People commonly use finasteride in Singapore to treat two male conditions: benign prostatic hyperplasia (enlarged prostate) and male pattern baldness, as it has long been associated with men’s health.
However, ladies, if you are looking for a hair loss prevention or regrowth, finasteride could be your solution. Get your hair loss treatment from Dame here.
Recent research suggests potential applications of finasteride in women’s health. At Dame, we unravel the lesser known facts of the medication, shedding light on its relevance for women in Singapore.
Understanding Finasteride: More Than A Men’s Health Solution
It is not uncommon to know a male relative or friend that is taking finasteride. In this section, we help you understand the history and current research into finasteride. Whether it is supporting a family member, or personally exploring finasteride as a potential treatment, this section is for you.
The History of Finasteride
The US FDA first approved finasteride in 1992 for the treatment of benign prostatic hyperplasia (enlarged prostate). Merck then marketed it under the brand name Proscar. The research team at Merck won the “Inventor of the Year” award for their work in finasteride.
In 1997, the US FDA approved finasteride for the treatment of male pattern hair loss, marketed under the brand name Propecia. To date, finasteride remains the only FDA-approved oral treatment for male pattern hair loss.
How Finasteride Works
Finasteride is a 5-alpha reductase inhibitor. It prevents the conversion of the male sex hormone testosterone to dihydrotestosterone (DHT). This reduces the concentration of DHT. You may have heard the term “DHT-blocker”; it is commonly used to describe medications like finasteride.
Hair Loss
Various factors contribute to the onset and progression of male pattern hair loss, scientifically known as androgenetic alopecia. Hormones, in addition to genetic and environmental factors, have been found to play an important role.
Researchers have found that DHT is the key male hormone involved in the onset of male hair loss. DHT promotes a process called follicle miniaturisation. Hair follicles undergo a shortened growing phase, resulting in shorter and thinner hair. As more follicles undergo miniaturisation, the hair coverage of the scalp progressively decreases.
Finasteride decreases DHT production, resulting in an increased amount of hair. At a dose of 1mg per day, oral finasteride can reduce DHT levels at the scalp by more than 60%. Continuing finasteride treatment for at least six months is necessary to fully assess its effectiveness. To maintain its hair benefits, one must continue oral finasteride.
Benign Prostatic Hyperplasia (BPH)
BPH is a condition that occurs when the prostate gland enlarges. This can often cause difficult urinary symptoms. DHT plays an important part in the development and growth of prostate gland cells. Taking finasteride lowers DHT levels in the prostate, preventing the prostate from growing further or even causing it to shrink.
Finasteride works better in men with a larger prostate. It can reduce difficult urinary symptoms and the need for surgery. As with the treatment of hair loss, finasteride takes time to work. Most men see an improvement in their prostate condition within six months of starting treatment. The main difference is in the dosing of finasteride. In the treatment of BPH, a higher daily dose of 5mg finasteride is typically used compared to 1mg in hair loss.
Breaking Stereotypes: Finasteride for Women
Shortly after finasteride was approved for BPH in 1992, the first study of finasteride in women was published in 1994. There has been an increasing interest in the use of finasteride in the treatment of various women’s health conditions. Here, we explore the current research into the use of finasteride in women.
Managing Hormonal Imbalances
A significant use of finasteride is in the treatment of hirsutism in women. Hirsutism refers to the growth of coarse, dark hair in areas where women typically grow fine hair or no hair at all. This excess hair growth typically occurs above the lip and on the chin, chest, abdomen and back.
Hirsutism is caused by an increased level of male hormones (androgens). It is commonly found in women with polycystic ovary syndrome (PCOS). Finasteride has been found to be effective in the treatment of hirsutism.
It may seem strange as finasteride is effective for the treatment of hair loss in men, right? Interestingly, while DHT has been found to promote hair loss from scalp skin follicles, it actually promotes growth of body hair. (This is why bald men still have hairy legs!). Finasteride, a DHT-blocker, reduces the amount of body hair and stops the growth of new hair in women with hirsutism.
Addressing Female Pattern Hair Loss
Contrary to popular belief, women can also experience pattern hair loss. This condition, known as female pattern hair loss, can have a profound impact on a woman’s confidence and quality of life.
Image Credit – Longevity Hair Transplant
The Ludwig hair loss classification is a pivotal diagnostic tool for Female Pattern Hair Loss (FPHL). Developed by Dr. Elise Ludwig, it categorizes female hair loss into three progressive stages. In Type I, there’s minimal thinning at the crown.
