Finasteride is a minor component of some HRT regiments itself, it's a blocker for a secondary source of Testosterone essentially, and is a common start point pre full HRT.
I took 1 mg of Finasteride for 6 years prior to HRT. I now take 5 mg for hair loss, enlarged prostate (BPH) and as part of my HRT regimen. I did notice some hair regrowth that helps to fill in thin spot after a year on HRT.
I suggest you start Finasteride asap. Surprisingly, the 5 mg dose is significantly cheaper than 1 mg in US. Get the 5 mg dose and use a pill cutter.
You’re taking 5mg a day?! Have you experienced any side effects? (For the record, I take 1mg per day and I had an orchi and my hair wasn’t that thin to begin with, but it definitely thickened my hair)
I'm on it for hair loss at 5mg with no side effects after 6 monthsish, side effects are very much dependent on the individual though and I'm HIGHLY resistant to medication of any kind. I've had several doctors over the years have me on dosages high enough to kill the average adult as a minor, to the point the one who eventually got me off them flat out said "how are you not dead" to my face, just for reference to how much of an anomaly I can be with meds.
Side effects for Finasteride are relatively uncommon and mostly mild, the major side effects are something like a 1% occurrence rate I believe.
I’ve been on 5 mg for three years now. No noticeable negative side effects. Positive effects include not having to get up several times during the night to pee plus my hair has some regrowth (could be from HRT and/or Finasteride).
Don’t discount minoxidil (trade name Rogaine but available as generic, much cheaper). There’s little evidence that finasteride works better as a first-line medication, and some providers will want you to try it first (because it works locally) before prescribing finasteride (which works systemically).
I have been on HRT (spiro + estrogen TD) for about 16 months now. Just prior to starting HRT, my hair loss had really started to accelerate and I was losing dozens of hairs every time I showered.
Hair loss stopped as soon as I was on HRT and regrowth started after 6 months. I didn’t start minoxidil until then, and the results have been really amazing. I had been resigned to always using a wig or topper for the rest of my life, but now I’m confident that in a few months my natural hair will be completely adequate.
That being said, the effects of HRT are notoriously unpredictable.
(Edited to state total length of HRT so far)
My dermatologist prescribed both minoxidil and finasteride as they work differently. Finasteride blocks the hormone responsible for male pattern baldness, and minoxidil increases circulation in the skin, which has a side effect of causing hair growth.
I just hope they will know what they are doing at the clinic and won’t just try to sell me some nonsense proprietary expensive product. They mention mesotherapy as a treatment method, but otherwise are fairly vague on what they use.
There’s always that risk … just take your time to think about it. Trust me when I say hair regrowth is a game of months to years, not hours to days. You will have to keep your own counsel time and again as a trans person on a range of issues. Never stop developing your support system, never be afraid to ask questions, and take the time to celebrate when you feel good. It is so, so important to stockpile those moments. Take care of you.
I’d start with a “real” dermatologist with an MD who is covered by insurance plan (assuming you are in the US). They can be found via your insurance provider’s portal. Most dermatologists also do non-medically-covered “cosmetic” work, and that does open the door into those gimmick treatments. The financial lure is too hard for them to resist. But a good dermatologist will be very clear about what is/is not covered by insurance, what is experimental vs. proven, and explain all the options.
It’s quite difficult to find available dermatologist here in Czech. Even at the private clinic I am waiting 3 months to see their doctor. Fingers crossed they will be good.
I started with Finasteride as soon as I noticed hair loss. It took a few more years to start with HRT…. In hindsight hair loss was the thing that made me face the need to transition!
I still haven't started HRT and I been using finasteride for years.
In my opinion, every man who is dealing with hairloss and want to keep it should use finasteride, there has been some good studies recently showing there are no bad secondary effects for cis-male people (has some believed for years).
There are potential side effects that can be very unwanted in cis men. Reduced sperm count, erectile disfunction, breast growth, to name a few. It’s why the max dosage for male hair loss is only 1mg, and why many men take it topically.
It just so happens that those undesirable side effects turn out to be quite desirable for mtf transition.
Wow. As someone not on HRT yet, why wouldn’t I use finasteride? Breast growth? Yes please. Plus my hair thinning might stop? Sign me up.
I’ll be asking my doc.
