Finasteride/Testosterone Undecanoate in Female to Male Transgender Patients with Androgenic Alopecia

Ten female to male transgender patients developed androgenic alopecia (AGA) during treatment with testosterone undecanoate. One of these patients also developed dyspepsia due to finasteride, which was administered to treat AGA. The patients received hormone replacement therapy with IM injection of testosterone undecanoate 1000mg every three months. Two to five years after the initiation of testosterone undecanoate, the patients developed AGA. The patients were started on oral finasteride 1mg daily for the treatment of AGA. Before the initiation of finasteride, the patients exhibited normal levels of testosterone, oestradiol, sex hormone binding globulin, luteinising hormone and follicle stimulating hormone. Following the initiation of finasteride treatment, the patients showed an improvement in AGA. However, three out of the 10 patients discontinued finasteride treatment; two stopped due to economic reasons and one stopped due to dyspepsia. In these three patients AGA improvement completely reversed following the discontinuation of finasteride.