Type II sees increased diffuse thinning, and in Type III, significant hair loss occurs. This system aids clinicians in assessing the severity of FPHL and determining appropriate interventions.
Understanding the Ludwig classification enhances precision in diagnosing and treating female hair loss, facilitating tailored strategies for individuals at different stages of this common condition. Regular evaluations using this classification contribute to effective long-term management.
Unlike men, hair loss is typically more diffuse, usually affecting the crown and frontal areas of the scalp. Women rarely develop completely bald areas. While there is no reported prevalence of female pattern hair loss in Singapore, studies reveal that prevalence increases with age. It most commonly occurs following menopause, affecting 50% of women during their lifetime.
Since the 1990s, topical minoxidil remains the only FDA-approved treatment for female pattern hair loss or androgenetic alopecia in females. However, about 40% of women do not show improvement with topical minoxidil.
Increasingly, practitioners have been using finasteride as an add-on to the treatment of female pattern hair loss. Current guidelines suggest treatment efficacy with finasteride at a dose of 2.5 to 5mg per day. This dose is higher compared to the 1 mg per day dosing in male pattern baldness. Similarly, one expects to see improvements in hair loss within six months of finasteride.
The Controversies Surrounding Finasteride for Women
To date, there is no FDA-approved use of finasteride in women. However, healthcare providers sometimes prescribe finasteride for women off-label in the treatment of hirsutism and female pattern hair loss. Doctors can prescribe finasteride off-label after careful consideration of other treatment options. In this section, we explore the challenges and difficulties in the use of finasteride in women.
Navigating Safety Concerns
Studies into the use of finasteride in women have been made difficult because finasteride is a pregnancy category X medication. This means that the use of finasteride in pregnant women demonstrates a risk to the foetus. Specifically, male foetuses are at high risk of an abnormal development of the male genital tract.
Women who could become or are pregnant should not touch or handle finasteride as it could be absorbed through the skin. If finasteride is used in premenopausal women, reliable contraception during treatment and at least 30 days after the last dose is advised.
Women usually tolerate finasteride well. However, there is limited data available on the side effects of finasteride in women. Studies in males have included reports of reduced libido and breast swelling or tenderness. Additionally in both men and women, there have been few reports of mood changes such as anxiety and depression.
Research and Empirical Evidence
Like androgenetic alopecia in males, researchers suspect that DHT plays a role in both hirsutism and female pattern hair loss. However, the nature and degree of DHT’s role in these female conditions are not as well understood as in males.
The limited use of finasteride in the treatment of women’s health conditions is due to the potential risk during pregnancy. Current research supports the use of finasteride for female pattern hair loss primarily in postmenopausal women. Various clinical reports suggest that it may also be effective in selected premenopausal women with pattern hair loss.
Ongoing research and empirical evidence continue to shape the understanding of the use of finasteride in women. As more studies unfold, the medical community gains valuable insights into its efficacy and potential applications beyond its conventional usage. In the next section, we discuss the current alternatives to finasteride in hirsutism and female pattern hair loss.
Alternatives to Finasteride for Hirsutism
Hirsutism means excess body hair in women. It could be due to high levels of male hormones called androgens. It can also happen if the hair follicles are very sensitive to normal levels of androgens.
The most common condition that leads to extra androgens in women is called polycystic ovary syndrome (PCOS). This condition also causes irregular periods, weight gain, acne and other symptoms.
Other than finasteride, there are several medications available for the treatment of hirsutism. These medications can reduce the amount of body hair and prevent the growth of new hair. They can also reduce the growth rate and coarseness of existing hair. For visible improvements medicine needs to be consumed for at least six months. Not all medications for hirsutism are equally effective in all women.
Combined Hormonal Contraceptives
Birth control pills and patches containing a combination of estrogen and progestin lower the levels of androgens in the body. They are usually the first choice for the treatment of hirsutism. Majority of women with hirsutism (60-100%) will observe improvement when taking these medications. Birth control pills and patches can also regulate period cycles and improve symptoms of PCOS.
Spironolactone
Spironolactone is a medication that can block the action of androgens on the hair follicle. Similar to finasteride, it may cause birth defects, and healthcare providers typically advise reliable contraception in premenopausal women. If hirsutism does not improve after taking birth control pills for six months, healthcare providers usually recommend spironolactone as add-on treatment.