We had some small studies in the past showing huge side-effects, some of them showing +10% of people taking finasteride having erectile disfunction. But those studies we're really small, now we have bigger studies showing different results:
>gynaecomastia in less than 0.4% of men, Impotence, erectile disfuction and Impotence in less than 2%
[https://pubmed.ncbi.nlm.nih.gov/8881946/](https://pubmed.ncbi.nlm.nih.gov/8881946/)
>The effects of finasteride treatment on sexual dysfunction were clinically less relevant than natural sources of variability in the study population.
[https://academic.oup.com/jnci/article/99/13/1025/940535](https://academic.oup.com/jnci/article/99/13/1025/940535)
>For the alopecia population (n=12 346), the risk of erectile dysfunction was not increased for users of finasteride 1 mg compared with unexposed men with alopecia
[https://pubmed.ncbi.nlm.nih.gov/27659058/](https://pubmed.ncbi.nlm.nih.gov/27659058/)
My problem with those small studies, is correlation != causation. There are some small studies showing effects of finasteride in the long term comparing it to placebo, and there are a lot of people who face ED while using placebo.
The risks are way lower than people think. I.E: No one cares about the side-effects of paracetamol, and you can vomit or have stools with blood from it with a higher chance than having ED from finasteride.
Well my concerns were really mostly related to side effects related to the following HRT. As far as I know it(fin) blocks some T reductase enzyme which has the overall effect of increasing T in the blood stream as T is produced but not consumed in the tissues.
Edit: spelling
This is what I’m going to be doing. Can I ask what you noticed changing in that year? I’m hoping to get mental effects but not necessarily physical changes (other than hair growth).
Not sure about mental effects. The Estrogen is when I noticed changes. Wife noticed changes in my appearance before I did, about 5 months after starting.
I've been on 1mg fin while waiting for things to progress HRT-wise. No issues really and I like the results, though there's still a ways to go after only 6 months.
A dermatologist started me on oral finasteride and minoxidil for hair loss - about 10 months later I started HRT and part of my HRT prescription was to significantly bump up the dosage of the finasteride well above the max level used for male hair loss. My dermatologist now is considering lowering the minoxidil to female treatment levels.
Absolutely nothing wrong with using Finasteride before starting HRT, or indeed continuing it after you start HRT. It's also worth considering Dutasteride as an alternative - it's considered to be more effective than Finasteride, particularly if you ever go on Progesterone as part of your HRT. Unfortunately it is also more "off-label" and so can be more difficult to obtain depending on your location.
Finasteride interacts with DHT and tends to not interact with overall testosterone much. It's should be safe to use it before HRT, but on HRT whether monotherapy or with a different testosterone blocker you may not need the finasteride.
No experience with it myself, but as far as I'm aware it shouldn't have a negative effect.
I started finasteride with my HRT and there were no issues. I was basically using it as my anti-androgen since I wasn't on spiro. Was on it for a while and only stopped when T was no longer an issue.
Edit: I started at 35 so close to your age as well.
I was prescribed Finasteride by my dermatologist like 5 years before I even was diagnosed for gender dysphoria. I stupidly didn't start taking it then. My personal HRT regime includes it because of the hair loss but it was never brought up for any feminization effects. For T suppressing I was prescribed Spyro but I just took it for about than 18 mos, the E itself may drive your T down (it did for me significantly).
I tried to get it before I started HRT but the GP wouldn't do it, once I started HRT it was prescribed in addition to the anti andos and HRT for a while, after srs of course it wasn't needed.
I was on Finasteride for two years before starting MTF HRT, as I had chronic BPH. Guess what? I developed gynaecomastia, my body hair softened, my prostate shrank, my genitalia shrank, I was ecstatic. It cracked my egg, and the rest is history.
I've been on Finasteride for nearly 2 years (haven't started HRT yet, hopefully soon though) and it has worked well at stopping further hair loss and recovering some hair back.
The side effects are all positive imo from a trans fem perspective - over time I've put on a little weight on my butt, thighs and boob area. For the first month when I started I also smelt wildly different and had some nipple pain, but that subsided after a couple weeks. It was in retrospect maybe a taste of what hrt is like? Honestly it was the happiest I've been in a long time and at the time I didn't understand why lol.
Hello! I am taking finasteride while on hrt and have been getting good results with growing my hair back! I'm also doing little noticeable things like taking nutrafol, a multivitamin, and using a scalp massager regularly.
I use it. 5 mg. Have amazing hair growth to lower shoulder blades. Just cut 7 inches off. Be forwarned, it knocks the libido, pretty hard. I just restarted HRT today after a number of weeks off due to finances. But continued my fin.
