Approximately 50% of women will experience some sort of hair loss over their lifetime. Female hair loss is commonly associated with stress, pregnancy, menopause, poor hair care or certain medical conditions. For women especially, hair loss can have a significant impact on their mental health and well-being, so it’s no surprise that women are looking at different ways to combat hair loss. Finasteride and minoxidil are the most popular medications to treat male pattern baldness, but what about women? 


What is Finasteride?

Finasteride is a hair loss treatment, primarily used by men – however, some research has suggested that finasteride may also be a potential treatment for hair loss in women. 

To understand finasteride, you first need to understand hair growth and what can affect it. There are four stages of hair growth: anagen, catagen, telogen, and exogen. The anagen phase is the growing phase – it lasts for about 3-5 years on the scalp, but can be shorter in other areas of the body. 

Catagen is the transitional phase, when the hair stops growing. Telogen is a resting phase when the hair remains on your head, but does not grow – this lasts around 3 months. Finally, hair enters the exogen phase, which is when the hair falls out (hair shedding). 

One thing that can affect the hair growth cycle is testosterone. People usually associate testosterone as being a male hormone, but it is also present in women, albeit at a much lower level. Testosterone shortens the anagen phase in which the hair is growing. 

Over time, this can lead to hair loss. Women generally do not have the same testosterone levels as men, but their follicles may be more sensitive to small increases in testosterone. 

After pregnancy and during the menopause, levels of oestrogen and progesterone decrease. Progesterone is one of the hormones that helps to keep testosterone levels in check. Therefore, when progesterone decreases, testosterone can increase, which may lead to hair loss.

Around 10% of testosterone is converted into a hormone called DHT. DHT is responsible for the shrinking of hair follicles, by reducing the blood flow to them. Finasteride blocks the enzyme that makes this conversion, stopping it from converting testosterone into DHT. In this way, finasteride can help counteract the raised testosterone levels that can lead to losing hair.

Finasteride is taken as a daily oral medication – one pill each day at the same time.   


Can Women Use Finasteride to Treat Hair Loss?

The hormone profile of men and women is very different. Women typically have much lower levels of testosterone. For this reason, finasteride is rarely used for female hair loss. For women, studies have shown that finasteride is only effective at relatively high doses, and higher doses carry an increased risk of side effects. 

Finasteride side effects include a reduced sex drive, breast tenderness and swelling, headaches, irregular periods, dizziness and increased body hair. Given the likelihood of experiencing side effects at this dose, the risks are typically not deemed to outweigh the benefits of finasteride for women.

In rare cases, finasteride has been prescribed to women with hormonal disorders leading to acne and excess body hair growth. However, considering the risk of side effects, finasteride is not usually prescribed to women. With this in mind, minoxidil is usually the recommended treatment for female pattern hair loss. 


Alternatives to Finasteride

As mentioned above, finasteride is typically not recommended for women, however, there are other treatment options available. The most commonly recommended medical treatment is minoxidil, also known as Regaine. 

Minoxidil is a topical treatment that is applied directly to the scalp. It works by increasing blood flow, stimulating the hair follicle and extending the growth phase (anagen). In some cases, this treatment may reactivate some hair follicles, stimulating hair growth and giving the impression of “regrowing” hair.


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Hair transplants are also becoming more available for women. Female hair loss is different from male balding. In male pattern hair loss (androgenic alopecia), the hairline recedes and the crown thins; in women, the hairline can recede, but there is also a more general thinning of the hair. For this reason, male and female hair transplants are different. 

The most popular form of female hair transplant is called FUE (follicular-unit excision). This involves taking hair follicles from areas where the hair is growing well and transplanting them into areas of hair loss. Unlike the male procedure, the head does not usually need to be shaved and the hair follicles are taken with the hair ‘long’. The follicles are then re-implanted between the natural follicles to give more thickness to the hair and added hair density in that area. 

Hair loss can affect women very differently and some women do not want to explore medical or surgical hair loss options. Some of these women may choose to wear head coverings, wigs or hair pieces to cover up their hair loss. 

There are also various groups available for women experiencing hair loss. They can provide further information and support, which can help you come to terms with these changes to your body.