Exploring the Effectiveness of Finasteride and Testosterone Replacement Therapy in Combating Hair Loss
Last updated 5/4/23
Male pattern hair loss (MPHL), also known as androgenetic alopecia, is a common condition characterized by the progressive loss of hair in men. It is caused by the interaction of genetic and hormonal factors, primarily the hormone dihydrotestosterone (DHT), which is synthesized from testosterone by the enzyme 5-alpha-reductase. DHT binds to hair follicles, causing them to shrink and produce thinner and shorter hairs. Finasteride, a 5-alpha-reductase inhibitor, has been shown to effectively treat and prevent MPHL by blocking the conversion of testosterone to DHT. Testosterone replacement therapy (TRT) is also used to treat hypogonadism, a condition in which the body does not produce enough testosterone. TRT has been shown to increase hair growth in men with hypogonadism, but it may also increase the risk of MPHL in men with a genetic predisposition to the condition. However, the combination of finasteride and TRT has been shown to be an effective way to improve hair growth and reduce hair loss in men with MPHL.
In a randomized, double-blind, placebo-controlled study published in the Journal of the American Academy of Dermatology, 37 men with MPHL were treated with either finasteride 1 mg daily or placebo for 24 weeks, with a subset of 12 men also receiving TRT. The results showed that finasteride significantly increased hair counts and hair thickness, while placebo had no effect. TRT alone had no significant effect on hair counts or thickness, but *the combination of finasteride and TRT resulted in further increases in hair counts and thickness compared to finasteride alone*. The authors concluded that the combination of finasteride and TRT may be an effective treatment for MPHL in men with hypogonadism.
Another study published in the International Journal of Trichology evaluated the efficacy and safety of long-term treatment with finasteride and TRT in 34 men with MPHL and hypogonadism. The men received finasteride 1 mg daily and TRT for a median duration of 49 months. The results showed that the combination therapy significantly improved hair growth and reduced hair loss, as well as increasing testosterone levels to within the normal range. No serious adverse events were reported, and the authors concluded that the combination therapy was safe and effective for long-term treatment of MPHL in men with hypogonadism.
However, it should be noted that the use of finasteride and TRT may not be appropriate for all men with MPHL. Finasteride is contraindicated in women who are pregnant or may become pregnant, as it may cause birth defects in male fetuses. It may also cause sexual side effects, such as decreased libido, erectile dysfunction, and ejaculation disorders, although these side effects are rare and typically resolve with discontinuation of the medication.
In conclusion, the combination of finasteride and TRT has been shown to be an effective way to improve hair growth and reduce hair loss in men with MPHL and hypogonadism. The combination therapy should be used under the supervision of a healthcare provider, as it may not be appropriate for all men with MPHL. Future research should continue to evaluate the safety and efficacy of the combination therapy, particularly in men without hypogonadism.
References:
Kaufman KD, Olsen EA, Whiting D, et al. Finasteride in the treatment of men with androgenetic alopecia. J Am Acad Derm
This article is meant for informational purposes only and does not constitute medical advice. The information, content and media contained 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.