Finasteride Explained

Propecia (finasteride) is one of those drugs that we’ve seen around the steroid community for decades, but hasn’t really been examined in the same kind of depth as we might see with steroids or even as we see with other ancillary compounds. As a result, most people know a single fact about the stuff: it prevents hair loss. Overlooked is that finasteride was available prior to being marketed as Propecia. In 1992 it was approved by the FDA under the brand name Proscar, a 5mg finasteride pill.

Back then, it was used to treat Benign Prostatic Hyperplasia (prostate enlargement). It failed to gain much traction within the bodybuilding community until 1997, when a 1mg pill was released under the name Propecia, with FDA approval to treat androgenic alopecia (male pattern baldness – hair loss from either your natural androgens or those you may have found cause to inject or otherwise ingest).

As you’ve likely surmised “benign” prostate hyperplasia isn’t a life threatening condition, and it’s most obvious symptom is urinary problems (difficulty urinating, waking up several times per night to go to the bathroom, etc…). Because these issues are of the annoying and not life threatening variety, their cause often remains undiagnosed and most bodybuilders simply endure the minor discomfort. Hair loss, on the other hand…well, that’s an aesthetic consideration where onset becomes obvious not only to the person in the mirror, but everyone they encounter. And bodybuilding is entirely about aesthetics – so as you could imagine, while Proscar struggled to gain a foothold in the community, Propecia was immediately embraced.

This created a bit of an odd situation, where a drug had been on the market for years, was not illegal or scheduled, and yet few bodybuilders had any experience with it. Remember, even though we’re really just talking about the same drug in different doses here, whether you take Proscar or Propecia is irrelevant, it works the same way; by reducing dihydrotestosterone.

With several of the world’s smartest bodybuilders working round-the-clock, they figured out that a 5mg Proscar tablet could be cut into fifths, thereby creating five 1mg slivers, which would be far cheaper than purchasing Propecia at the same cost per box. Few bodybuilders were interested in protecting against prostate enlargement, but when it came to hair loss, they lined up to add another drug into their stacks. When Propecia first hit the market, it became the newest must-have drug in everyone’s stack. Add a standard anti-estrogen and you had a side-effect free cycle!

Except that’s not how it worked out. Bodybuilders had already realized that using tamoxifen (Nolvadex) in a cycle would reduce overall gains (normally speculated to be a result of lowered IGF-I levels). The same effect was seen with the newer anti-estrogens, i.e. aromatase inhibitors; the more we used, the less we gained. Estrogen is anabolic…but too much will cause a bunch of nasty side effects (as will too little). As the months and years passed, bodybuilders started to learn that dihydrotestosterone was important to building an ideal physique.

Finasteride doesn’t work by simply eliminating DHT, but rather it acts on an enzyme called 5α-reductase, which itself is responsible for the systemic conversion of testosterone into the dihydro version.

Initially, bodybuilders started using finasteride with their contest prep cycles and noticing that they couldn’t achieve the same level of muscle hardness. This made a lot of sense, because if we take a look at the most prized cutting drugs (i.e. Primobolan, Anavar, Winstrol, etc…) they’re all modified forms of dihydrotestosterone. Dihydrotestosterone has anti-estrogenic properties There was also a noticable loss of aggression in bodybuilders using finasteride and sometimes a loss of well-being. Although nobody really gave it much thought at the time, this is all intuitive stuff. Dihydrotestosterone is the body’s most potent androgen, even more so than testosterone, and if we prevent our body from producing it, or we
limit its effects, then we can run into problems.

Too much DHT and we can also run into problems: hair loss, acne, and (in women) pronounced development of male secondary characteristics (a deepening voice, growth of body hair, etc…). Just like we see with estrogen, we want some, but probably not too much. We want to strive for something not quite a natural balance, but something a little more ideal than natural. It might be beneficial to lower DHT levels a bit, but finasteride is almost too effective for this purpose – it lowers serum DHT levels by up to 70% (and even more in site-specific locations such as the prostate). I’d speculate that what we have here is a drug that is harsh in the same way that letrozole is harsh – and that microdosing makes a lot more sense than taking a full milligram each day.