Finasteride for Women
Finasteride is not indicated in women, and it is contraindicated in women who could potentially become pregnant, as it might cause abnormalities in the male fetus, including hypospadias and undervirilization. Exposure to semen of men on finasteride does not pose a problem.
Price performed a study using finasteride 1 mg for 12 months in a prospective, randomized, placebo-controlled, double-blind study and failed to show improvements in post-menopausal women. Whiting also showed no improvement after 12 months using scalp biopsies. However, in an uncontrolled study in 2006, Iorizzo found that post-menopausal women on 2.5 mg finasteride showed improvement but they were also simultaneously on an oral contraceptive (as hormone replacement therapy) so it is unclear whether the improvement was due to the finasteride or the contraceptive pill. Shum reported in a series of 4 women who had hyperandrogenism, improvement in hirsutism at 6 months and as late as 2.5 years after initiation.
POSITION STATEMENT OF THE LAM INSTITUTE FOR HAIR RESTORATION ON FINASTERIDE USAGE IN WOMEN
Finasteride is unsafe in women of reproductive age, and the Lam Institute for Hair Restoration (LIHR) does not prescribe finasteride for pre-menopausal women. The evidence as elaborated above for prescribing finasteride in post-menopausal women is unclear. However, after Dr. Lam has spoken to several of his respected colleagues and begun to evaluate the effects of finasteride in select post-menopausal women he believes there may be some limited benefit in this sub-select group of women. His position may change over time depending on updated clinical studies and his own personal observations, which will in turn be updated in this section of the website. Although finasteride has been shown to improve hirsutism in post-menopausal women, Dr. Lam does not treat hirsutism and will refer his female patients to a consulting dermatologist for professional assistance.