Search "finasteride NZ" and you'll find overseas pharmacies and ads that make it sound like a checkout process. The actual position: finasteride is a prescription medicine in New Zealand. There's no legitimate way to get it without a NZ-registered prescriber deciding it's appropriate for you — and that consult is not a hoop. It's where the diagnosis gets confirmed, the side-effect conversation happens and the plan gets set. Here's how it works, including the side-effect information to read before starting — not after.
What finasteride 1 mg is, and its status in NZ
Finasteride blocks the enzyme (Type II 5-alpha reductase) that converts testosterone into DHT — the hormone that progressively miniaturises genetically susceptible scalp follicles. Less DHT, slower miniaturisation. That's the whole mechanism.
The NZ regulatory position, from the Medsafe data sheet:
- Finasteride 1 mg is Medsafe-registered for male pattern hair loss (androgenetic alopecia) in men — "to increase hair growth and prevent further hair loss".
- It is not indicated for women or children, and the data sheet notes it is not effective in postmenopausal women with androgenetic alopecia.
- It is classified as a prescription medicine.
- It is not funded for hair loss — as Healthify puts it, hair-loss treatment "isn't funded in Aotearoa New Zealand". You pay for the medicine on a private prescription at any community pharmacy.
The dose is one 1 mg tablet daily. (The separate 5 mg tablet is the same molecule registered for prostate enlargement — different product, different use.)
Why the diagnosis comes first
Finasteride treats exactly one kind of hair loss: the androgenetic, DHT-driven pattern. Classic presentation is gradual — thinning at the hairline, a thinning patch at the crown, progressing over years, usually with family history somewhere.
Plenty of hair loss isn't that, and finasteride does nothing for it:
- Telogen effluvium — diffuse shedding starting 2–4 months after a trigger: significant illness or fever, major stress, surgery, rapid weight loss, iron deficiency, thyroid problems, some medicines. Usually recovers once the trigger resolves — a DHT blocker is irrelevant.
- Alopecia areata — smooth, round, coin-sized bald patches. Autoimmune, completely different disease, different treatment.
- Scalp conditions — fungal infection (tinea capitis), psoriasis and dermatitis can all cause localised loss with scale or itch.
- Traction — loss from persistent pulling (tight braiding, certain styling).
Typical hereditary pattern loss is a clinical diagnosis — Healthify notes no tests are needed to diagnose it, though blood tests are sometimes used to rule out other causes when the story doesn't fit. A shedding problem treated as a DHT problem is twelve months of daily tablets for nothing.
The three routes to a prescription in NZ
All three end at the same medicine, dispensed by the same pharmacies, under the same rules. What differs is access, focus and depth.
| Your own GP | Dermatologist | Telehealth clinic | |
|---|---|---|---|
| Getting seen | Book a standard appointment | Usually a referral or private booking; waits can be long | Days; no referral needed |
| Strengths | Knows your full history and medications | The right call for diagnostic uncertainty, scarring or patchy loss | Time dedicated to the hair question specifically |
| Watch for | Hair loss competing with everything else in a short appointment | Access and wait times | Quality varies — see below |
| Best fit | Straightforward pattern loss, existing GP relationship | Atypical, inflamed or scarring presentations | A focused assessment without the wait |
None of these is the "correct" route; all three are legitimate. What matters more is what the consult covers.
What a proper prescribing consult should cover
Whoever you see, a real finasteride consult looks like this:
- Pattern assessment — where the thinning is, how fast it's moving, baseline photos worth keeping.
- History — family history of pattern loss, timeline, shedding versus gradual thinning, general health, current medicines.
- Mood history — a 2024 UK regulator (MHRA) safety update, covered by bpac NZ, advises prescribers to ask about any history of depression or suicidal thoughts before prescribing finasteride. A history of low mood isn't automatically a no — but it belongs in the conversation up front.
- The side-effect conversation — the section below, out loud, before the script is written.
- A plan — what to expect month by month, when to review (photos at 6 and 12 months), and exactly what to do if side effects appear.
If a service — online or in person — issues the script off a tick-box form with no diagnosis discussion and no side-effect conversation, that's not a shortcut; that's the important part being skipped.
The side-effect conversation (read this before you start)
This is the section that should never be buried, so here it is in full.
In the registration trials (placebo-controlled studies in over 3,200 men, per the NZ data sheet), the medicine-related effects reported in at least 1% of men on finasteride, plus decreased ejaculate volume, were:
| Effect | Finasteride | Placebo |
|---|---|---|
| Decreased libido | 1.8% | 1.3% |
| Erectile dysfunction | 1.3% | 0.7% |
| Decreased ejaculate volume | 0.8% | 0.4% |
Most men experienced none of these; slightly fewer men stopped finasteride for adverse effects than stopped placebo (1.7% vs 2.1%). In the trials, these effects resolved in men who stopped — and in many who continued.
