Can you take finasteride with HRT?

Finasteride is a medication that blocks the action of 5-alpha-reductase, an enzyme that converts testosterone into dihydrotestosterone (DHT). It is commonly used to treat hair loss and enlarged prostate.
Hormone replacement therapy (HRT) involves taking medications or supplements to adjust hormone levels. It is often used to treat symptoms of menopause in women or low testosterone in men. HRT can involve taking various hormones like estrogen, progesterone, or testosterone.

The short answer is yes, you can take finasteride while on HRT. However, there are some important considerations:

Effects on Hormone Levels

• By blocking DHT, finasteride causes slight increases in testosterone levels. This may enhance or alter the effects of testosterone used in HRT.


• Estrogen levels should not be impacted by taking finasteride with HRT.

Monitoring Hormone Levels

• When taking finasteride with HRT, it is important to routinely monitor hormone levels to ensure they remain in the proper therapeutic range.


• Dosages of HRT medications may need adjustment if finasteride significantly alters testosterone or estrogen levels.

Considerations for Transgender Patients

• For transgender women on HRT, taking finasteride may help slow or prevent hair loss, facial hair growth, and other effects of high DHT level that counteract feminizing therapy.


• For transgender men on HRT, finasteride could inhibit some masculinizing effects of testosterone therapy. This should be carefully discussed with a healthcare provider.

Potential Side Effects

• The combination of finasteride and HRT is generally well tolerated. However, possible side effects could include erectile dysfunction, loss of libido, breast tenderness, and emotional changes.


• Let your healthcare provider know if any concerning or serious side effects develop. Adjustments in medications may be required.

In summary, taking finasteride with HRT is appropriate and safe in most cases. Close communication with your healthcare provider is important to:

• Monitor hormone levels


• Adjust HRT dosing if needed


• Discuss goals of therapy


• Manage any potential side effects

If you are considering finasteride for hair loss or prostate issues, be sure to discuss compatibility with any HRT you are taking. This will allow optimization and personalization of therapy.

Can Finasteride Be Taken at the Same Time As Other Medications Used in HRT?

• Estrogen: Yes, there are no known interactions between finasteride and the forms of estrogen used in HRT. Estradiol and estradiol patches/gels can be safely taken with finasteride.


• Progesterone: Yes, natural progesterone and progestins like medroxyprogesterone can typically be taken along with finasteride without issues.


• Testosterone: Finasteride may cause slight increases in testosterone levels, which could enhance masculinizing effects of testosterone therapy. Testosterone doses may need to be adjusted.


• Dutasteride: Taking finasteride and dutasteride (another 5-alpha reductase inhibitor) together is not recommended, as it can greatly increase DHT suppression and side effects.

Who Should Not Take Finasteride With HRT?

Those who should generally avoid taking finasteride while on HRT include:

• Transgender women undergoing feminizing HRT: Finasteride may inhibit desired effects.


• Transgender men hoping to grow facial/body hair: Finasteride reduces DHT needed for optimal masculinization.


• Those with a history of severe depression or suicidal thoughts: Hormone changes from combined therapy may increase mental health risks.


• People with severe liver or kidney dysfunction: Difficulty metabolizing and excreting finasteride could lead to complications.

As always, speak to your knowledgeable healthcare provider about your specific situation before starting any new medication like finasteride.