Editing Finasteride (section)

==Medical uses==
Finasteride has been used for the treatment of symptomatic [[benign prostatic hyperplasia]] (BPH)<ref name="Proscar FDA label" /> and for the treatment of male [[pattern hair loss]] in men.<ref name="Propecia FDA label" />

===Enlarged prostate===
Physicians sometimes prescribe finasteride for the treatment of benign prostatic hyperplasia, informally known as an enlarged [[prostate]].<ref>{{Cite journal |vauthors=Smith AB, Carson CC |date=June 2009 |title=Finasteride in the treatment of patients with benign prostatic hyperplasia: a review |journal=Therapeutics and Clinical Risk Management |volume=5 |issue=3 |pages=535–45 |doi=10.2147/tcrm.s6195 |pmc=2710385 |pmid=19707263 |doi-access=free}}</ref> Finasteride may improve the symptoms associated with BPH such as difficulty urinating, getting up during the night to urinate, hesitation at the start and end of urination, and decreased urinary flow.<ref>{{Cite web |date=20 October 2017 |title=Benign prostate enlargement |url=https://www.nhs.uk/conditions/prostate-enlargement/ |url-status=live |archive-url=https://web.archive.org/web/20201018014542/https://www.nhs.uk/conditions/prostate-enlargement/ |archive-date=18 October 2020 |access-date=20 October 2020 |website=nhs.uk |language=en}}</ref>

The use of the drug showed significant sexual adverse effects such as erectile dysfunction and less sexual desire, in particular when obstructive symptoms due to an enlarged prostate were present.<ref name="pmid28453908">{{Cite journal |display-authors=6 |vauthors=Corona G, Tirabassi G, Santi D, Maseroli E, Gacci M, Dicuio M, Sforza A, Mannucci E, Maggi M |date=July 2017 |title=Sexual dysfunction in subjects treated with inhibitors of 5α-reductase for benign prostatic hyperplasia: a comprehensive review and meta-analysis |journal=Andrology |volume=5 |issue=4 |pages=671–678 |doi=10.1111/andr.12353 |pmid=28453908 |s2cid=3577324 |doi-access=free |hdl=11380/1132897}}</ref>

===Pattern hair loss===
Finasteride is also used to treat [[pattern hair loss|male pattern baldness]] (androgenic alopecia) in men, a condition that develops in up to 80% of Caucasian men aged 70 and over.<ref name="pmid29178529">{{Cite journal |vauthors=Kanti V, Messenger A, Dobos G, Reygagne P, Finner A, Blumeyer A, Trakatelli M, Tosti A, Del Marmol V, Piraccini BM, Nast A, Blume-Peytavi U |date=January 2018 |title=Evidence-based (S3) guideline for the treatment of androgenetic alopecia in women and in men – short version |journal=Journal of the European Academy of Dermatology and Venereology |volume=32 |issue=1 |pages=11–22 |doi=10.1111/jdv.14624 |pmid=29178529 |doi-access=free}}</ref><ref name="Propecia FDA label">{{Cite web |date=15 November 2019 |title=Propecia – finasteride tablet, film coated |url=https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=4e07adb4-7807-47d3-b9a9-2332a3047410 |url-status=live |archive-url=https://web.archive.org/web/20210606214628/https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=4e07adb4-7807-47d3-b9a9-2332a3047410 |archive-date=6 June 2021 |access-date=16 September 2020 |website=DailyMed}}</ref> In the United States, finasteride and [[minoxidil]] are the only two [[FDA]]-approved drugs for the treatment of male pattern hair loss as of 2017.<ref>{{Cite journal |vauthors=Adil A, Godwin M |date=July 2017 |title=The effectiveness of treatments for androgenetic alopecia: A systematic review and meta-analysis |journal=Journal of the American Academy of Dermatology |volume=77 |issue=1 |pages=136–141.e5 |doi=10.1016/j.jaad.2017.02.054 |pmid=28396101 |s2cid=46036459}}</ref> Treatment with finasteride slows further hair loss<ref name="Habif2015">{{Cite book |url=https://books.google.com/books?id=N_D5CQAAQBAJ&pg=PA934 |title=Clinical Dermatology |vauthors=Habif TP |date=23 April 2015 |publisher=Elsevier Health Sciences |isbn=978-0-323-26607-9 |pages=934– |access-date=22 October 2016 |archive-url=https://web.archive.org/web/20230110031702/https://books.google.com/books?id=N_D5CQAAQBAJ&pg=PA934 |archive-date=10 January 2023 |url-status=live}}</ref> and provides about 30% improvement in hair loss after six months of treatment, with effectiveness persisting as long as the drug is taken.<ref name="2014AArev" /> 

