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Finasteride during transition

Finasteride inhibits the enzyme 5-alpha reductase, which converts testosterone into the stronger androgen dihydrotestosterone (DHT).

Action

Finasteride inhibits the enzyme 5-alpha reductase, which converts testosterone into the stronger androgen dihydrotestosterone (DHT). It is routinely prescribed for benign prostatic hyperplasia and androgenic alopecia.

Role in feminising therapy

In transgender care, finasteride is sometimes used as an addition to feminising hormone therapy to counteract hair loss (androgenic alopecia), not as a primary anti-androgen. International guidelines do not count it among the standard anti-androgens.

Side effects and concerns

Known side effects are loss of libido, erection problems (in persons with a penis) and mood complaints. Post-finasteride syndrome is a contested clinical condition in which complaints persist after stopping the agent.