Does Finasteride Lower Testosterone?

Knox Beasley, MD

Reviewed by Knox Beasley, MD

Written by Vanessa Gibbs

Published 05/30/2024

If you’re taking finasteride — or the brand name versions Propecia® or Proscar® — you’re probably checking your hairline for changes. But there might be something else you’re worried about changing: your testosterone levels.

So, does finasteride lower testosterone? No. In fact, it can increase it.

But before you get excited, this testosterone increase is temporary (if it happens at all) and subsequent changes in your body reduce testosterone production, so levels end up remaining about the same as they were before you took it.

Below, we dive deeper into the relationship between testosterone and finasteride and provide some finasteride alternatives in case all this testosterone talk has you searching for a different hair loss treatment.

Overall, finasteride doesn’t change your testosterone levels. But when you first start taking finasteride, your testosterone levels may temporarily rise.

Keep in mind: Male pattern hair loss isn’t the only condition doctors prescribe finasteride tablets to treat.

Research shows that taking 5 milligrams (mg) of finasteride a day for benign prostatic hyperplasia (BPH) — an enlarged prostate — can lead to a 15 to 25 percent increase in testosterone levels.

This may sound like a large increase, but it doesn’t happen for everyone.

A 2019 meta-analysis looked at 11 studies that included almost 1,800 people. Participants ranged from 18 to 83 years old and were taking 5-alpha-reductase inhibitors like finasteride and dutasteride, which is also used to treat prostate enlargement.

Across all studies, the average baseline change in circulating serum testosterone levels (the amount of testosterone in your blood) was 27 percent. However, results were mixed and the meta-analysis concluded that 5-alpha-reductase inhibitors weren’t associated with consistent and significant increases in serum testosterone levels.

What’s more, men with low levels of testosterone at baseline saw an increase in testosterone when taking 5-alpha-reductase inhibitors, but men with high levels of testosterone at baseline didn’t see a change in testosterone.

Plus, if you’re taking finasteride for androgenetic alopecia, or male pattern hair loss, you’ll probably be on a 1mg dose rather than a 5mg dose, so your testosterone levels may not change by the amount these studies suggest — no matter how much testosterone you’re starting with.

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Finasteride works by blocking the enzyme 5-alpha-reductase, which converts testosterone into dihydrotestosterone (DHT), a hormone linked to male pattern hair loss.

DHT binds to androgen receptors in your hair follicles, causing miniaturization and gradual hair loss. With finasteride blocking 5-alpha-reductase, less testosterone is converted into DHT, meaning you’ll have more testosterone in your system.

But this rise in testosterone doesn’t last forever.

To offset the higher testosterone levels, your body secretes less luteinizing hormone, which reduces how much testosterone is made in your testes.

Beyond this, more testosterone binds to proteins in your body like sex hormone binding globulin (SHBG). This reduces your free testosterone levels.

When we balance the books, finasteride doesn’t significantly change your testosterone levels in the long run.

As finasteride doesn’t lower your testosterone levels, it shouldn’t cause any side effects related to low testosterone like reduced sex drive, delayed ejaculation, or other sexual dysfunction problems.

If you’re experiencing any sexual side effects from taking finasteride, this may be due to the changes in DHT levels or neurosteroids, a type of steroid produced in the brain.

Research shows that 1mg doses of finasteride are unlikely to cause side effects and there’s no clear evidence that finasteride — both 1mg and 5mg daily doses — negatively affects erectile function.

Long-term placebo-controlled studies back this up, showing that there isn’t clear evidence that finasteride is linked to erectile dysfunction.

Finasteride may lead to a reduction in ejaculatory volume — but not enough to interfere with fertility.

In older men, finasteride increases levels of circulating testosterone, which can then be converted into estrogen. This may shift the hormonal balance between androgens and estrogens toward having too much estrogen, which may increase the risk of prostate cancer. Conversely, finasteride has been found to reduce the incidence of low-grade prostate cancer. More research is needed to determine if there’s a link.

Experiencing side effects? Discontinuation of finasteride treatment should clear them up, although some men report ongoing side effects even after they stop taking finasteride.

Seek medical advice if you’re concerned about finasteride testosterone levels or side effects. You can get tested to see if your testosterone levels fall within a normal range and talk through any changes you may want to make.

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Male pattern baldness may not be life-threatening, but it can impact your quality of life. If you’re looking for treatments, finasteride pills aren’t your only option.

There are other FDA-approved and natural alternatives to choose from if you decide not to take finasteride, including:

  • Minoxidil. You might know minoxidil better as Rogaine®. It’s a topical product available in a few forms, including a minoxidil foam or minoxidil solution. Minoxidil can promote new hair growth and prevent further hair loss. But patience is key — it can take six to 12 months to see results.