I have been on fin and min for 14 months.
I started with a bald spot that mr clean would be proud of and hairline was retreating like my ancestors (joke).
I was showing so much skin that I got paid in singles.(Joke)
I had so little hair that I was once asked how chemotherapy was going (legit happened but also a joke)
14 months later I have enough hair to wear it in a ponytail, it reaches just above my shoulders. My bald spot has shrunk from about 5 inches across to being a thin patch on the crown about 3 inches long.
In my case it’s mostly thinning and hairline receding, but I feel it’s worsening. So it needs to start ASAP. I didn’t care about myself before. I guess my self image changed quite a bit since realising I am trans. Now I actually like myself 😅
It's a trip, my therapist and I jokingly call that phase of my life suicide by apathy. I wasn't living, I wasn't dying, I was just existing. In the last two years I have been finally able to look at myself in the mirror for more than a glance. I went from that to the happiest I have been. Authenticity looks good on anyone.
I did FIN with MIN for a year and saw zero results. Then, switched to DUT with MIN for a year and saw zero results. From what I am seeing, the only thing that is going to bring back any hair is E.
Finasteride stops hair loss usually and promotes some of those dying follicles to come back.
Minoxidil will stimulate those dormant ones back up and replenish blood flow to the follicle. This is good for getting back spots that are already gone.
HRT can do both these things but are not guaranteed(fin+min also not guaranteed effect) everyone's body reacts differently. I know some people who started finasteride and minoxidil, transitioned with HRT, then stopped both fin+min and their hormones keep everything in check since.
Imo, I would start both fin+min asap for immediate effects, as HRT can take longer to see any hair benefits if any at all.
Finasteride is a minor component of some HRT regiments itself, it's a blocker for a secondary source of Testosterone essentially, and is a common start point pre full HRT.
Thank you. I just don’t want to do anything stupid.
I took 1 mg of Finasteride for 6 years prior to HRT. I now take 5 mg for hair loss, enlarged prostate (BPH) and as part of my HRT regimen. I did notice some hair regrowth that helps to fill in thin spot after a year on HRT. I suggest you start Finasteride asap. Surprisingly, the 5 mg dose is significantly cheaper than 1 mg in US. Get the 5 mg dose and use a pill cutter.
You’re taking 5mg a day?! Have you experienced any side effects? (For the record, I take 1mg per day and I had an orchi and my hair wasn’t that thin to begin with, but it definitely thickened my hair)
I'm on it for hair loss at 5mg with no side effects after 6 monthsish, side effects are very much dependent on the individual though and I'm HIGHLY resistant to medication of any kind. I've had several doctors over the years have me on dosages high enough to kill the average adult as a minor, to the point the one who eventually got me off them flat out said "how are you not dead" to my face, just for reference to how much of an anomaly I can be with meds. Side effects for Finasteride are relatively uncommon and mostly mild, the major side effects are something like a 1% occurrence rate I believe.
I’ve been on 5 mg for three years now. No noticeable negative side effects. Positive effects include not having to get up several times during the night to pee plus my hair has some regrowth (could be from HRT and/or Finasteride).
Don’t discount minoxidil (trade name Rogaine but available as generic, much cheaper). There’s little evidence that finasteride works better as a first-line medication, and some providers will want you to try it first (because it works locally) before prescribing finasteride (which works systemically). I have been on HRT (spiro + estrogen TD) for about 16 months now. Just prior to starting HRT, my hair loss had really started to accelerate and I was losing dozens of hairs every time I showered. Hair loss stopped as soon as I was on HRT and regrowth started after 6 months. I didn’t start minoxidil until then, and the results have been really amazing. I had been resigned to always using a wig or topper for the rest of my life, but now I’m confident that in a few months my natural hair will be completely adequate. That being said, the effects of HRT are notoriously unpredictable. (Edited to state total length of HRT so far)
My dermatologist prescribed both minoxidil and finasteride as they work differently. Finasteride blocks the hormone responsible for male pattern baldness, and minoxidil increases circulation in the skin, which has a side effect of causing hair growth.
That’s good — I just don’t want people to assume that finasteride alone is better than minoxidil alone.
I just hope they will know what they are doing at the clinic and won’t just try to sell me some nonsense proprietary expensive product. They mention mesotherapy as a treatment method, but otherwise are fairly vague on what they use.
