Hair loss treatments

Finasteride and Pregnancy

Young couple considering finasteride and pregnancy safety.

You’ve likely noticed that finasteride treatment comes with a warning: the medication should not be handled or used by women who are, or may become pregnant. The key issue is that finasteride is a 5-alpha reductase inhibitor and works by lowering dihydrotestosterone (DHT) levels. DHT happens to play a critical role in male development and because of this, doctors are extra cautious when prescribing this medication to female patients. Other precautions also apply to men who may be living with a female roommate or partner. In these cases, women should avoid accidentally handling finasteride.

In this article, we’ll address questions around finasteride and pregnancy, whether finasteride affects pregnancy or causes birth defects, when to stop finasteride before pregnancy and the safe handling of finasteride during pregnancy. If you or your partner become pregnant over the course of your finasteride treatment, you must notify your doctor.

Does finasteride affect pregnancy? Is finasteride safe during pregnancy?

Finasteride is not safe to use during pregnancy and should be avoided by women who are breastfeeding. Finasteride can cross the placenta and may also find its way into breast milk. Additionally, in animal studies, finasteride pregnancy has been associated with birth defects.

Due to ethical concerns, research on the effects of finasteride and other related medications during pregnancy is limited. But there have been reported cases of finasteride causing abnormal development of the male genital tract in male fetuses exposed to finasteride in utero. To minimize the potential risk for harm, women who are, or could become pregnant should avoid handling finasteride pills or topical forms of finasteride.

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Is topical finasteride safe in pregnancy?

Finasteride in any form is not considered safe for use by women planning to conceive. This includes topical finasteride. Female patients experiencing significant hair loss should discuss the risks and benefits of topical finasteride vs oral finasteride with a doctor, who will be able to counsel and offer advice on the safety of hair loss treatments. If finasteride isn’t the ideal treatment for your hair loss there may be other options available to you, such as topical minoxidil.

Can I take finasteride while my partner is pregnant?

Whether you can take or continue taking finasteride while your partner is pregnant is something that you should discuss with your doctor. Although concentrations are likely very low, finasteride may still be detected in semen. To reduce the risk of possibly transferring finasteride to your partner, your doctor may advise you to discontinue your finasteride (a) if your partner is trying to become pregnant and (b) during your partner’s pregnancy, unless barrier contraception is used (e.g. condoms).

For some couples, topical finasteride may still be a treatment option for male pattern hair loss. This is something that you may want to discuss with a doctor. Because topical finasteride is applied directly to the skin, it may result in lower circulating levels of finasteride in the bloodstream and pose a lower risk to a developing fetus. But even if this risk is low, it is not zero. It’s still necessary to discuss all the risks and benefits with a healthcare provider.

When to stop finasteride before pregnancy?

Although it hasn’t been formally studied, many doctors will recommend that their male patients stop using finasteride at least one month before trying to conceive with a female partner. Stopping finasteride one month prior to beginning to try and conceive seems scientifically validated, given that the half life of the medication is 5-6 hours.

To further prevent accidental pregnancy during this one month period, doctors may also recommend using some form of barrier contraception, such as condoms. As with most issues discussed in this article, the decision of when it’s safe to stop finasteride before your partner tries to conceive should be made by consulting a doctor.

Finasteride handling: Pregnancy

Out of an abundance of caution, women should not handle finasteride during pregnancy or while breastfeeding. This could mean touching finasteride pills or touching topical finasteride, intentionally or accidentally. It’s important to inform your female partner of these risks and work together to lower these risks.

For example, if you are using topical finasteride, it's important to follow the prescribing doctors’ instructions or those contained in the safety brochure. Applying the topical treatment in the morning and not before bedtime is important and washing your hair before bed is a good idea to help minimize the chances of finasteride transferring from your scalp onto your pillows and to your female partner’s skin. It also goes without saying that if you’re using a topical form of finasteride, you should avoid letting your partner touch or massage your scalp (no matter how much you may want her to).

Finasteride and pregnancy: Takeaway

Finasteride is often an essential component to a hair regrowth regimen, but it does require careful handling, especially if you live with a female partner who is, or could become pregnant, or even a female roommate. It’s generally recommended that if you’re trying to conceive, you should discontinue finasteride treatment at least a month before your female partner tries to become pregnant. During this washout period, it’s important to use barrier contraception. If you’d like to continue using finasteride during your partner’s pregnancy, it’s important to discuss the risks and benefits with your prescribing doctor.

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