  • Topical finasteride and minoxidil spray. Instead of popping a finasteride pill, you can use a topical finasteride product. We combined it with minoxidil to amp up the impact in our topical finasteride and minoxidil spray.

  • Ketoconazole shampoo. Ketoconazole can treat fungal infections, but it might also be useful for hair loss. Experts say it works by acting on DHT and side effects are rare. Learn more in our guide to ketoconazole shampoo.

  • Pumpkin seed oil. Pumpkin seed oil is rich in antioxidants and essential fatty acids that could help treat hair loss and promote hair growth. Bonus: It doesn’t have any significant adverse effects or cause observed changes to serum-free testosterone.

  • Saw palmetto. Saw palmetto is used for a variety of conditions, and hair loss is one of them. Just like finasteride, saw palmetto is a 5-alpha-reductase blocker. You can find saw palmetto in hair-thickening shampoos.

  • Microneedling. Who knew a device with hundreds of tiny needles could stimulate hair growth? Research shows that combining microneedling with minoxidil could lead to more hair growth than minoxidil treatment alone.

With so many products and concentrations to choose from, we’d tap a healthcare provider to help find the best hair loss treatment for you.

Hair loss treatments, delivered

Hair loss can be frustrating enough on its own. So when you hear that a hair loss treatment like finasteride could add “low testosterone” to your list of concerns, it’s only natural to get spooked.

Friendly PSA: Finasteride does have an effect on your testosterone levels — but this isn’t something you need to worry too much about.

Here’s a recap of what we’ve covered:

  • Finasteride can temporarily increase your testosterone levels. Finasteride is a 5-alpha-reductase inhibitor, which blocks the conversion of testosterone into DHT. This means there’s more testosterone in your body.

  • Overall, your testosterone levels will probably stay the same. This rise in testosterone is offset by a reduction in testicular testosterone production and an increase in testosterone binding to proteins in your body. It all evens out and testosterone typically returns to its previous level over time.

  • You shouldn’t notice any sexual side effects from the testosterone changes. Finasteride can cause side effects just like any other drug. But changes in testosterone levels are probably not to blame for any changes in sexual function you might experience from the use of finasteride.

If you’re worried about the side effects of finasteride tablets, there are other hair loss treatments to try. These range from minoxidil and topical finasteride to natural alternatives like pumpkin seed oil and saw palmetto.

Check out our range of hair loss treatments available online, including finasteride now that we’ve cleared its name.

Our Hair Power Pack contains both finasteride and minoxidil alongside other hair-boosting treatments and supplements. It can be a great place to start.

7 Sources

  1. American Academy of Dermatology Association. (2022). Hair loss: Diagnosis and treatment. https://www.aad.org/public/diseases/hair-loss/treatment/diagnosis-treat
  2. Anitha, B, et al. (2009). Finasteride-its impact on sexual function and prostate cancer. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2840927/
  3. Kinter, KJ, et al. (2023). Biochemistry, dihydrotestosterone. https://www.ncbi.nlm.nih.gov/books/NBK557634/
  4. Mysore, V. (2012). Finasteride and sexual side effects. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3481923/
  5. Propecia (finasteride) tablets for oral use. (2012). https://www.accessdata.fda.gov/drugsatfda_docs/label/2012/020788s020s021s023lbl.pdf
  6. Traish, AM, et al. (2019). Do 5α-reductase inhibitors raise circulating serum testosterone levels? A comprehensive review and meta-analysis to explaining paradoxical results. https://pubmed.ncbi.nlm.nih.gov/30098986/
  7. Ufomadu, P. (2023). Complementary and alternative supplements: a review of dermatologic effectiveness for androgenetic alopecia. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10761108/
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Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references. See a mistake? Let us know at [email protected]!

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.

Knox Beasley, MD

Dr. Knox Beasley is a board certified dermatologist specializing in hair loss. He completed his undergraduate studies at the United States Military Academy at West Point, NY, and subsequently attended medical school at Tulane University School of Medicine in New Orleans, LA. 

Dr. Beasley first began doing telemedicine during his dermatology residency in 2013 with the military, helping to diagnose dermatologic conditions in soldiers all over the world. 

Dr. Beasley is board certified by the American Board of Dermatology, and is a Fellow of the American Academy of Dermatology.

Originally from Nashville, TN, Dr. Beasley currently lives in North Carolina and enjoys spending time outdoors (with sunscreen of course) with his wife and two children in his spare time. 

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