Finasteride is a medication primarily prescribed to men for conditions like male pattern hair loss and benign prostatic hyperplasia (enlarged prostate). While effective for men, finasteride carries significant concerns for women due to its hormonal effects. Understanding its risks is important, especially concerning exposure during pregnancy or for women of childbearing potential. This clarifies why caution is necessary when handling finasteride.
Understanding Finasteride’s Mechanism
Finasteride works by inhibiting an enzyme called 5-alpha reductase. This enzyme converts testosterone into dihydrotestosterone (DHT), a more potent male hormone. DHT plays a role in male characteristics like hair growth and prostate enlargement. By reducing DHT levels, finasteride helps shrink the prostate and can slow or reverse hair loss.
This reduction of DHT is why finasteride is a concern for women. DHT is crucial for the normal development of male genitalia in a fetus. Disrupting this hormonal balance can have serious consequences during pregnancy. Finasteride can decrease circulating DHT levels by approximately 65-70%.
Risks of Exposure for Women
Finasteride can be absorbed through the skin, posing a risk to women, even without direct ingestion. This absorption is a primary concern, particularly for women who are pregnant or may become pregnant. Topical finasteride is also absorbed through the skin and into the bloodstream, though typically at lower concentrations than oral forms.
The most severe risk of finasteride exposure for pregnant women is to a male fetus. Exposure can lead to abnormal development of external genitalia, such as hypospadias. This occurs because the drug’s anti-androgenic effects interfere with the formation of these structures. Due to these severe risks, finasteride is classified as a Pregnancy Category X drug by the U.S. Food and Drug Administration (FDA), meaning there is clear evidence of fetal risk, and it is contraindicated in pregnancy.
For non-pregnant women, direct exposure to finasteride, particularly to crushed or broken tablets, might lead to hormonal effects. Symptoms can include changes in menstrual cycles, headaches, dizziness, dry skin, mild acne, and breast tenderness or enlargement. Some women have also reported decreased libido or anxiety. These effects indicate the drug’s systemic impact even in women.
Immediate Actions After Exposure
If a woman accidentally touches finasteride, especially a crushed or broken tablet, immediate action is necessary. For skin contact, thoroughly wash the affected area with soap and water to minimize absorption.
In the event of eye contact, flush the eyes with water immediately. If finasteride is accidentally ingested, seek immediate medical attention or contact poison control.
It is advisable to contact a healthcare professional for advice following any exposure, particularly if the woman is pregnant, planning a pregnancy, or experiences any unusual symptoms. This ensures appropriate guidance and monitoring.
Safe Handling and Prevention
Preventing exposure to finasteride is the most effective way to avoid risks for women. Generally, only the individual prescribed finasteride should handle the medication. Intact, film-coated tablets typically pose minimal risk during normal handling because the coating acts as a barrier.
However, caution is paramount when dealing with crushed, broken, or otherwise damaged tablets, as the active ingredient can be absorbed through the skin. If a tablet is broken, or if a woman must handle the medication for someone else, wearing disposable gloves is an effective preventive measure.
Proper storage of finasteride is important to prevent accidental exposure. Keep the medication in its original, tightly closed container at room temperature, away from excessive heat and moisture, and out of reach of children and women of childbearing potential. For disposing of unused or expired finasteride, use drug take-back programs or mix the medication with an undesirable substance like coffee grounds or kitty litter, place it in a sealed bag, and then discard it in the household trash. Do not flush medications down the toilet unless instructed by a healthcare provider.