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Evidence record

Finasteride × Benign Prostatic Hyperplasia

DHT reduction decreases prostate volume and improves urinary flow.

Approved
PublishedLast updated June 24, 2026Download evidence report
Drug: FinasterideDisease: Benign Prostatic HyperplasiaTarget: 5α-reductase

Why this drug?

Finasteride was developed for BPH and serendipitously found to promote hair regrowth, leading to a second approved indication for androgenetic alopecia—a classic mechanistic repurposing story.

Known risks

  • Sexual dysfunction
  • Depression (reported, debated incidence)
  • PSA reduction (masking prostate cancer screening)
  • Contraindicated in pregnancy (teratogenic)

Evidence behind this

Confidence score95%
Signal strength: HighLevel 1 (RCT + regulatory approval)
Evidence grade
Approved

Reduced prostate volume, improved symptom scores vs placebo.

Mechanism

DHT reduction decreases prostate volume and improves urinary flow.

clinical trialfda labelPhase III

Authoritative sources

  • PubMed · 7688365

    Finasteride in benign prostatic hyperplasia (PLESS)

    McConnell JD et al. (1993)

    View
  • ClinicalTrials.gov · NCT00021880

    PLESS trial

    View
  • FDA · 020180

    Proscar (finasteride)

    View

AI-generated summary

Generated March 15, 2026Last verified June 24, 2026

Finasteride is FDA-approved for BPH with Phase III PLESS trial evidence demonstrating symptom and volume benefits. 5α-reductase mechanism directly addresses disease pathophysiology.

Source papers
  • McConnell JD et al., NEJM 1993

This summary is AI-assisted and human-reviewed. It does not constitute medical advice. Always consult authoritative sources and qualified professionals.