Finasteride and Gynecomastia: What Every Man Needs to KnowAustin Gynecomastia Center

Finasteride, commonly prescribed under brand names like Propecia (for hair loss) and Proscar (for enlarged prostate), has gained widespread use among men of all ages. But as its popularity grows, so do concerns about potential side effects—particularly its association with gynecomastia, the enlargement of male breast tissue.

At the Austin Gynecomastia Center, we’ve seen a clear trend: more men are developing gynecomastia after starting finasteride. While the risk may be considered “rare” in clinical trials, real-world experience—and the countless reports online—tell a different story.

How Does Finasteride Cause Gynecomastia?

Finasteride works by blocking the enzyme 5-alpha reductase, which converts testosterone into dihydrotestosterone (DHT). While this can help stop hair loss or reduce prostate volume, it also disrupts hormonal balance. When DHT levels drop, some of that testosterone may convert into estrogen, the primary female hormone. Even a modest rise in estrogen can stimulate breast tissue growth in susceptible men.

Gynecomastia caused by finasteride is typically unilateral or bilateral, and often presents with tenderness, firmness, or visible enlargement behind the nipple. In many cases, the breast tissue remains even after stopping the medication.

Is the Condition Reversible?

While early gynecomastia might regress if the drug is stopped promptly, many men are left with persistent breast tissue that does not go away on its own. In these cases, surgical removal is the most effective treatment. At the Austin Gynecomastia Center, we specialize in the complete and permanent removal of gynecomastia tissue, even in complex or recurrent cases.

Bottom Line

If you are using or considering finasteride, be aware of this potential side effect. Gynecomastia isn’t just a cosmetic issue—it can significantly affect your confidence and well-being. If you’ve noticed breast enlargement while on finasteride, don’t ignore it. Schedule a consultation to explore your options.