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Finasteride & Pregnancy: Safety, Side Effects, Alternatives
Dr Mir Malkani
Medically reviewed by
Dr Mir Malkani
Updated on July 16, 2024

When you’re pregnant or trying for a baby, there’s a lot to think about when it comes to your own well-being and the health of your baby. That’s why it’s important to consider the medication you’re taking and whether it’s safe during pregnancy.

Finasteride, a widely used hair loss drug, isn’t usually recommended for women because of its implications in pregnancy. In this article, we’ll go over:

  • The risks of Finasteride in pregnancy
  • How Finasteride affects pregnancy
  • When is a safe time to take Finasteride to treat hair loss
Table of Contents

What is Finasteride and how does it work?

Finasteride is part of a group of drugs known as 5-alpha reductase inhibitors. 5-alpha reductase inhibitors minimise the production of a hormone called dihydrotestosterone (DHT), which is converted from testosterone.

finasteride chemical structure

DHT binds to the hair follicles, causing them to shrink. By blocking DHT production, Finasteride can reverse this process, slowing hair loss and stimulating hair regrowth.

If you have hair loss during pregnancy, you may be considering a hair loss treatment like oral or topical Finasteride. Studies have shown that Finasteride can effectively treat female pattern hair loss, so in limited circumstances it may be suggested by a medical practitioner as a female hair loss treatment [1].

before and after using 5mg of Finasteride for 1 year
A female patient before and after 1 year of Finasteride use, taking 5mg daily [1].
However, women are generally advised to avoid using Finasteride, as it causes hormonal changes that can disrupt the menstrual cycle and lead to complications in pregnancy. As a result, Finasteride hasn’t been licensed to treat female pattern hair loss or any other female hair loss condition.

Is Finasteride safe during pregnancy?

Studies show there may be some risks associated with Finasteride use during pregnancy, particularly at high doses [2-4].

As a result, most women are advised against taking Finasteride, especially those of premenopausal age. Even women who aren’t planning a pregnancy should avoid Finasteride, as it can cause irregularities in the menstrual cycle [5].

Does Finasteride affect pregnancy?

DHT is an important hormone for a developing male fetus. It’s needed for the development of sexual organs in the uterus.

As a DHT blocker, exposure to Finasteride in pregnancy may inhibit the physical development of a male fetus:

Sexual differentiation and development in a normal male at birth and a male with 5α-reductase deficiency
Sexual differentiation and development in a normal male at birth and a male with 5α-reductase deficiency [6].

Can Finasteride cause birth defects?

There are limited studies investigating the link between Finasteride use in pregnancy and birth defects. One research paper found that a woman who was taking 2.5mg of oral Finasteride daily when she conceived had a healthy baby, with no birth defects [7].

However, researchers noted that this single case doesn’t necessarily mean Finasteride is safe to use in pregnancy, or that it’s not linked with birth defects.

Other studies have linked Finasteride exposure to hypospadias, a birth defect in boys in which the opening of the urethra is not located at the tip of the penis [8].

Does taking Finasteride increase the chance of miscarriage?

There haven’t yet been any studies to determine whether Finasteride use in pregnancy can lead to miscarriage [9]. One study found that taking a low dose of Finasteride could damage the DNA integrity of sperm, which may lead to pregnancy loss [10].

Does Finasteride increase the risk of preterm delivery?

Some animal studies suggest Finasteride may be linked with preterm birth, though these are experimental and the findings don’t necessarily translate to humans [9].

Is it dangerous to handle Finasteride pills while pregnant?

Pregnant women are often advised to avoid handling Finasteride. You’re more at risk if you handle crushed or broken Finasteride tablets as the active ingredients are more likely to be absorbed through the skin [9].

If Finasteride tablets are intact, the coating on the outside of the pill should stop you from absorbing any of the drug. It is also advised that pregnant women avoid any contact with topical finasteride as well.

Can you take Finasteride while breastfeeding?

It’s not known if Finasteride is excreted in breast milk, so women are usually advised to avoid using Finasteride while breastfeeding [11].

Can men take Finasteride while trying for a baby?

Finasteride may be present in a man’s semen, so it’s often recommended that men stop taking Finasteride when trying to conceive.

However, most researchers agree that the amount of Finasteride in semen is low enough that the risks for foetal development are minimal [9]. So try not to worry if you’ve conceived while your partner is taking Finasteride for their male pattern hair loss.

In rare cases, Finasteride can lead to sexual performance problems in men, such as erectile dysfunction. This may be problematic when trying for a baby, so men should weigh up the pros and cons of taking Finasteride during conception.

When should you stop Finasteride before pregnancy?

Finasteride has a half-life of between three and 16 hours, so it may take a few days for the drug to leave your system entirely [11]. This is especially true if you’re a long-term user.

After stopping Finasteride treatment, DHT levels will return to normal within 14 days. So it’s a good idea to stop Finasteride at least two weeks before trying to conceive.

Can I use other DHT blockers while pregnant?

No. Other DHT blockers may have the same negative implications as Finasteride in pregnancy, so it’s a good idea to avoid these.

This includes other 5-alpha reductase inhibitors like Dutasteride, and natural DHT blockers. It’s also advised to avoid topical Finasteride as well as it can still lower DHT levels.

Does Finasteride damage DNA?

There is a possible link between DNA damage and Finasteride use [5, 10].

One study of 30 women in Saudi Arabia found that taking 5mg Finasteride every day could lead to DNA damage in lymphocytes (a type of white blood cell found in your immune system) [5].

Another single-patient study suggested Finasteride use could damage sperm DNA integrity [10]. Finasteride can significantly reduce sperm count, which may also reduce the chance of pregnancy.

How to deal with hair loss in pregnancy

All the evidence suggests you should avoid taking Finasteride if you’re pregnant or trying to become pregnant. Not taking Finasteride may reduce the risk of birth defects, miscarriage, and premature birth.

Using Minoxidil in pregnancy also poses risks. So what can you do if your hair is falling out during pregnancy?

Women’s hair loss is tricky to diagnose and treat, so specific diagnostic tools and exams are needed to unearth the root cause. So whether you’re still in the early stages of pregnancy, or experiencing postpartum hair loss, we can help.

At the Wimpole Clinic, our female hair loss treatment plans and diagnostics are designed to find out exactly what’s causing your hair loss and offer bespoke hair loss treatments that will work for you.

Book a consultation today to get started.

Finasteride & Pregnancy: Safety, Side Effects, Alternatives, Wimpole Clinic

Dr Mir Malkani
Medically reviewed by Dr Mir MalkaniUpdated on July 16, 2024
The Wimpole Clinic offers FUE Hair, Beard & Eyebrow Transplants & Trichology.
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