Benign prostatic hyperplasia
Physicians use finasteride for the treatment of benign prostatic hyperplasia (BPH), informally known as an enlargedprostate. The FDA-approved dose is 5mg once a day. Six months or more of treatment with finasteride may be required to determine the therapeutic results of treatment. If the drug is discontinued, any therapeutic benefits reverse within about 6–8 months. Finasteride may improve the symptoms associated with BPH such as difficulty urinating, getting up during the night to urinate, hesitation at the start of urination, and decreased urinary flow.
As measured by hair counts, in a five-year study of men with mild to moderate hair loss, two out of three of the men who took 1 mg of finasteride daily regrew some hair. In contrast, all of the men in the study who were not taking finasteride lost hair. In the same study, based on photographs that were reviewed by an independent panel of dermatologists, 48% of those treated with finasteride experienced visible regrowth of hair, and a further 42% had no further loss. Average hair count in the treatment group remained above baseline, and showed an increasing difference from hair count in the placebo group, for all five years of the study. Finasteride is effective only for as long as it is taken; the hair gained or maintained is lost within 6–12 months of ceasing therapy.In clinical studies, finasteride, like minoxidil, was shown to work on both the crown area and the hairline,but is most successful in the crown area.
A recent 10-year study of 118 men treated with 1mg/day finasteride for androgenic alopecia found that 86% of men continued to benefit from treatment over the entire course of 10 years—showing increased or stable rates of hair growth—and only 14% experiencing any further hair loss. Interestingly, it was found that subjects who showed the most hair growth in their first year of treatment were more likely to have better hair growth after 5 years, with nearly 69% of these patients experiencing continued growth; however, many of those who experienced no growth in their first year of treatment were found to improve later on. It was also found that subjects who were older than 30 years of age tended to have better hair growth in the long run, presumably due to having experienced more hair loss by that point in their lives in comparison.
Side effects were seen in only 5.9% of patients, and no patients reporteddepressionorgynecomastia. The authors concluded that the effectiveness of finasteride in treating androgenic alopecia does not reduce over time, even in older patients (including those over 40 years of age), and that it is well-tolerated.This study specifically looked at users who continued using the medication. A recentcase controlevaluated male pattern baldness patients with psychiatric sequellae after discontinuation of finasteride, and reported depressive symptomatology andsuicidal ideationfor those who also experienced sexual side effects during use of the drug.
Some users, in an effort to save money, buy Proscar (finasteride 5mg) instead of Propecia, and split the Proscar pills into several parts to approximate the Propecia dosage.The pills are coated to prevent contact with the active ingredient during handling, and the dust or crumbs from broken Proscar tablets should be kept away from pregnant women or women who may become pregnant.
Finasteride is sometimes used inhormone replacement therapyformale-to-female transsexualsin combination with a form ofestrogendue to itsantiandrogenproperties.However, littleclinical researchof finasteride use for this purpose has been conducted and evidence of efficacy is limited. Indeed, finasteride is a substantially weaker antiandrogen in comparison to conventional antiandrogens likespironolactoneandcyproterone acetate. Finasteride has also been found to mitigate the effects of withdrawal after chronic alcohol use.