Finasteride 1 mg After Menopause: What the Trial Found

Finasteride 1 mg is approved in the US for male-pattern hair loss in men. Its label says it is not indicated for women. A prescription for a woman therefore needs an explanation of the proposed use, expected benefit and supporting evidence.¹

Who entered the trial?

The 2000 randomized, double-blind trial² enrolled 137 postmenopausal women, ages 41–60, with androgenetic alopecia, or pattern hair loss. They took finasteride 1 mg daily or placebo for 12 months. Researchers evaluated scalp counts, patient and investigator assessments, blinded photograph ratings and scalp biopsies.²

Did the hair counts improve?

The published abstract reports no statistically significant between-group difference in hair-count changes at one year. Counts decreased in both groups in the front/middle scalp. Photographs, self-assessments, investigator assessments and biopsy findings also failed to demonstrate benefit over placebo.²

This trial does not establish whether higher doses help, or answer treatment questions for other hair-loss diagnoses.²

What does that mean for a prescription today?

Ask what diagnosis the dermatologist has established. The American Academy of Dermatology³ notes that other causes can resemble female-pattern hair loss and need different treatment. It recommends topical minoxidil most often for this condition and describes several prescription options used outside their approved indications.³

If finasteride is proposed, ask for evidence matching your dose and diagnosis, the outcome that will judge benefit, and a review date. A treatment plan should state whether it is aiming for regrowth, slower progression or both. Bring photographs taken before treatment so the comparison does not depend on memory.

The finasteride label includes postmarketing reports of depression, suicidal thoughts or behavior, and sexual dysfunction that continued after stopping. Such reports cannot reliably establish how often an effect occurs or prove the medicine caused it. Review your history and the instructions for new symptoms with the prescriber. Our finasteride prescribing questions cover formulation and safety discussions.¹

Hair, Everywhere describes a Hair Log with monthly photographs, treatment names and start dates. Use the same lighting, distance and angle when recording your part and hairline, and take the log to follow-up. See the book.