Every year, more young Dutch men take finasteride. In 2024, there were 12,500 users, an increase of almost 17% compared to the previous year. Most are between 25 and 30 years old. This says something about how severely hair loss affects people and how quickly they seek a solution.
Finasteride works. But there's more to it than most users know beforehand. This article gives you an honest picture.
What exactly does finasteride do?
Male hair loss is largely caused by DHT, a hormone produced when testosterone is converted by an enzyme called 5-alpha-reductase. DHT binds to hair follicles, causing them to gradually shrink. Hairs become thinner, shorter, and eventually fall out.
Finasteride blocks this enzyme. This reduces DHT production. Less DHT means less attack on the hair follicles.
The drug is available as a 1 mg tablet, specifically intended for hair loss (androgenetic alopecia). The 5 mg version is for prostate problems.
How well does it work?
Quite well. Studies show that finasteride prevents further hair loss in over 80% of men. Approximately one-third also experience hair regrowth. Results become visible after three to six months, sometimes longer.
However: it only works as long as you use it. If you stop, hair loss often resumes within a year. So, it's not a one-time cure but a long-term treatment.
Side effects you should know about
This is often glossed over in most articles. Official clinical studies report sexual side effects in 2 to 4% of users. That may sound low, but it includes erectile dysfunction, decreased libido, or ejaculation problems.
What is less known: for some men, these symptoms persist even after they stop taking the medication. This is called Post-Finasteride Syndrome (PFS). Science has not yet determined how often this occurs, but it is sufficiently recognized to be taken seriously.
What was officially established in 2025
In May 2025, the European Medicines Agency (EMA), followed by the Dutch Medicines Evaluation Board (CBG), officially updated the product information for finasteride: suicidal thoughts are no longer only mentioned as a warning but as a recognized side effect.
Most cases have been observed in users of the 1 mg variant, precisely the variant used for hair loss. The frequency is unknown, but it has been sufficiently demonstrated to be formally included.
As a result, patient information leaflets will be added to packages, and healthcare providers will receive an information letter. Mood swings, depressive thoughts, and decreased libido are now explicitly described as signals requiring immediate discontinuation and a call to a doctor.
This does not mean you cannot or should not use finasteride. But it does mean you should do so consciously, with proper guidance.
Who is finasteride suitable for?
This is not a question you can fully answer yourself, but a doctor can help you make an assessment. In general, finasteride is recommended for men who meet the following description:
- A clearly visible and progressive hair loss pattern where the impact on well-being is high. The Dutch College of General Practitioners (NHG) refers to high distress as a condition for prescribing.
- Willingness to use it long-term and monitor for side effects.
- No history of mood problems, where the risks may outweigh the benefits.
What if you (still) don't choose medication?
Finasteride is not the only effective treatment for hair loss. For men who are earlier in the process, want to avoid side effects, or prefer to start without hormones, there are alternatives that work directly on the hair follicles without affecting DHT production.
The Hairborn Growth Serum contains active ingredients like Redensyl and caffeine, which stimulate hair follicles and inhibit hair loss without hormonal action. It is not a substitute for finasteride if hair loss is advanced, but for men who start early or want to postpone medication, it is a serious first step.
What to take away from this?
Finasteride works, and for some men, it's the right choice. But it is a medication with a side effect profile that goes beyond what most people expect when they start taking it.
If you are seriously considering it: talk to a GP. Not because it is necessarily dangerous, but because you will then be doing it consciously and know what to look out for.
If you are still early in the process and want to see if you can slow down hair loss without medication, it is worth trying that first.
Frequently Asked Questions
What should you do if you notice mood symptoms?
Stop use immediately and contact your doctor, as explicitly stated on the patient information leaflet. Do not wait to see if it goes away on its own, as mood symptoms should be taken seriously as soon as they occur.
Is the risk of side effects higher in younger users?
There is no strong evidence that younger users inherently have a higher risk, but because more and more men between 25 and 30 years old use finasteride, this group stands out in recent figures. Age alone is not a reliable predictor of who will experience side effects.
Can you combine finasteride with antidepressants?
Always discuss this with your doctor before starting, as combining finasteride with antidepressants requires extra attention given the recognized link between finasteride and mood changes. A doctor can make the right assessment based on your medical history.
Why did the 1 mg variant receive more reports than the 5 mg variant?
The 1 mg variant is specifically intended for hair loss and is therefore much more frequently used by a younger, generally healthier group of men than the 5 mg variant for prostate problems, which can partly explain why reports stand out there. The exact mechanism behind the difference has not yet been fully elucidated.
Should you have a conversation about mental health before starting?
Yes, that is a sensible step, especially given the recent update to the official product information. A doctor can then also identify previous mood symptoms, which helps to better assess changes during use.
Can you test beforehand if you are sensitive to these side effects?
No, there is currently no reliable test that predicts beforehand whether you are sensitive to these specific side effects. This makes good monitoring during use and open communication with your doctor extra important.
What is the difference between a "warning" and a "recognized side effect"?
A warning indicates a possible link that has not yet been fully established, while a recognized side effect means that regulators like the EMA have seen sufficient evidence to officially confirm it as a consequence of the drug. That changes how healthcare providers and patients should weigh the risk.
Can you get finasteride without a prescription from abroad?
Technically, sometimes yes, but it is strongly discouraged. Without a doctor's supervision, you miss the guidance and monitoring that have become particularly important after the recent recognition of serious side effects. A prescription from a doctor remains the safest and most responsible route.
Will doctors' approaches change due to the EMA amendment in 2025?
Yes, the amendment ensures that doctors explicitly consider mood symptoms as a reason to stop, and that patients are better informed about these signals via the enclosed patient information leaflet. The prescribing policy itself has not fundamentally changed, but the information surrounding it has.
Is it wise to inform your partner if you start taking finasteride?
Yes, that can be wise, especially given the recognized side effects related to mood and libido. Someone in your environment who is aware can more quickly notice if something changes that you might not notice as quickly yourself.