Taking finasteride leads to a reduction in scalp and serum DHT levels; by lowering scalp levels of DHT, finasteride can maintain or increase the amount of terminal hairs in the [[Hair follicle|anagen phase]] by inhibiting and sometimes reversing miniaturization of the hair follicle. Finasteride is most effective on the [[Crown (anatomy)|crown]] but can reduce hair loss in all areas of the scalp.<ref>{{Cite journal |vauthors=Yim E, Nole KL, Tosti A |date=December 2014 |title=5α-Reductase inhibitors in androgenetic alopecia |journal=Current Opinion in Endocrinology, Diabetes and Obesity |volume=21 |issue=6 |pages=493–8 |doi=10.1097/MED.0000000000000112 |pmid=25268732 |s2cid=30008068}}</ref><ref>{{Cite journal |vauthors=Gupta AK, Charrette A |date=April 2014 |title=The efficacy and safety of 5α-reductase inhibitors in androgenetic alopecia: a network meta-analysis and benefit-risk assessment of finasteride and dutasteride |journal=The Journal of Dermatological Treatment |volume=25 |issue=2 |pages=156–61 |doi=10.3109/09546634.2013.813011 |pmid=23768246 |s2cid=24833568}}</ref> Finasteride has also been tested for pattern hair loss in women; however, the results were no better than placebo.<ref name="FPArev">{{Cite journal |vauthors=Levy LL, Emer JJ |date=August 2013 |title=Female pattern alopecia: current perspectives |journal=International Journal of Women's Health |volume=5 |pages=541–56 |doi=10.2147/IJWH.S49337 |pmc=3769411 |pmid=24039457 |doi-access=free}}</ref> Finasteride is less effective in the treatment of scalp hair loss than [[dutasteride]].<ref name="pmid32279398">{{Cite journal |vauthors=Dhurat R, Sharma A, Rudnicka L, Kroumpouzos G, Kassir M, Galadari H, Wollina U, Lotti T, Golubovic M, Binic I, Grabbe S, Goldust M |date=May 2020 |title=5-Alpha reductase inhibitors in androgenetic alopecia: Shifting paradigms, current concepts, comparative efficacy, and safety |journal=Dermatol Ther |volume=33 |issue=3 |pages=e13379 |doi=10.1111/dth.13379 |pmid=32279398 |s2cid=215748750 |doi-access=free}}</ref><ref name="pmid30863034">{{Cite journal |vauthors=Zhou Z, Song S, Gao Z, Wu J, Ma J, Cui Y |date=2019 |title=The efficacy and safety of dutasteride compared with finasteride in treating men with androgenetic alopecia: a systematic review and meta-analysis |journal=Clin Interv Aging |volume=14 |pages=399–406 |doi=10.2147/CIA.S192435 |pmc=6388756 |pmid=30863034 |doi-access=free}}</ref>

===Prostate cancer===
In males aged 55 years old and over finasteride decreases the risk of low-grade [[prostate cancer]] but may increase the risk of high-grade prostate cancer and has no effect on overall survival.<ref>{{Cite web |date=28 August 2013 |title=Finasteride for Prostate Cancer Prevention |url=https://www.cancer.gov/types/prostate/research/finasteride-reduces-low-grade |url-status=live |archive-url=https://web.archive.org/web/20200206153247/https://www.cancer.gov/types/prostate/research/finasteride-reduces-low-grade |archive-date=6 February 2020 |access-date=8 February 2020 |website=National Cancer Institute}}</ref>

A 2010 review found a 25% reduction in the risk of prostate cancer with 5α-reductase inhibitor.<ref name="pmid20977593">{{Cite journal |vauthors=Wilt TJ, Macdonald R, Hagerty K, Schellhammer P, Tacklind J, Somerfield MR, Kramer BS |year=2010 |title=5-α-Reductase inhibitors for prostate cancer chemoprevention: an updated Cochrane systematic review |journal=BJU Int. |volume=106 |issue=10 |pages=1444–51 |doi=10.1111/j.1464-410X.2010.09714.x |pmid=20977593 |s2cid=22178061 |doi-access=free}}</ref> A follow-up study of the [[Medicare (United States)|Medicare]] claims of participants in a 10-year Prostate Cancer Prevention Trial suggests the reduction in prostate cancer is maintained even after discontinuation of treatment.<ref>{{Cite journal |vauthors=Unger JM, Hershman DL, Till C, Tangen CM, Barlow WE, Ramsey SD, Goodman PJ, Thompson IM |date=March 2018 |title=Using Medicare Claims to Examine Long-term Prostate Cancer Risk of Finasteride in the Prostate Cancer Prevention Trial |journal=Journal of the National Cancer Institute |volume=110 |issue=11 |pages=1208–1215 |doi=10.1093/jnci/djy035 |pmc=6235685 |pmid=29534197}}</ref> However, 5α-reductase inhibitors have been found to increase the risk of developing certain rare but aggressive forms of prostate cancer (27% risk increase), although not all studies have observed this.<ref name="Hirshburg2016">{{Cite journal |vauthors=Hirshburg JM, Kelsey PA, Therrien CA, Gavino AC, Reichenberg JS |year=2016 |title=Adverse Effects and Safety of 5-alpha Reductase Inhibitors (Finasteride, Dutasteride): A Systematic Review |journal=J Clin Aesthet Dermatol |volume=9 |issue=7 |pages=56–62 |pmc=5023004 |pmid=27672412}}</ref> No impact of 5-α-reductase inhibitor on survival has been found in people with prostate cancer.<ref name="Hirshburg2016" />

===Excessive hair growth===
Finasteride has been found to be effective in the treatment of [[hirsutism]] (excessive facial or body hair growth) in women. In a study of 89 women with [[hyperandrogenism]] due to [[persistent adrenarche syndrome]], finasteride produced a 93% reduction in facial hirsutism and a 73% reduction of bodily hirsutism after 2 years of treatment. Other studies using finasteride for hirsutism have also found it to be effective.<ref name="Blume-PeytaviWhiting2008" />