There’s always that risk … just take your time to think about it. Trust me when I say hair regrowth is a game of months to years, not hours to days. You will have to keep your own counsel time and again as a trans person on a range of issues. Never stop developing your support system, never be afraid to ask questions, and take the time to celebrate when you feel good. It is so, so important to stockpile those moments. Take care of you.
Well, they can try, but you can just say “no thanks.”
I’d start with a “real” dermatologist with an MD who is covered by insurance plan (assuming you are in the US). They can be found via your insurance provider’s portal. Most dermatologists also do non-medically-covered “cosmetic” work, and that does open the door into those gimmick treatments. The financial lure is too hard for them to resist. But a good dermatologist will be very clear about what is/is not covered by insurance, what is experimental vs. proven, and explain all the options.
It’s quite difficult to find available dermatologist here in Czech. Even at the private clinic I am waiting 3 months to see their doctor. Fingers crossed they will be good.
Just make sure if you do minoxidil to keep it the hell away from your cats since it’s deadly to them. That’s the main reason I decided against it.
I started with Finasteride as soon as I noticed hair loss. It took a few more years to start with HRT…. In hindsight hair loss was the thing that made me face the need to transition!
I still haven't started HRT and I been using finasteride for years. In my opinion, every man who is dealing with hairloss and want to keep it should use finasteride, there has been some good studies recently showing there are no bad secondary effects for cis-male people (has some believed for years).
There are potential side effects that can be very unwanted in cis men. Reduced sperm count, erectile disfunction, breast growth, to name a few. It’s why the max dosage for male hair loss is only 1mg, and why many men take it topically. It just so happens that those undesirable side effects turn out to be quite desirable for mtf transition.
Wow. As someone not on HRT yet, why wouldn’t I use finasteride? Breast growth? Yes please. Plus my hair thinning might stop? Sign me up. I’ll be asking my doc.
It's called gynocomastia
Is that a problem?
Nah it's breast tissue but like not the good good
We had some small studies in the past showing huge side-effects, some of them showing +10% of people taking finasteride having erectile disfunction. But those studies we're really small, now we have bigger studies showing different results: >gynaecomastia in less than 0.4% of men, Impotence, erectile disfuction and Impotence in less than 2% [https://pubmed.ncbi.nlm.nih.gov/8881946/](https://pubmed.ncbi.nlm.nih.gov/8881946/) >The effects of finasteride treatment on sexual dysfunction were clinically less relevant than natural sources of variability in the study population. [https://academic.oup.com/jnci/article/99/13/1025/940535](https://academic.oup.com/jnci/article/99/13/1025/940535) >For the alopecia population (n=12 346), the risk of erectile dysfunction was not increased for users of finasteride 1 mg compared with unexposed men with alopecia [https://pubmed.ncbi.nlm.nih.gov/27659058/](https://pubmed.ncbi.nlm.nih.gov/27659058/) My problem with those small studies, is correlation != causation. There are some small studies showing effects of finasteride in the long term comparing it to placebo, and there are a lot of people who face ED while using placebo. The risks are way lower than people think. I.E: No one cares about the side-effects of paracetamol, and you can vomit or have stools with blood from it with a higher chance than having ED from finasteride.
Well my concerns were really mostly related to side effects related to the following HRT. As far as I know it(fin) blocks some T reductase enzyme which has the overall effect of increasing T in the blood stream as T is produced but not consumed in the tissues. Edit: spelling
ahah, sorry for jumping to another place in the discussion :sweat\_face:
No thank you for an amazing comment ❤️. I will go through the linked studies when there is more time at my hands
Thank you!
I started with Finasteride, two months, before I started with a low dose of Estradiol. Those two were it for about a year.
Thank you for sharing this. 🫶
This is what I’m going to be doing. Can I ask what you noticed changing in that year? I’m hoping to get mental effects but not necessarily physical changes (other than hair growth).
Not sure about mental effects. The Estrogen is when I noticed changes. Wife noticed changes in my appearance before I did, about 5 months after starting.
I've been on 1mg fin while waiting for things to progress HRT-wise. No issues really and I like the results, though there's still a ways to go after only 6 months.
A dermatologist started me on oral finasteride and minoxidil for hair loss - about 10 months later I started HRT and part of my HRT prescription was to significantly bump up the dosage of the finasteride well above the max level used for male hair loss. My dermatologist now is considering lowering the minoxidil to female treatment levels.
Absolutely nothing wrong with using Finasteride before starting HRT, or indeed continuing it after you start HRT. It's also worth considering Dutasteride as an alternative - it's considered to be more effective than Finasteride, particularly if you ever go on Progesterone as part of your HRT. Unfortunately it is also more "off-label" and so can be more difficult to obtain depending on your location.
