If you’re thinking about starting a family soon, we recommend pausing the use of finasteride for around three months before trying to conceive, and avoiding it until after the first trimester of pregnancy. This advice is taken out of an abundance of caution, rather than because of proven harm in humans.
Below, we’ll explain when and why finasteride is usually stopped temporarily, what that means for your hairline, and what you can do to protect your hair in the meantime.
When and why you should stop using finasteride
Finasteride is a DHT‑blocker, meaning it prevents testosterone from being converted into dihydrotestosterone (DHT). This makes it effective for treating male pattern hair loss, which is driven by DHT binding to hair follicles and causing them to gradually shrink (a process known as miniaturisation).
However, this mechanism is also why finasteride is usually paused when you’re trying to start a family, for two main reasons.
1. Potential risk during pregnancy (out of caution)
During early pregnancy, DHT plays a role in the development of male genitalia. For this reason:
- Pregnant women are advised not to handle broken or crushed finasteride tablets, or come into contact with finasteride solutions
- Intact tablets are coated, which helps prevent contact with the active ingredient
This guidance is based on animal research. In one study, pregnant monkeys exposed to high doses of finasteride gave birth to some male fetuses with genital abnormalities. To date, there are no documented cases of birth defects in humans caused by finasteride exposure.
Because there is limited human data in this area, medical advice generally takes a precautionary approach, particularly during the first 8–12 weeks of pregnancy.
What about finasteride in semen?
The amount of finasteride present in semen is extremely small. Even if a partner absorbed 100% of it, exposure would still be around 650 times lower than the amount needed to affect DHT levels in men. This is considered very unlikely to pose a risk to a developing fetus.
Possible effects on fertility
Research suggests finasteride could potentially affect fertility in some men, but findings are mixed.
One study found that taking 1mg of finasteride daily did not affect sperm parameters such as sperm count or motility. Another study found that a higher 5mg dose (used to treat an enlarged prostate and rarely prescribed for hair loss) did reduce semen count, concentration, motility, and other parameters.
In a study involving men with fertility issues, 0.9% reported using finasteride. After discontinuing use, their semen counts improved.
In short, finasteride may impact fertility in a small number of men, but evidence suggests fertility typically returns to normal within 2–3 months of stopping treatment.
How will stopping finasteride affect your hair?
Finasteride only works while you’re taking it consistently. Most of a 1mg dose is cleared from the body within 24 hours, which is why it needs to be taken daily. Research shows that DHT levels generally return to baseline within around 14 days of stopping.
As DHT levels rise, hair loss may gradually resume. While this can feel frustrating, stopping finasteride doesn’t mean doing nothing for your hair. There are effective alternatives you can continue using safely while trying to start a family.
Effective alternatives to finasteride
Minoxidil
Minoxidil is the only other licensed treatment for male pattern hair loss. It’s clinically proven to be effective in up to 84% of men at slowing or stopping hair loss.
Unlike finasteride, minoxidil doesn’t affect hormones or DHT. Instead, it works by improving blood flow to hair follicles and extending the anagen (growth) phase of the hair cycle. It’s available as a topical solution or oral capsule and is considered safe to use while your partner is pregnant.
Microneedling (derma rolling)
Microneedling involves using tiny needles to create controlled micro‑injuries in the scalp, which is thought to stimulate hair follicles. Studies suggest it can encourage regrowth and improve the effectiveness of minoxidil by increasing absorption.
Clinical research has found that men using microneedling alongside minoxidil achieved better results than those using minoxidil or finasteride alone. If you’d like to learn more, you can read our in‑depth guide here.
Outside of pregnancy planning, these treatments can also be used alongside finasteride for best results. While you’re trying for a baby, they can help keep things ticking along in the meantime.
All of our blog articles are reviewed by our Medical Director before publication.
