Your first months on finasteride

This is a practical companion to our finasteride guide, which covers how finasteride works, the evidence, side effects and the 2025 EU safety review in full. Here we focus on the first year: what to do on day one, what is normal, and when to call your doctor.

Day one

Before your first tablet:

Take your "before" photos. Hairline from the front, both temples, and the crown from above, in the same light. See how to take progress photos. You will need them at month six.
Read the leaflet and the patient card. Since 2025, packs of finasteride 1 mg in the EU include a card about mood changes.²
Tell someone close to you that you have started a new medicine. If your mood changes, people around you sometimes notice first.
Store the tablets safely. Women who are or may become pregnant should not handle crushed or broken tablets. Whole, coated tablets are fine to touch.

Then take one tablet a day. Food makes no difference. Choose a time you will remember, such as with breakfast or when you brush your teeth.

A simple way to track how you feel

Many men worry about side effects. A short weekly note helps in two ways: it lets you spot a real change early, and it stops a bad day being mistaken for a side effect.

Once a week for the first three months, then once a month, note:

your mood overall (good, normal, low)
your sex drive and erections compared with usual
anything else new, such as breast tenderness
anything else going on: stress, poor sleep, illness, alcohol

Sexual problems have many causes, including stress and worry about hair loss. Notes covering the weeks before and after you started make the conversation with your doctor much easier.

What is normal, month by month

Fig. 1 The first year on finasteride1 square = 1 month

Months 1 to 3: usually no visible change. Some men notice slightly more shedding early on, though this is talked about more with minoxidil.
Months 3 to 6: shedding may slow. The thinning area often looks the same, which already counts as progress if it was getting worse before.
Month 6: an early check. Compare your photos. The 2017 European guideline advises assessing at six months, but notes that in some men the effect only shows at twelve.¹
Month 12: the fair verdict. In the large trials, men on finasteride had about 107 more hairs than men on placebo in a small circle on the crown after a year.³

Results at the crown tend to be easier to see than at the hairline. "No worse than a year ago" is a real result: without treatment, pattern hair loss usually keeps progressing.³

When to call your doctor

Make a routine appointment, without stopping on your own, if:

you notice changes in sex drive, erections or ejaculation that bother you. Since 2025, the leaflet advises getting medical advice for these, because they can affect mood.²
you notice breast tenderness, swelling, a lump or discharge from the nipple
you are going to have a PSA blood test for the prostate. Tell the doctor you take finasteride, because it affects the result.

After the first year

If finasteride is working, the guideline advises staying on it to keep the effect.¹ Stopping lets DHT return to its usual level, and your hair is likely to go back to where it would have been over the following months.

If a year of daily use has made no difference, ask your doctor about next steps. Options include adding minoxidil, trying finasteride spray, or, as a second line the guideline says can be considered, dutasteride.¹