The post-marketing reports deserve equal billing. The NZ data sheet records the following reported since the medicine came to market:
- Decreased libido and sexual dysfunction (erectile dysfunction and ejaculation disorders) that continued after stopping treatment
- Depression
- Suicidal ideation — added to the NZ data sheet in the December 2023 revision
- Breast tenderness and enlargement; also reports of male breast cancer — report any breast lump, pain or nipple discharge promptly
- Testicular pain
- Male infertility and/or poor semen quality, with normalisation or improvement reported after stopping
The data sheet is explicit that these are voluntary reports from a population of uncertain size, so the true frequency can't be reliably estimated and causation isn't established. That cuts both ways: "everyone gets ruined by finasteride" is not what the evidence says, and "everything reverses when you stop" overstates what anyone can promise you. Both the persisting sexual dysfunction reports and the mood reports are real entries on the NZ data sheet, not internet folklore.
What I tell men is simple: if your mood changes on finasteride, stop the tablet and contact your doctor straight away — Healthify's advice too, which also lists Healthline (0800 611 116). For sexual side effects, don't white-knuckle it for months; report early and reassess the plan.
The first 12 months, realistically
- Months 0–3: usually nothing visible — the data sheet says daily use for three months or more is generally needed before any effect shows.
- Months 3–6: the earliest window for visible change — Healthify puts typical first results at about 3–6 months.
- Months 6–12: the fair test — compare photos, same lighting and angle.
The primary win is keeping the hair you have. Many men also see some thickening and regrowth, but this medicine is maintenance first, regrowth second. For the fuller efficacy picture and the stronger off-label relative — dutasteride, registered in NZ for prostate enlargement, not hair loss — the comparison is here: finasteride vs dutasteride.
Many men also run finasteride alongside topical minoxidil, which works through a completely different, non-hormonal mechanism and needs no prescription — covered in the topical minoxidil guide.
It's a long-term commitment
The data sheet states it plainly: continued use is recommended to maintain benefit, and withdrawal leads to reversal of the effect within 12 months — stop, and your scalp resumes its genetic programme. So the real question before starting isn't "does it work"; it's "am I prepared to take a daily tablet indefinitely, and keep an eye on myself while I do". "No" is a legitimate answer — better discovered before month one than after month eight.
Who shouldn't take it — and the conception question
- Women and children — not indicated, full stop. It's contraindicated in women who are or may be pregnant, because DHT blockade can cause abnormal genital development in a male foetus.
- Pregnant women shouldn't handle crushed or broken tablets. Intact tablets are coated, which prevents contact with the active ingredient in normal handling — but it matters in shared households.
- If your partner is pregnant or may be: small amounts of finasteride are secreted in semen; Healthify advises using a condom in that situation.
- Planning children soon: the data sheet records post-marketing reports of male infertility and poor semen quality, with improvement reported after stopping. Not a reason to panic — but timing is a conversation to have with your doctor before starting.
- A history of depression or suicidal thoughts: raise it with the prescriber. It shapes monitoring.
- One practical extra: finasteride lowers PSA readings — if any doctor orders prostate tests for you, tell them you take it.
Getting assessed in New Zealand
Whichever route you take, the sequence is the one described above: diagnosis first, the options walked through honestly with the side-effect conversation included, and a monitoring plan agreed before anything starts. Whether a prescription is appropriate is a clinical decision made at a consultation — not a foregone conclusion. Enhanced Men's own hair loss assessment is one option among the three; the details of that service, including what it costs, are set out on its own page.
FAQ
Can I buy finasteride online in NZ without a prescription? No. Finasteride is a prescription medicine in NZ. Any legitimate online option is a telehealth consult with a NZ-registered prescriber who assesses you first — if a website sells it with no prescriber involved, it isn't operating within NZ rules.
How long does finasteride take to work? Three months of daily use is generally the minimum before any effect shows, with first visible results typically around 3–6 months. Judge it properly at 6–12 months with comparison photos.
Do I need blood tests before starting finasteride? Usually not. Typical pattern hair loss is diagnosed clinically from the history and the pattern. Blood tests are used when the picture doesn't fit — sudden shedding, patchy loss, or symptoms suggesting thyroid, iron or other causes.
What should I do if I get side effects? Stop the tablet and contact your doctor promptly — especially for any mood change, where Healthify's advice is to tell your doctor immediately or ring Healthline on 0800 611 116. Report breast changes (lump, pain, nipple discharge) promptly too.
What happens if I stop taking it? The benefit reverses. The NZ data sheet states the effect reverses within 12 months of stopping, after which hair loss continues on its previous genetic course.
References (NZ-specific)
- Medsafe — Finasteride 1 mg tablet, NZ data sheet (rev. December 2023): https://www.medsafe.govt.nz/profs/Datasheet/p/Propeciatab.pdf
- Healthify NZ — Finasteride: https://healthify.nz/medicines-a-z/f/finasteride
- Healthify NZ — Medicines for hair loss (minoxidil and finasteride): https://healthify.nz/medicines-a-z/h/hair-loss-treatment
- Healthify NZ — Hair loss (normal or hereditary): https://healthify.nz/health-a-z/h/hair-loss-normal-or-hereditary
- Healthify NZ — Hair loss (temporary or abnormal): https://healthify.nz/health-a-z/h/hair-loss-temporary-or-abnormal
- bpac NZ — Best Practice Bulletin, Issue 98 (finasteride safety communication, May 2024): https://bpac.org.nz/bulletin/bestpractice/ninety-eight.aspx
This article is general health information, not personal medical advice. Whether finasteride is appropriate for you depends on your diagnosis, history and circumstances — that's a decision to make with a NZ-registered doctor.