejaculation

Uncommon side effects (reported by fewer than 1% of participants in studies):

• Enlarged breast tissue in men (gynecomastia)

• Sensitive or sore breasts

• Irritated or inflamed skin

• Aching or discomfort in the testicles

• Mood changes, including depression

• Higher chance of prostate or male breast cancer

• Serious birth defects if used or touched during pregnancy

• Allergic responses like swelling, itching, or breathing issues

Below, we explain six potential side effects of Finasteride and how you can handle each one.

1. Decreased Sex Drive

Reduced sex drive (low libido) can occur as a side effect of Finasteride. Around 6% of users reported this in studies, with about 2% affected at the lower dose. Your libido may return as your body adapts to the medication.

Remember, stress and poor sleep can also impact desire. Staying active, sleeping well, and eating a nutritious diet may help increase libido.

If low sex drive starts to affect your daily life, talk to your doctor. They can offer ways to manage the issue or switch you to another treatment.

2. Erectile Dysfunction

Erectile dysfunction (ED) ranks as the most frequently reported side effect of Finasteride. You might find it hard to get or keep an erection. The amount of semen released may also decrease because Finasteride affects the prostate.

These symptoms often ease as your body adapts to the drug. In the meantime, speak with your doctor about possible treatments. Several ED medications can be taken alongside Finasteride to help manage this issue. Don’t wait to bring it up if it’s affecting you.

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3. Breast Enlargement in Men

Although uncommon, some men taking high-dose Finasteride may develop enlarged breast tissue (gynecomastia). You might also notice soreness or tenderness in the chest. Unlike other side effects, breast-related symptoms tend to appear more often the longer you use Finasteride.

While this side effect may feel alarming, it usually doesn’t pose a health risk and often goes away after stopping the medication. Still, report any breast changes to your doctor. In rare cases, these symptoms could signal male breast cancer unrelated to Finasteride.

Worth noting: Breast-related effects were only seen in clinical trials of the 5 mg dose. No such cases were reported with the 1 mg version.

4. Depression or Mood Changes

Depression can also occur as a side effect of Finasteride. Though not seen in early clinical trials, later studies found a higher risk of depression and suicidal thoughts in people using Finasteride compared to those who weren’t.

Sexual side effects from the drug may play a role in triggering low mood. In some cases, these symptoms can continue even after stopping the medication—more on that below.

If your mood shifts while taking Finasteride, inform your doctor. They can help you find the right way to address it.

If you or someone you know is thinking about suicide, support is available and you are not alone.

5. Lowered Blood Pressure

Finasteride can increase your chances of orthostatic hypotension, a drop in blood pressure when you sit or stand after lying down. This may cause lightheadedness or, in some cases, fainting.

The risk rises if you take Finasteride with an alpha blocker, another drug used for prostate symptoms. Tamsulosin (Flomax) and doxazosin (Cardura) are common examples.

To reduce the chance of dizziness, stand up slowly and steady yourself when moving. If you feel lightheaded, sit down or grab onto something for support to prevent falling. If this effect becomes troublesome, let your doctor know—they may need to adjust your treatment.

6. Post-Finasteride Syndrome

Most Finasteride side effects go away on their own once you stop using the drug. But in rare situations, some issues may stick around. If symptoms last more than three months after stopping Finasteride, doctors call it post-finasteride syndrome.

Post-finasteride syndrome may involve:

• Sexual symptoms: Reduced libido or trouble maintaining an erection

• Physical symptoms: Swollen breast tissue or ongoing tiredness

• Mental symptoms: Depressed mood or thoughts of self-harm

Experts don’t know how often post-finasteride syndrome occurs, since most reports come directly from patients. No confirmed treatment exists yet, but your doctor can help manage specific symptoms. Let your healthcare provider know if side effects continue after stopping Finasteride.

Finasteride Alternatives

Before looking into alternatives to Finasteride, it’s useful to understand why some people want other options. While Finasteride helps many with androgenetic alopecia (pattern baldness), about 3% report side effects such as low sex drive or trouble with erections. Other possible issues include depressed mood, mental fog, or breast tissue growth.

It’s also key to know that Finasteride targets male-pattern hair loss specifically. People dealing with different types of hair loss—like alopecia areata or thinning related to female hormones—don’t see benefits from this drug. Oral treatments can also bring risks for those with liver, kidney, or mental health conditions, and may interfere with other medications.

Start with Plant-Based Hair Loss Treatment With Keyoma

Think through your daily habits, goals, available time, and overall health before choosing alternatives to Finasteride. A mix of approaches often works best over time. If your hair loss is mainly genetic—like male or female pattern thinning—you might focus on strong, well-researched treatments.

But if your thinning comes with poor nutrition, high stress, or recent illness, consider targeting the root causes. Improve your diet, boost scalp blood flow, and support full-body wellness to gently restore balance and slow widespread shedding.

Start with natural solutions like Keyoma’s Pure Batana Oil—rich in nutrients that nourish the scalp, support stronger roots, and help restore thinning hair over time. It’s easy to apply, rooted in tradition, and fits into any daily routine.