Weight Loss
Weight loss in overweight females can reduce levels of androgens and lessen hirsutism. Women with irregular period cycles may also observe a more regular period cycle after losing weight. At Dame, weight loss can be achieved in a safe and sustainable way, consult our doctors here.
Physical Hair Removal Treatments
Several methods can be used to physically remove or lighten excess hair so that it is less visible. These methods can be used concurrently with medications.
Shaving: a safe and effective method for hair removal, but may require daily sessions.
Chemical hair removal, waxing and bleaching: chemical agents used may cause skin sensitivity in some women. Always follow directions for patch testing before use.
Electrolysis: uses a tiny needle and a mild electrical current to destroy hair follicles. Best suited for small areas. Treatment is safe and effective but can be painful and often expensive.
Laser hair removal: uses a laser to destroy hairs. Works faster and less painful but usually more expensive than electrolysis. Most women require multiple treatment sessions to achieve satisfactory results.
Alternatives to Finasteride for Female Pattern Hair Loss
Losing hair is frustrating and upsetting. While it is normal and common to lose hair with age, it can be distressing. At Dame, we are here to navigate your hair journey with you. Other than finasteride, we discuss other available treatment options for female pattern hair loss.
Topical Minoxidil
The FDA has approved only topical minoxidil for treating female pattern hair loss, and healthcare providers recommend it for all women with this condition due to its strong evidence of effectiveness and safety.
In Singapore, topical minoxidil is available over-the-counter, without a prescription. Women who start applying topical minoxidil in the early stages of their hair loss, and who have smaller affected areas, respond best to topical minoxidil.
Apply topical minoxidil twice a day at a concentration of 2%, and it can be applied once a day at a higher concentration of 5%. Use daily application of topical minoxidil to the scalp for at least 4 months.
Hair shedding may occur at the initiation of treatment and usually decreases within two months. Hair growth may then be seen within 4-8 months. A full year of treatment is usually recommended.
Oral Minoxidil
Although topical minoxidil is an effective treatment option for hair loss, some women find it hard to adhere to applying a scalp treatment twice or even once a day. Some may not like the resulting hair texture, while some may experience scalp irritation after application of topical minoxidil.
In recent years, there has been growing evidence that a low dose of oral minoxidil can be safe and effective for the treatment of female-pattern hair loss. More studies are still required to establish its role in female hair loss.
To date, there is no oral minoxidil product registered with the HSA in Singapore. The recommendation by the FDA is still for topical minoxidil in the treatment of female-pattern hair loss. In Singapore, doctors are able to apply for a special licence to bring in oral minoxidil. Doctors are able to prescribe the medication off-label on a case-by-case basis. You can book an appointment with Dame’s doctors to find out more.
Read our comparison between topical and oral minoxidil here.
Spironolactone
Spironolactone is a prescription medication in Singapore. Like finasteride, it reduces the production of hormones that contribute to androgenetic alopecia or female pattern hair loss. Medical guidelines increasingly suggest the addition of spironolactone to topical minoxidil for the treatment of hair loss in females.
Spironolactone is often prescribed as a low dose, with dose increment over time. It usually takes about six months or longer to understand how the medication is working. Like finasteride, spironolactone should not be used during pregnancy. Reliable birth control has to be used in women of childbearing age.
Get Minoxidil or Spironolactone delivered directly to your doorstep in just 3 easy steps with Dame. Start here.
Ketoconazole
It is common to see anti-dandruff shampoos being marketed as anti-hair loss shampoos. In hair loss treatment, it is essential to treat scalp conditions like dandruff to minimise additional hair loss related to scalp inflammation.
Antifungal agents like ketoconazole are well established in the treatment of dandruff. Depending on the severity of the dandruff, topical corticosteroids like betamethasone may be added on to reduce itching.
Iron Supplements
Iron deficiency is a common cause of hair loss in women due to the monthly loss of blood during menstruation. It plays an important role in delivering oxygen to the hair follicles and supporting their growth and strength.
Vegans and vegetarians are at a higher risk for iron deficiency due to the lower availability of dietary iron in plants compared to meat and fish. At Dame, we recommend including iron-rich foods such as lean meats, leafy green vegetables such as spinach and kale, beans, and fortified cereals in your diet to maintain optimal iron levels for healthy hair growth. Always check with a healthcare professional if you plan to start iron supplementation for your hair loss.
Curious about organic hair regrowth solutions? Read more about it here.
