Finasteride side effects: an honest guide before you start
Finasteride helps many men, but it has side effects you should hear about from the start. This guide explains how it works, which results are realistic, what the 2025 EMA review found and how to report a problem.
Finasteride side effects in short: most men have no problems, but a minority have reactions serious enough that you should know about them before you start. The most important are changes in mood, including low mood and thoughts of suicide, and sexual problems such as reduced desire. If your mood changes, stop the treatment and speak to a doctor. Our doctors can go through the risks, your medical history and your options with you by video, with no pressure.
Causes
Why does hair thin?
If you have noticed your hairline receding or the crown thinning, you are not alone. Male pattern hair loss is common, and for many men it starts as early as the age of 20. It is not a medical emergency, but it can knock your confidence, and wanting to do something about it is perfectly natural.
It comes down to two things, broadly: genes and a hormone called DHT (dihydrotestosterone). If you have inherited sensitive hair follicles, DHT gradually shrinks them. Each new hair grows in a little thinner and shorter than the one before, until the follicle stops producing a visible hair at all. That is why the process is slow and usually shows at the temples, the crown or both.
How it works
Finasteride 1 mg: how it works and who it is for
Finasteride is one of the treatments you will hear about most often. It works well for many men. It also has side effects that are worth knowing from the start, not from the small print. So here is the straight version, from the doctors who would be prescribing it to you.
Finasteride blocks the enzyme that turns testosterone into DHT. Less DHT means less pressure on the follicles, so hair loss slows down and, in many men, some hair grows back.
In Romania, the 1 mg tablet is authorised for men aged 18 to 41 with early stages of male pattern hair loss (androgenetic alopecia). (You will also find a 5 mg version online: it is a different medicine, used for an enlarged prostate (benign prostatic hyperplasia), not for hair.) Finasteride tablets are not authorised for women or for anyone under 18.
Sources: ANMDMR, Propecia 1 mg: patient leaflet; ANMDMR, Propecia 1 mg: summary of product characteristics; ANMDMR communication of 20 June 2025.
What to expect
Realistic results: how long it takes and what to expect
It is a slow treatment, and patience is part of it. You take one tablet a day, with or without food. In most men there is not much to see in the first three to six months, and only around a year in can you really judge whether it is working.
It works best at keeping what you have. Many men stop losing hair, and some notice visible regrowth, mostly at the crown. It is less likely to restore a hairline that has already receded a long way.
One thing many people do not know: it only works for as long as you take it. If you stop the treatment, the hair you kept or regrew is usually lost again within the following year.
Source: ANMDMR, Propecia 1 mg: summary of product characteristics.
Safety
Finasteride side effects: what you should know, honestly
Most men who take finasteride have no problems. A minority do, though, and some of the effects are serious enough that we want you to know about them before you decide, not after.
Mood and mental health
In 2025, the European Medicines Agency (EMA) completed an EU-wide review of medicines containing finasteride and dutasteride. It confirmed suicidal ideation (thoughts of suicide) as a side effect of finasteride tablets; warnings about mood changes, including depression, were already in the product information. How often it happens cannot be stated (the frequency is “not known”), but most of the reported cases were in men taking 1 mg tablets for hair loss.
If you have ever had depression, anxiety or thoughts of suicide, please tell us before you start. That does not automatically rule finasteride out, but it is an important part of the conversation.
Sex life
A small number of men notice changes such as:
- reduced sexual desire
- difficulty getting or keeping an erection
- changes in ejaculation, including a smaller amount of semen
In most men these effects go away after the tablets are stopped. In some, however, they continued after the treatment ended (more on that below). According to the EMA, in some men these sexual problems may contribute to changes in mood. So if anything changes, tell your doctor early. It is a common thing to mention and you will not be the first.
Breast changes
Some men have tender or enlarged breasts. Breast cancer has also been reported in men taking finasteride. If you notice a lump, pain, swelling or any discharge from the nipple, tell a doctor straight away.
