When to stop finasteride? Understanding Discontinuation and Its Effects

October 7, 2025 •

4 min read

While finasteride effectively slows or prevents hair loss in a majority of men, a small percentage may not see a full response or may experience intolerable side effects. This can prompt the important question of when to stop finasteride?.

Quick Summary

Deciding when to stop finasteride involves evaluating side effects, considering family planning, assessing its long-term efficacy, or choosing to embrace hair loss. Discontinuation leads to the reversal of its effects, and a doctor's guidance is crucial for a safe transition.

Key Points

Side Effects: If bothersome sexual, psychological, or physical side effects persist, stopping finasteride may be necessary, but talk to a doctor first.
Family Planning: A temporary stop of at least three months is recommended for men trying to conceive to allow semen parameters to normalize.
Hair Loss Reversal: Stopping finasteride will cause DHT levels to rebound, and hair loss will likely resume within months as the drug's benefits are not permanent.
Lack of Efficacy: If no significant improvement is observed after 12 months of consistent use, continuing treatment may not be worthwhile.
Consider Alternatives: Other treatments, like topical minoxidil or the stronger DHT blocker dutasteride, can be explored after stopping finasteride, especially if side effects are a concern.
Medical Supervision: Always consult a healthcare provider before discontinuing finasteride to discuss the risks, what to expect, and alternative strategies.

Common Reasons for When to Stop Finasteride

Adverse Side Effects

Experiencing unwanted side effects is one of the most common reasons men decide to discontinue finasteride. While many side effects are mild and temporary, some may be persistent or severe enough to outweigh the benefits of hair retention. Common side effects include:

Sexual Dysfunction: This includes reduced libido (sex drive), erectile dysfunction, and decreased ejaculation volume. In most cases, these issues resolve after stopping the medication. However, a small number of men may experience persistent sexual problems even after discontinuation, a condition sometimes referred to as Post-Finasteride Syndrome (PFS).
Psychological Changes: Changes in mood, such as depression, anxiety, and even suicidal thoughts, have been reported by some users. Drug safety information advises immediately stopping the medication if these symptoms develop and contacting a doctor.
Physical Symptoms: Breast tenderness or enlargement (gynecomastia) can occur. Some long-term safety concerns have also been raised regarding potential metabolic dysfunctions, such as non-alcoholic fatty liver disease (NAFLD) and insulin resistance, although these are still being investigated.
Allergic Reaction: Though rare, a severe allergic reaction (anaphylaxis) requires immediate medical attention.

Family Planning

Finasteride can affect sperm count and semen volume, and therefore, men planning to conceive with a partner are often advised to stop taking the medication. A typical 'washout period' of at least three months is recommended before trying to conceive to allow sperm production to normalize. This precaution is taken to minimize any potential risk, even though any fertility issues from finasteride are typically reversible.

Lack of Efficacy

Finasteride is not effective for everyone. For treating hair loss, if a patient has been taking finasteride consistently for at least 12 months without noticing any improvement or stabilization of hair loss, further treatment with the medication is unlikely to be helpful. In such cases, a doctor might recommend discontinuing finasteride and exploring alternative treatments.

Personal Choice

For some men, the decision to stop finasteride is a personal one. They may decide that the inconvenience of taking a daily pill is no longer worth the benefit, or they may simply decide to embrace their hair loss as they get older. This is a valid reason and represents a change in personal priorities rather than a medical necessity.

What Happens After You Stop Taking Finasteride?

Discontinuing finasteride is a straightforward process, and it can be stopped 'cold turkey' without withdrawal symptoms. However, the effects of the medication will reverse over time. Within a few weeks, the body's dihydrotestosterone (DHT) levels will return to pre-treatment levels. This means that the hair follicles, which were previously protected from miniaturization, will once again be vulnerable to the effects of DHT.