Dame – Broadening Perspectives on Finasteride
The evolving landscape of healthcare embraces the expanded use of finasteride beyond men’s health, particularly in addressing women’s concerns. From addressing female pattern hair loss to navigating hormonal imbalances, finasteride’s potential applications are expanding.
For women in Singapore, exploring the potential benefits of finasteride requires a careful understanding of its applications in addressing female-specific health concerns. Before considering finasteride, women should consult with their healthcare provider to discuss potential benefits, risks and alternative treatments. At Dame, every individual’s health profile is unique – consult with our doctors today.
Frequently Asked Questions (FAQs)
At Dame, we answer all your burning questions on the use of finasteride in women.
Q: Can women safely use finasteride for hair loss?
Yes, women can use finasteride safely for hair loss upon consultation with a healthcare professional before starting treatment. Finasteride can be prescribed as an off-label treatment on a case-by-case basis. At Dame, our doctors will explain to you the risks and benefits associated with treatment. It is essential to understand all other treatment options to identify the best treatment for you.
Q: Are there significant differences in how finasteride works for men and women?
Finasteride works by blocking the action of the hormone dihydrotestosterone (DHT), which plays a role in male and female hair loss. The dosage and potential side effects may vary between genders. Research shows that a higher dose of finasteride (2.5 to 5 mg/day) is more effective in female pattern hair loss. The typical dose of finasteride used in the treatment of male pattern hair loss is 1 mg/day.
Women generally tolerate finasteride well. However, as its use is currently limited in women, more studies are required to fully understand how it affects women. Higher doses of finasteride (5 mg/day) commonly used to treat some prostate conditions may cause side effects including erectile dysfunction and decreased sex drive in males. However, such side effects are rarely seen with the finasteride 1mg dose used to treat male hair loss.
Q: What side effects should women be aware of when using finasteride?
Finasteride is usually well tolerated in women. Studies in males have included reports of sexual dysfunction and breast swelling or tenderness. It is important to monitor for any adverse effects and discuss them with your doctor.
Finasteride is not safe for use during pregnancy. There is a risk that it could cause abnormal development of the sexual organs in a male foetus. Finasteride treatment should be avoided in women who are pregnant or considering becoming pregnant. In women of childbearing age, reliable contraception should be used when taking finasteride.
Q: How long does it take to see results when using finasteride for female pattern hair loss?
Improvements in hair loss are expected to be seen within six months of daily use of finasteride. However, results may vary. Patience is key in hair regrowth, it usually takes up to a year to fully assess the benefits of finasteride. Always discuss with your doctor about your concerns.
Q: Is finasteride the only option for women experiencing hair loss?
Finasteride is one of the options for treating female hair loss. Other medications and treatments available include topical and oral minoxidil, spironolactone, topical ketoconazole and iron supplements. It is important to consult with a healthcare professional to explore the best suited options for you.
Q: Are there natural alternatives to finasteride for women?
Natural alternatives like diet and lifestyle changes may help promote hair growth. However, their effectiveness may vary depending on the cause of the hair loss. It is important to consult a healthcare professional for personalised advice. You can read more about organic hair regrowth solutions here.
Q: Can finasteride be used during pregnancy or breastfeeding?
Finasteride is not recommended for use during pregnancy as it may pose risks to the developing foetus. Pregnant or breastfeeding women should consult with their healthcare provider for alternative options.
Q: How to reduce the side effects of finasteride in both men and women?
To minimise the risk of side effects, it is important to use finasteride as prescribed. Communicate any concerns with your doctor. By monitoring for changes and dose adjustments if necessary can help manage potential side effects.
Q: Where can I buy finasteride in Singapore?
Finasteride is available by prescription in Singapore. At Dame, you can consult a MOH-licensed healthcare professional to obtain a prescription and guidance on its appropriate use. Avoid purchasing from unverified sources to ensure product authenticity and safety.
Disclaimer: Articles on Dame are for informational purposes only and do not constitute medical advice, diagnosis, or treatment. If you have concerns about your health, please consult a licensed doctor for personalised medical advice.
Speak with a Licensed Doctor Online
Our doctors are experienced in women’s health and provide confidential consultations through our secure telemedicine platform. If you have questions about symptoms, treatment options or your overall health, our team can help guide you with evidence-based medical advice.
Speak with a Licensed Doctor Online
Our doctors are experienced in women’s health and provide confidential consultations through our secure telemedicine platform. If you have questions about symptoms, treatment options or your overall health, our team can help guide you with evidence-based medical advice.