Fertility
Infertility and poor semen quality have been reported in men taking finasteride, sometimes together with other risk factors. After the treatment was stopped, normalisation or improvement of semen quality was reported. If you and your partner are trying for a child, it is worth speaking to a doctor first.
Less common effects
Some men have reported allergic reactions (skin rash, itching, hives or swelling of the lips, tongue or face), testicular pain, blood in the semen, palpitations or changes in liver tests. If you have difficulty breathing or swallowing, treat it as an emergency and get help immediately.
Sources: European Medicines Agency (EMA), review of finasteride and dutasteride; ANMDMR communication of 8 May 2025; ANMDMR communication of 20 June 2025; ANMDMR, Propecia 1 mg: patient leaflet; ANMDMR, Propecia 1 mg: summary of product characteristics.
After stopping
Post-finasteride syndrome: symptoms that continue after stopping
“Post-finasteride syndrome” is a name you will come across online for symptoms that continue after someone has stopped finasteride. The product information from Romania that we checked does not use this name, so here is what it says instead.
Among the reported side effects, the leaflet lists difficulty getting an erection, reduced sex drive and ejaculation disorders that continue after the treatment is discontinued. Separately, it lists anxiety and thoughts of suicide as possible side effects. For all of these, the frequency is “not known”, meaning it cannot be estimated from the available data.
So we cannot tell you how many men are affected. We can only say that it has been reported, and if you notice sexual or mood symptoms during treatment, or ones that continue after you have stopped, it is best to speak to a doctor early.
Sources: ANMDMR, Propecia 1 mg: patient leaflet; ANMDMR, Propecia 1 mg: summary of product characteristics.
In the box
Finasteride: the leaflet and the patient card in the box
Following the EMA review, the packaging of finasteride 1 mg tablets includes a patient card. It summarises the risk of mood changes, including thoughts of suicide, and of sexual problems, and what to do if they occur. It is worth reading carefully, together with the leaflet, and keeping somewhere you will find it.
Sources: European Medicines Agency (EMA), review of finasteride and dutasteride; ANMDMR communication of 20 June 2025; ANMDMR, Propecia 1 mg: patient leaflet.
Good to know
A few practical things to remember
- PSA tests: finasteride lowers the PSA level, a blood test used to detect prostate problems. If you ever have this test, tell the doctor that you take finasteride so that the result is interpreted correctly.
- If your partner is pregnant: finasteride can affect the development of a male foetus. Women who are or may be pregnant must not touch broken or crushed tablets. Whole tablets are film-coated (covered with a coating), and contact with the active substance is prevented during normal use.
- Blood donation: if you donate blood, tell the staff at the transfusion centre that you take finasteride and follow their instructions.
Sources: ANMDMR, Propecia 1 mg: patient leaflet; ANMDMR, Propecia 1 mg: summary of product characteristics.
Topical options
Finasteride spray: what the EMA review found
Finasteride also exists as a spray for the skin, used for the same type of early male pattern hair loss. The EMA review found no evidence linking suicidal ideation to finasteride skin sprays and therefore added no new information to the product information for these products.
This finding concerns only thoughts of suicide. It is not a promise that a topical product has no side effects at all. Whether a topical option is worth discussing depends on your situation, and a doctor can weigh it up alongside the other options.
Sources: European Medicines Agency (EMA), review of finasteride and dutasteride; ANMDMR communication of 8 May 2025; ANMDMR communication of 20 June 2025.
Your decision
Minoxidil and finasteride: what suits your case?
Overall, the EMA concluded that the benefits of medicines containing finasteride continue to outweigh the risks. But that is a judgement about large groups of people. Whether finasteride makes sense for you depends on your medical history, on how much the hair loss bothers you and on how you feel about the possible side effects. There is no wrong answer.
It is not the only option either. Topical minoxidil, topical finasteride, light therapy and hair transplants each have their place, and some men simply choose not to treat at all. That is a perfectly valid choice too.
