Hi.

I have read conflicting opinions about the role of finasteride as an anti androgen in a medically supervised mtf HRT program.  Apparently some say finasteride is not to be included as an anti androgen, as it is not an anti androgen per se.  But I also see finasteride listed as an anti androgren, but it is used to inhibit effects of Dihydrotestosterone rather than testosterone.

Finasteride is used for other medical purposes, such as stopping male pattern baldness.  Other anti androgens, such as Spirolactone or cyproterone acetate (Androcur) are often prescribed as anti androgens for those that have not have orchiectomies.  Some may take an anti androgen and finasteride.

Some say that finasteride stops male pattern baldness but does not reverse it.  Some think that it reverses it, that is, it creates new head hair.  Some say that estrogen or Minoxidil may be the cause of the new head hair instead of finasteride.  If you use finasteride, has it helped with your head hair?

When I say "some" (people) that refers to various posted comments here or elsewhere, not controlled medical studies.

So, is finasteride in your mtf HRT program?  If so, was that because you asked to try it or your doctor suggesting that you try it?  If you tried it, are you still using it? 

Is there any way for you to conclude that finasteride helps or not as an anti androgen or is there no way for you of knowing that it is better or not to have finasteride and estrogen taken together?

As always, our results may vary.  What works or not for you may not necessarily work or not work for others. 

Chrissy

I honestly haven't read anything positive about any benefits of Finasteride for MtF transition that would make me risk its mood destabilizing side effects. I suppose if someone is fighting male pattern baldness it would be beneficial, but the combination of an estrogen form and T blocker can be just as effective and even cause hair regrowth.

When I started my journey the HRT doctor I chose was only taking new patients if they were transgender, and then only for transgender-specific care. I had to select a someone else as my primary care physician. I was able to get in for an annual checkup (which I had NEVER done) about a month before my appointment to begin HRT. During my checkup I mentioned that I thought I had an enlarged prostate, it seems I could rarely make it through the night with getting up to use the bathroom. She did a prostate exam (my first ever) and noted it was slightly enlarged, so she prescribed finasteride upon my request (I knew it could help prevent hair loss, which I was concerned about). A month later my HRT doctor prescribed estradiol patches and kept me on finasteride. Four months later my testosterone was still over 600, so she added spironolactone.

To be honest I don't know if finasteride ever had much of an effect, but it didn't hurt either! My HRT doctor has told me that once I have GCS then I can stop taking both finasteride and spironolactone.

When I first started my transition, I also had prostate issues and Finasteride was prescribed for that reason. I continued the Finasteride even after GCS to prevent any more hair loss. A year or so later I had my Testosterone and Dihydrotestosterone levels checked  and both were so low that my doctor and I both felt that Finasteride was not doing much of anything. I stopped the Finasteride and I do not miss it. My T and DHT levels are still so low that my test results come back with unmeasurable levels for DHT.  My T levels are normal for a female. This is just where I want to be.

Some cisgendered women take it to alleviate acne. Apparently, some women have an issue with DHT which creates oily skin and sebum. So given some cis-women have dht issues, it obviously isn't only high  testosterone levels that causes free dht to bind to hair follicles or clog pores. I would think post op women with acne driven by adrenal produced t and dht may benefit from its use for clearer skin.

I also have prostate issues (BPH) and was prescribed dutasteride, which is also used with feminizing hormones.  Maybe it would be a better choice than finasteride, as it is also apparently more effective for BPH.

https://en.wikipedia.org/wiki/Dutasteride

Let m chip in.  I take Finasteride (the strongest version) for many years now, because of blood in my urine I have no blood in my urine since I take the stuff.  My endocrinologist did put me on Spirolactone in addition to the Finasteride.

Today I was at an urologist (because of pain in my testicles), and he said that they are very likely to shrunk to still produce any testosterone.  I asked if I could stop Finasteride if my testicles would be removed, and he said no, if I would not want blood in my urine again, I have to continue to take the little blue pill for the rest of my life!
This indicates to m that Finasteride is not really meant to control or reduce testosterone but rather to control dihydrotestosterone.

I do not know whether Finasteride has done anything to my head hair, because I had still a full head of hair when I started to take it, and I have not seen any changes with my hair.
Since my intersex syndrome plays other funny games with my body hair, it may as well be that my head hair is still there because of being intersex, or is it Finasteride?  I don't know!

Hello again Chrissy

I am 11 months HRT and started with E Patches and Finasteride.

After 3 months my T was 1.6 (Intl) or 46 (US) but after 6 months had increased to 2.4 (Intl) or 69 (US) although also at 6 months my E was very high. Hence my Endo added Decapeptyl/Triptorelin by injection to my regimen and after 9 months my T was 0.7 (Intl) or 20 (US). I remain on 3 forms of medication.

I am inclined to believe Finasteride helped to some degree but I think my T may have been below the norm for men at the start of HRT anyway.

My hair loss has stopped but it had virtually stopped anyway before HRT.

Sorry but my simple response must be "Inconclusive".

Hugs

Pamela

I took finasteride early my transition and when I was still pre-op. I probably took it for 3-6months together with spironolactone when I wqs still in the process of lowering my T levels. The side effect that I only experienced was weakness in general

I don't take finasteride but I do take dutasteride.  5-alpha reductase is the enzyme that converts T to its more powerful form, dihydrotesterone (DHT)   DHT is in the skin and prostate.  Finasteride only blocks two forms of the enzyme but dutasteride blocks all three.   So, no more DHT in my skin.

I developed very soft skin and lost almost all my body hair while taking it.

Quote from: Russngrl on January 05, 2019, 08:08:17 PM
I don't take finasteride but I do take dutasteride.  5-alpha reductase is the enzyme that converts T to its more powerful form, dihydrotesterone (DHT)   DHT is in the skin and prostate.  Finasteride only blocks two forms of the enzyme but dutasteride blocks all three.   So, no more DHT in my skin.

I developed very soft skin and lost almost all my body hair while taking it.

I can't judge what Finasteride did to my skin or hair.  I never finished puberty and never lost my soft, pre-puberty skin.  My body did not develop any secondary male sex characteristics, which means no body hair (legs, torso, arms and under my arms), and no visible Adams Apple.
I don't know if my long term use of Finasteride would have made a difference with this, it definitely eliminated the blood in my urine, and that was the only reason I was taking it for.
I may never have had enough DHT in my system to influence my skin condition or my body hair growth.