Does finasteride lower testosterone?

A doctor or healthcare professional may prescribe finasteride to help treat an enlarged prostate (benign prostatic hyperplasia) or male pattern hair loss.

Finasteride is the generic version of Proscar and Propecia. While these medications effectively treat both conditions, as with all drugs, there are risks of side effects.

With finasteride, the side effects can be due to changes in your testosterone levels.

What is finasteride?

Finasteride is the active ingredient in the prescription-only oral drugs Proscar and Propecia.

Proscar is available as 5 milligrams (mg) tablets, while Propecia is available as 1 mg tablets.

Finasteride blocks the action of an enzyme your body naturally produces, called 5-alpha-reductase. This enzyme is responsible for converting testosterone into another form.

How might finasteride affect testosterone?

Finasteride (Proscar) works to block the breakdown of testosterone. While taking finasteride, you may experience increased levels of testosterone circulating in your bloodstream.

However, this means that certain testosterone byproducts are unavailable for your body to use. These byproducts can be important for a range of bodily functions, like:

• erectile function
• sex drive (libido)
• ejaculate volume
• sperm motility

What does this mean for hair growth?

The molecule that triggers male pattern hair loss is the androgen, or male sex hormone, dihydrotestosterone (DHT).

As DHT flows through your bloodstream and reaches your scalp, it affects your hair follicles. Once it links to the receptors within your hair follicles, it can shrink them, causing fewer healthy hairs to grow. This can contribute to hair loss.

Finasteride (Proscar) blocks testosterone from breaking down into DHT by blocking the action of the 5-alpha reductase enzyme.

Does DHT cause any other health conditions?

While DHT is essential for many processes as you grow, such as the formation of your prostate, it may have some negative effects, especially as you age.

These negative effects can include:

• slow skin healing
• enlarged prostate
• coronary heart disease
• prostate cancer

Does testosterone increase when taking finasteride?

The amount your testosterone levels may change while taking finasteride will depend on you as an individual. It will also depend on the dosage you take.

According to an older review, taking 5 mg of finasteride daily for an enlarged prostate can result in a 15–25% increase in testosterone levels.

Another older study showed that those with low baseline testosterone levels had the greatest increase when using finasteride.

Any hormonal changes you experience while taking finasteride (Proscar) will reverse if you stop taking the medication.

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Can you take finasteride and testosterone together?

Whether or not you can take testosterone supplements will depend on the reason your doctor is prescribing finasteride.

According to an older clinical trial, it is safe to have testosterone replacement therapy medications alongside finasteride. This can help if you need to take finasteride but have low serum testosterone levels to begin with. It may also help you retain a safe level of DHT in your bloodstream, for example, to help retain muscular strength.

Always speak with a doctor before starting a new medication or over-the-counter supplements.

Finasteride side effects and safety

Several side effects may develop while you’re taking finasteride (Proscar), and the most common include:

• impotence
• lower libido
• depression
• enlarged breast tissue
• lower ejaculate volume
• physical weakness or tiredness
• low blood pressure
• dizziness

Finasteride may increase your risk of developing a particularly aggressive type of prostate cancer. Symptoms of prostate cancer include:

• blood in your pee or semen
• pain in your back
• pain while peeing
• needing to pee more than your usual amount

Are there finasteride alternatives?

Depending on the health condition causing your symptoms, there are different alternatives to finasteride available.

Hair loss

For hair loss, alternatives include minoxidil (Rogaine) and triamcinolone acetonide (Kenalog 10, Kenalog 40, Kenalog 80).

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Prostate

For an enlarged prostate, a doctor may recommend the following alternatives:

• terazosin hydrochloride
• doxazosin (Cardura)
• alfuzosin (Uroxatral)

Summary

Finasteride is a safe and effective medication that works to stop the progression of male pattern hair loss and enlarged prostate by blocking the formation of DHT.

However, it can cause changes to the amount of testosterone in your bloodstream, leading to various symptoms, such as low libido, tiredness, and dizziness.

If you find that finasteride is not suitable for you, a doctor or healthcare professional can help you explore other options.

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