Minoxidil and finasteride are different medicines. Minoxidil is applied to the scalp, and the product information says that the exact mechanism by which it stimulates hair growth is not known. Finasteride tablets work by lowering DHT. Minoxidil also has its own precautions: the leaflet from Romania asks for special care in people who have or have had low blood pressure or cardiovascular disease, and says it should not be applied at the same time as other skin medicines on the scalp. Whether one of them, the other or both make sense is something a doctor can decide after going through your history.
Sources: European Medicines Agency (EMA), review of finasteride and dutasteride; ANMDMR, minoxidil 50 mg/ml cutaneous solution: patient leaflet; summary of product characteristics.
Online care
Talk to us
Our doctors can see you by video, assess your hair loss, go through your medical and mental health history and help you weigh up your options, with no pressure.
If you decide that finasteride is the answer, we will keep following up, including how you are feeling, not just how your hair looks. Some situations call for an in-person physical examination, and the doctor will tell you if yours is one of them.
Book a hair loss consultation and talk to one of our doctors about the benefits, side effects and alternatives.
Support
If things are hard right now
Reporting
Reporting side effects
If you suspect you have a side effect, speak to your doctor or pharmacist. You can also report it directly to the Romanian National Agency for Medicines and Medical Devices (ANMDMR), online at adr.anm.ro, or by sending the patient form by post, fax or email. The ANMDMR page for patients explains how to report: patients, carers and their relatives can do it, and it is enough for the reaction to be only suspected. ANMDMR cannot give medical advice, so discuss your symptoms with a doctor as well. Every report helps make medicines safer for the next person.
Care in Romania
Talk to a doctor about hair loss
A video consultation can look at your hair loss, your medical and mental health history and your options, including the choice not to treat.
- Hair loss consultation
- Profile of Dr Robert Gabriel Brîndus
- Doctors available in Romania
- All blog articles
Thinking about finasteride? Talk first.
Go through your hair loss, your history and the possible side effects with one of our doctors, by secure video, with no pressure to start a treatment.
Sources
The evidence behind this article
Sources checked on 24 October 2026.
The EMA review and the ANMDMR communications concern finasteride and dutasteride; this article concerns finasteride only. The ANMDMR communications are translations and adaptations of EMA press releases, published on anm.ro, not a separate national communication. The product details come from the information on a single medicine authorised in Romania (Propecia 1 mg, revised in September 2026) and on one Romanian minoxidil product; other brands may differ. The article describes risks and what a consultation can cover; any treatment decision is made by a doctor after an individual assessment.
Questions
Frequently asked questions about finasteride side effects
Finasteride side effects: what are the main ones?
Most men have no problems. A minority notice changes in mood, including low mood and, with an unknown frequency, thoughts of suicide, or sexual effects such as reduced desire, difficulty with erections and a smaller amount of semen. Tender or enlarged breasts, allergic reactions and testicular pain have also been reported. If your mood changes, stop finasteride and speak to a doctor.
How long does finasteride take to show results?
In most men there is not much to see in the first three to six months, and only around a year in can you judge whether it is working. Finasteride is most effective at keeping the hair you have and is less likely to restore a hairline that has already receded a long way.
Does regrown hair stay if I stop finasteride?
No. Finasteride only works for as long as you take it. If you stop, the hair you kept or regrew is usually lost again within the following year.
What is post-finasteride syndrome?
It is a name used online for symptoms that continue after finasteride is stopped. The product information from Romania that we checked does not use this name, but it lists sexual problems that continue after stopping as reported side effects, with a frequency that cannot be estimated. If you notice symptoms like these, tell a doctor early.
Is finasteride spray linked to thoughts of suicide?
The 2025 EMA review found no evidence linking suicidal ideation to finasteride skin sprays. The finding concerns only thoughts of suicide. If a topical option might suit you, it is worth discussing with a doctor.
Can I use minoxidil and finasteride together?
That is a decision for a doctor who knows your history. They are different medicines that work in different ways, and minoxidil has its own precautions: the leaflet from Romania asks for special care in people with low blood pressure or cardiovascular disease and says it should not be applied at the same time as other skin medicines on the scalp.
