While the drug is contraindicated for restoring hair in females of childbearing age, patients who are interested in using Finasteride for pattern baldness must work closely with a physician in terms of complete disclosure and compliance with prescribed guidelines for taking the oral medication.
Studies on Women, Propecia and Hair Restoration
There have actually been studies performed on the effects of Finasteride for reversing hair loss in women. These were done using the dosage of 1mg per day. Significant improvements were not seen at this level.
Other countries have published similar research on women. But higher dosages between 2.5-5.0 mg were used instead. And the data actually did reveal better outcomes on female pattern baldness in women.
The Use of Off-Label Drugs for Fighting Hair Loss
At the moment, there are only two FDA approved medications for the management of androgenic alopecia.
(1) Rogaine (Minoxidil)
Rogaine is a topical, over the counter medication which is available as 2% Minoxidil and 5% Minoxidil. 2% is considered to be the safe level for women. Females can also use 5% under the direction of a physician
(2) Propecia (Finasteride)
Propecia is indicated for men, but can be prescribed off-label for women
Off- label means that the medication is not listed for a particular indication by the FDA. However, doctors are allowed by law to prescribe these drugs when they feel it is safe or effective to do so.
The primary risk in taking off-label medications is the lack of sufficient research which shows specific long term effects. Also dosage restrictions are not clear. Therefore physicians need to be extremely cautious through a conservative approach when prescribing these medications for their patients.
Spiranolactone as a Medication to Treat Female Hair Loss
Most doctors are reluctant to recommend oral medication for female pattern baldness. Pattern hair loss in women is often the result of many different variables working together. This often includes hormonal fluctuations, in addition to the effect of androgens on protein receptors within the follicles.
The use of drugs for hair loss can only be effective when there is a primary causal factor at work. Therefore, doctors are more likely to recommend the use of Minoxidil for women as the first stage.
If the topical medical does not help, Spironolactone may be considered. Dosages can range up to 200 mg a day. Its main indication is as a diuretic. But it is also capable of occupying androgen receptors on the hair follicle to prevent the destructive miniaturizing dynamics of DHT.
Spironolactone is also contraindicated during pregnancy. But its effects do not linger as long as Finasteride. Therefore, it offers more safety in case a female patient changes her mind about having children in the future.
