Can a 33 Year Old Women Who Plans Never to Have Kids Use Propecia for Hair Loss?

I am a 33 year old female who has androgenetic alopecia. I have had some mild improvements with minoxidil but not entirely to my satisfaction. I have read up on Propecia and know it is not indicated for women. However, it's worked well for my brother. Is it safe to use if I don't plan on getting pregnant/having children? Is there any reason to believe that it may be effective in women?

Doctor Answers (4)

Propecia in Women

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Propecia (sometimes called finasteride) is not FDA approved for treating genetic hair loss in women. However, it is important to be aware that there are studies showing it can benefit post menopausal women at a dose of 2.5-5 mg per day. Certainly, many post menopausal women benefit from finasteride. 

Studies in premenopausal women are more limited. The drug can cause serious birth defects should a woman become pregnant while using finasteride. For this reason, many physicians never prescribe finasteride to women of child-bearing age.  


There is more evidence for the use of another hormone blocking pill called Spironolactone. When used at a dose of 200 mg daily it can stop hair loss in 30 % of women with female pattern hair loss and regrow hair in another 30 %. Again, spironolactone is not formally FDA approved for the treatmentof female  pattern hair loss, but is frequently prescribed by physicians around the world.  

The only formally FDA approved medication for female pattern hair loss is minoxidil. However, that doesn't mean it's the only option for treatment. In addition to spironolactone, other options include low level laser therapy and platelet rich plasma. 

If you aren't satisfied with minoxidil, be sure to make an appointment with a physician who specializes in hair loss. You want to learn about all your options, the chances of success and the potential side effects of each. 


Toronto Dermatologist

Propecia Simple Facts

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Propecia has more side effects than Rogaine and is not FDA-approved for use by women for both safety reasons and lack of efficacy. I would not recommend it in this situation.


 

Sanusi Umar, MD
Redondo Beach Dermatologic Surgeon
5.0 out of 5 stars 22 reviews

Spironolactone?

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Is there a reason why you can't take Spironolactone?  While it is also contraindicated during pregnancy, it is the drug of choice for women suffering with androgenetic alopecia.  The effects are not lingering, so if you change your mind and want to have children at some point later in life, that option will remain.  Studies have only shown efficacy for women who are post-menopausal anyway.  

Corey L. Hartman, MD
Birmingham Dermatologic Surgeon
5.0 out of 5 stars 4 reviews

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Finasteride may help women, but consider spironolactone first

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Yes, you are right to believe that finasteride may work for you, too.

The reason that it is not indicated for hair loss in women is due to the safety issues.

It is ABSOLUTELY contraindicated in women of childbearing age. Pregnancy could

result in  serious birth defects, especially with a male fetus.  In addition, the

preliminary studies using finasteride 1mg daily in women did not demonstrate an appreciable

difference. However, there are published studies from other countries showing that finasteride

at higher doses of 2.5mg and 5mg daily may improve female pattern hair loss. If you can locate

a dermatologist who is familiar with these studies and willing to prescribe it to you, it may be worth

a try. That being said, we do not have long-term safety data using such a drug in women. Therefore

you and your doctor would have to be very comfortable with that.

I prefer starting my female patients on 1) minoxidil, and then 2) spironolactone, at doses up to 200mg /day

before going to finasteride. As with the minoxidil or any medical treatment for hair loss, you must allow a full

6-12 months to see an effect. And I would recommend taking before and after photos to help document your

improvement. If neither of these treatments help, hair transplantation may be the next step.  Best wishes!

Nicole E. Rogers, MD
New Orleans Dermatologist

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.