Return of Hair Loss: Within 3 to 12 months of stopping, most men will experience a resumption of their pre-treatment hair loss. Any hair gained or preserved during treatment is likely to be lost.
Side Effect Resolution: For most men, any side effects experienced while on finasteride will gradually disappear after discontinuation. However, it is crucial to monitor for any persistent symptoms and consult a healthcare provider if they continue, especially concerning sexual or mental health.

Alternatives to Consider After Stopping

For those who stop finasteride due to side effects or lack of efficacy but still wish to treat their hair loss, several alternatives exist. A comparison of these options is shown in the table below.


Feature	Oral Finasteride	Topical Finasteride	Topical Minoxidil (e.g., Rogaine)
Mechanism	Inhibits 5α-reductase, reducing DHT systemically.	Reduces scalp DHT with lower systemic absorption.	Promotes hair growth by increasing blood flow to follicles.
Application	Daily oral tablet.	Daily topical solution or spray.	Daily topical solution or foam.
Side Effects	Rare but include sexual dysfunction, depression, and gynecomastia.	Lower risk of systemic side effects compared to oral.	Potential for local irritation or scalp sensitivity.
Effectiveness	Highly effective for slowing hair loss and promoting regrowth.	Clinical trials show similar efficacy to oral with fewer side effects.	Proven to slow hair loss and stimulate regrowth.
After Stopping	Hair loss returns within 3-12 months.	Hair loss is expected to resume.	Hair loss returns upon discontinuation.

Medical Consultation Before Discontinuation

Before deciding to stop finasteride, it is essential to consult with the prescribing doctor. They can offer personalized advice based on your medical history and the reasons for discontinuation. They can also help you:

Address Side Effects: Discuss options for managing side effects, which might include adjusting the treatment approach or considering a topical version.
Create a Transition Plan: Develop a strategy for transitioning to an alternative treatment, such as minoxidil, to minimize the return of hair loss.
Evaluate PFS Risk: Assess your risk for Post-Finasteride Syndrome and provide guidance if persistent symptoms occur.
Plan for Surgery: Some surgeons may recommend temporarily stopping medication before a hair transplant, and your doctor can help with timing.

Conclusion

Deciding when to stop finasteride is a personal decision that should be made in consultation with a healthcare professional. Whether prompted by intolerable side effects, family planning, or a lack of desired results, understanding the implications of discontinuation is crucial. While the benefits of finasteride—namely, hair retention—will reverse, side effects typically resolve. Exploring alternatives like topical finasteride or minoxidil can provide a new path forward for those still committed to managing hair loss. It is important to weigh the ongoing benefits of the medication against its potential drawbacks to determine the best course of action for your long-term health and well-being. For additional information on medication interactions and side effects, visit the MedlinePlus drug information page for finasteride.

Frequently Asked Questions

You can safely stop finasteride 'cold turkey' without experiencing withdrawal symptoms. However, your DHT levels will return to their baseline within weeks, causing the return of your hair loss, typically within 3 to 12 months.

The hair loss that was prevented or reversed by finasteride will likely resume gradually over several months. Most men experience the full return of their baseline hair loss within 9 to 12 months after stopping.

For the majority of users, finasteride side effects such as reduced libido or erectile dysfunction will resolve within weeks of stopping the medication. However, a small number of men report persistent side effects.

PFS is a controversial and not fully understood condition where some men experience persistent sexual, physical, and mental health side effects that continue long after stopping finasteride. The medical community is still researching its causes and prevalence.

Yes, if you stop finasteride, you can discuss alternatives with your doctor. Topical minoxidil is a common alternative, while dutasteride is a more potent DHT blocker that some may switch to, though it carries a higher risk of side effects.

You should follow your surgeon's specific instructions, but generally, finasteride does not need to be stopped before procedures like a hair transplant. It is not a blood thinner and does not interfere with the procedure.

If you have consistently taken finasteride for 12 months without seeing results, it's possible you are a non-responder. In this case, talk to a dermatologist about other options, such as switching to a more potent blocker like dutasteride or considering other treatments.