By: Plume Community Member
Gender transition is a complex and emotional journey. One of the milestones of this journey often involves taking gender-affirming medications. Finasteride and dutasteride are two medications commonly used in gender-affirming hormone therapy (GAHT, also called HRT or hormone replacement therapy).
Finasteride and dutasteride are some of the medications that your Care Team can prescribe to support your gender transition. At Plume, many of our Members choose to take these medications along with other gender-affirming hormone therapy (GAHT, also called HRT or hormone replacement therapy). This article describes the effects of finasteride and dutasteride, how Plume prescribes finasteride and dutasteride, any risks associated with finasteride and dutasteride, how to take the medications when they are prescribed, and common side effects of the medicines.
What are finasteride and dutasteride?
Finasteride and dutasteride are medications that belong to a class of medications called 5 alpha reductase inhibitors. We call these DHT blockers, because instead of blocking the testosterone receptor like spiro, they block the conversion of testosterone to dihydrotestosterone, or DHT, which is the stronger form of testosterone in the body. DHT plays a big role in scalp hair loss especially, which is why finasteride is also prescribed for hair loss outside of gender-affirming care. For folks that are more worried about scalp hair loss, or concerned about the side effects of spiro, this can be a good option to supplement estradiol. Some people like to take a DHT blocker with spiro to have a double effect of blocking the changes made by T, which is totally fine to do.
How can I take finasteride or dutasteride?
Finasteride is taken as one 5 mg tablet swallowed once per day and dutasteride is taken as one 0.5 mg capsule swallowed once daily. There is some thought that dutasteride might have a stronger effect because it blocks the type 1 isoenzyme, whereas finasteride blocks type 2 and 3 isoenzymes, which are less potent. With a GoodRx coupon, a 1-month supply of finasteride is about $10-12 and dutasteride is about $15-17.
Are there any possible risks or side effects?
Both finasteride and dutasteride are typically well-tolerated with limited side effects. The side effects are what you would expect from any estrogen-related medication: decreased libido, decreased ability to make genital parts erect, and decreased fluids related to orgasm. There are some anecdotal reports of increased depression, but our care providers have not seen that in the context of gender-affirming care.
Prostate health, prostate cancer, and finasteride and dutasteride
DHT blockers are also used to shrink the size of the prostate for folks with enlarged prostate symptoms. This could mask the presence of prostate cancer. Because prostate cancer symptoms show up the same as enlarged prostate symptoms, if you were taking a DHT blocker medicine that shrinks the prostate then you might not notice symptoms of prostate cancer (when you otherwise would).
Prostate cancer typically isn’t something to worry about until you are over 50 years old. You should talk with your primary care provider about prostate cancer once you turn 50, and whether or not you need to be tested for it. In general, the medical community is moving away from testing for prostate cancer because in most cases it is a slow growing and benign cancer. For most folks, this side effect of DHT blockers will be a non-issue, but important to be aware of.
Getting started with finasteride and dutasteride
With the help of Plume, you can access finasteride and dutasteride, as well as other services and medications that support your gender transition. Plume is committed to providing you with the support and resources necessary to make your gender transition process easier.
Plume is an online platform co-founded by a trans woman doctor. Plume provides personalized care, education, and support for those transitioning with gender-affirming medications. Through Plume, you can learn about the different types of gender-affirming medications available, the potential side effects, and how to best manage them. Plume also provides access to an experienced Care Team who can provide guidance and advice throughout your transition, as well as a unique care plan customized to your transition goals.
With Plume, you can have the peace of mind that you are taking the best steps to safely and effectively transition to your true self. Ready to start? Click here to become a Member today.