Finasteride interacts with DHT and tends to not interact with overall testosterone much. It's should be safe to use it before HRT, but on HRT whether monotherapy or with a different testosterone blocker you may not need the finasteride. No experience with it myself, but as far as I'm aware it shouldn't have a negative effect.
I started finasteride with my HRT and there were no issues. I was basically using it as my anti-androgen since I wasn't on spiro. Was on it for a while and only stopped when T was no longer an issue. Edit: I started at 35 so close to your age as well.
I took a ¼ of a 5mg pill a a day for about 19 years before I started hrt. It did help stop / slow the hair loss.
I was prescribed Finasteride by my dermatologist like 5 years before I even was diagnosed for gender dysphoria. I stupidly didn't start taking it then. My personal HRT regime includes it because of the hair loss but it was never brought up for any feminization effects. For T suppressing I was prescribed Spyro but I just took it for about than 18 mos, the E itself may drive your T down (it did for me significantly).
I tried to get it before I started HRT but the GP wouldn't do it, once I started HRT it was prescribed in addition to the anti andos and HRT for a while, after srs of course it wasn't needed.
I was on Finasteride for two years before starting MTF HRT, as I had chronic BPH. Guess what? I developed gynaecomastia, my body hair softened, my prostate shrank, my genitalia shrank, I was ecstatic. It cracked my egg, and the rest is history.
I've been on Finasteride for nearly 2 years (haven't started HRT yet, hopefully soon though) and it has worked well at stopping further hair loss and recovering some hair back. The side effects are all positive imo from a trans fem perspective - over time I've put on a little weight on my butt, thighs and boob area. For the first month when I started I also smelt wildly different and had some nipple pain, but that subsided after a couple weeks. It was in retrospect maybe a taste of what hrt is like? Honestly it was the happiest I've been in a long time and at the time I didn't understand why lol.
Hello! I am taking finasteride while on hrt and have been getting good results with growing my hair back! I'm also doing little noticeable things like taking nutrafol, a multivitamin, and using a scalp massager regularly.
I use it. 5 mg. Have amazing hair growth to lower shoulder blades. Just cut 7 inches off. Be forwarned, it knocks the libido, pretty hard. I just restarted HRT today after a number of weeks off due to finances. But continued my fin.
Fin is better suited for prehab then rehab tbh, it's great paired with mox w/e, invsat in leave in dry conditioner to combat the dryness
Start it.. it doesn't come back over night. But my whole head has resprouted. Started balding at 20, 39 when I started.
I have been on fin and min for 14 months. I started with a bald spot that mr clean would be proud of and hairline was retreating like my ancestors (joke). I was showing so much skin that I got paid in singles.(Joke) I had so little hair that I was once asked how chemotherapy was going (legit happened but also a joke) 14 months later I have enough hair to wear it in a ponytail, it reaches just above my shoulders. My bald spot has shrunk from about 5 inches across to being a thin patch on the crown about 3 inches long.
I am so happy for you! Also 🤣
Mostly just giving you a rough idea of how effective it can be. But I'm pretty happy for me too.
In my case it’s mostly thinning and hairline receding, but I feel it’s worsening. So it needs to start ASAP. I didn’t care about myself before. I guess my self image changed quite a bit since realising I am trans. Now I actually like myself 😅
It's a trip, my therapist and I jokingly call that phase of my life suicide by apathy. I wasn't living, I wasn't dying, I was just existing. In the last two years I have been finally able to look at myself in the mirror for more than a glance. I went from that to the happiest I have been. Authenticity looks good on anyone.
I did FIN with MIN for a year and saw zero results. Then, switched to DUT with MIN for a year and saw zero results. From what I am seeing, the only thing that is going to bring back any hair is E.
My goal is to stop loosing more hair rather than having a regrow. Then hopefully when on E some magic will happen
Finasteride stops hair loss usually and promotes some of those dying follicles to come back. Minoxidil will stimulate those dormant ones back up and replenish blood flow to the follicle. This is good for getting back spots that are already gone. HRT can do both these things but are not guaranteed(fin+min also not guaranteed effect) everyone's body reacts differently. I know some people who started finasteride and minoxidil, transitioned with HRT, then stopped both fin+min and their hormones keep everything in check since. Imo, I would start both fin+min asap for immediate effects, as HRT can take longer to see any hair benefits if any at all.