Online medical consultation for Propecia.

Finasteride is the same molecule sold as Propecia (1 mg, alopecia) and Proscar (5 mg, benign prostatic hyperplasia). For hair, the relevant presentation is the 1 mg oral tablet.

It blocks 5α-reductase type II, the enzyme responsible for converting testosterone into dihydrotestosterone (DHT) — the main hormone driving progressive follicular miniaturisation in male androgenetic alopecia.

By lowering scalp DHT (≈60–70 % in studies), finasteride slows follicular miniaturisation. The clinical effect has two components:

• Stops shedding in most patients during the first year of sustained treatment.
• Partially restores density in areas where miniaturised but viable follicles remain (not on bald areas where follicles are lost).

The action only persists while treatment continues — once stopped, shedding resumes its natural course within months.

The EMA indication is for adult men with mild-to-moderate androgenetic alopecia. It is not indicated in women of childbearing age or during pregnancy (teratogenic risk).

The licensed doctor reviews your questionnaire, history and expectations. Alternative causes — telogen effluvium, alopecia areata, nutritional deficiencies — are ruled out before proposing finasteride, which is not a universal solution.

Visible effects appear slowly. Most men on sustained treatment notice stabilisation in the first 4–6 months; density changes typically take 6–12 months to become visible on photographs.

Daily adherence is critical — missed doses reduce cumulative efficacy and reset the response cycle.

The most reported adverse events are sexual: erectile dysfunction, reduced libido, ejaculatory changes. In clinical trials the incidence is 1–2 %, though post-marketing series report wider rates and persistence after discontinuation in a minority of cases (post-finasteride syndrome).

The doctor discusses these data openly before prescribing and monitors via the private chat throughout treatment. If side-effects appear, treatment is paused and alternatives reviewed.

It is contraindicated in pregnant women — even contact with crushed tablets is restricted due to teratogenic risk for male foetuses.