For many men the gradual thinning of hair is about more than just their appearance. Finasteride, a drug widely prescribed for the treatment of male pattern baldness has been used effectively for many years for this deeply personal problem.

Yet, behind its use are growing concerns about its link to the development of depression, anxiety, and even suicidal thoughts.

There is now critical discussion among both users and health-care professionals about the potential hazards associated with its continued use.

So how does the drug work? And what does the evidence say about the risk of developing a mental health problem?

How does finasteride work?

Finasteride is used to treat androgenetic alopecia, also known as male pattern baldness. It works to regrow hair and prevent the further loss of hair.

One of the key causes of pattern baldness is the production of a hormone called dihydrotestosterone which the body makes from testosterone. When it binds to the follicles of hairs, it initiates a process called hair follicle miniaturisation. This is where the growth cycle of the hair becomes progressively shorter, resulting in thinner and weaker hair.

Finasteride works by blocking the enzyme that converts testosterone to dihydrotestosterone. By blocking the enzyme, dihydrotestosterone concentrations can be reduced by around 60–70% for the majority of men.

Finasteride was first approved in the late 1990s as a prescription-only medicine and is taken as a daily 1 milligram oral tablet. Medications available at a higher 5 mg daily dose are not used for baldness, but as a treatment for non-cancerous prostate enlargement.

This medication is not indicated for women, even though they can also have this type of hair loss.

How can it impact your mental health?

Changes in mental health are not listed as an established side effect in Australian guidance given to health-care professionals.

Based on clinical trials, the most common effects include:

• decreased libido
• erectile dysfunction
• reduced semen production.

The guidance also describes an increased risk of prostate cancer and a potential risk for breast cancer. Yes, men can get breast cancer too.

While initial clinical trials conducted to obtain approval for the drug didn’t demonstrate mental health concerns, monitoring of patients using the drug has since indicated a potential increased risk of depression and suicidal thoughts. But as this is based on patients self-reporting symptoms, according to the guidance there is no definitive link.

However, in May 2025, the European Medicines Agency safety committee stated suicidal thoughts was a confirmed side effect of finasteride. The European Union also advises patients that finasteride can cause a depressed mood and depression.

Similarly, in a warning about compounded finasteride, the United States Food and Drug Administration stated in April 2025 that topical formulations of the drug has similar side effects to the oral version. These include depression, anxiety and suicidal thoughts.

What should you do if it is affecting your mental health?

If you notice changes in your mental health while taking the drug, try not to handle significant mood changes by yourself. If you’re feeling unusually low, anxious or emotionally unstable, check in with a doctor so they can help you figure out whether finasteride is contributing to your mood and what support you may need.

If the symptoms are mild, they may suggest pausing finasteride to see whether things improve, or continuing with additional mental health support. If your symptoms are more severe, stopping the medication and getting prompt medical review may be appropriate.

If you are taking finasteride and are worried about its side effects, it is safe to stop immediately. Most side effects ease once the medication is out of your system, although a small number of people have reported symptoms that persist.

If you do decide to stop, this will mean that your hormone levels will gradually return to baseline and the hair growth seen with the drug will be lost over time.

If finasteride is not the right fit for you, there is another evidence-based alternative.

Topical minoxidil is a first-line treatment that can be used on its own or with other treatments and is available from pharmacies over the counter. It only works while it’s being used and may irritate the scalp, but its effectiveness is well-established and widely recommended.

While depression and anxiety are associated with minoxidil, the incidence is much lower because of their topical application.

There is also a medication called dutasteride. However, as it works in a similar way to finasteride, it may also increase your risk of developing mental health problems. So it is best to avoid dutasteride if finasteride is not suitable for you.

If this story has raised any issues for you, please contact one of the services below:

• Lifeline: 13 11 14 or lifeline.org.au
• Suicide Call Back Service (ages 15+): 1300 659 467 or suicidecallbackservice.org.au

Nial Wheate, Professor, School of Natural Sciences, Macquarie University and Jasmine Lee, Pharmacist and PhD Candidate, University of Sydney

This article is republished from The Conversation under a Creative Commons license. Read the original article.

What’s the difference? is a new editorial product that explains the similarities and differences between commonly confused health and medical terms, and why they matter.

Vegan and vegetarian diets are plant-based diets. Both include plant foods, such as fruits, vegetables, legumes and whole grains.

But there are important differences, and knowing what you can and can’t eat when it comes to a vegan and vegetarian diet can be confusing.

So, what’s the main difference?

What’s a vegan diet?

A vegan diet is an entirely plant-based diet. It doesn’t include any meat and animal products. So, no meat, poultry, fish, seafood, eggs, dairy or honey.

What’s a vegetarian diet?

A vegetarian diet is a plant-based diet that generally excludes meat, poultry, fish and seafood, but can include animal products. So, unlike a vegan diet, a vegetarian diet can include eggs, dairy and honey.

But you may be wondering why you’ve heard of vegetarians who eat fish, vegetarians who don’t eat eggs, vegetarians who don’t eat dairy, and even vegetarians who eat some meat. Well, it’s because there are variations on a vegetarian diet:

• a lacto-ovo vegetarian diet excludes meat, poultry, fish and seafood, but includes eggs, dairy and honey
• an ovo-vegetarian diet excludes meat, poultry, fish, seafood and dairy, but includes eggs and honey
• a lacto-vegetarian diet excludes meat, poultry, fish, seafood and eggs, but includes dairy and honey
• a pescatarian diet excludes meat and poultry, but includes eggs, dairy, honey, fish and seafood
• a flexitarian, or semi-vegetarian diet, includes eggs, dairy and honey and may include small amounts of meat, poultry, fish and seafood.

Are these diets healthy?

A 2023 review looked at the health effects of vegetarian and vegan diets from two types of study.

Observational studies followed people over the years to see how their diets were linked to their health. In these studies, eating a vegetarian diet was associated with a lower risk of developing cardiovascular disease (such as heart disease or a stroke), diabetes, hypertension (high blood pressure), dementia and cancer.

For example, in a study of 44,561 participants, the risk of heart disease was 32% lower in vegetarians than non-vegetarians after an average follow-up of nearly 12 years.

Further evidence came from randomised controlled trials. These instruct study participants to eat a specific diet for a specific period of time and monitor their health throughout. These studies showed eating a vegetarian or vegan diet led to reductions in weight, blood pressure, and levels of unhealthy cholesterol.

For example, one analysis combined data from seven randomised controlled trials. This so-called meta-analysis included data from 311 participants. It showed eating a vegetarian diet was associated with a systolic blood pressure (the first number in your blood pressure reading) an average 5 mmHg lower compared with non-vegetarian diets.

It seems vegetarian diets are more likely to be healthier, across a number of measures.

For example, a 2022 meta-analysis combined the results of several observational studies. It concluded a vegetarian diet, rather than vegan diet, was recommended to prevent heart disease.

There is also evidence vegans are more likely to have bone fractures than vegetarians. This could be partly due to a lower body-mass index and a lower intake of nutrients such as calcium, vitamin D and protein.

But it can be about more than just food

Many vegans, where possible, do not use products that directly or indirectly involve using animals.

So vegans would not wear leather, wool or silk clothing, for example. And they would not use soaps or candles made from beeswax, or use products tested on animals.

The motivation for following a vegan or vegetarian diet can vary from person to person. Common motivations include health, environmental, ethical, religious or economic reasons.

And for many people who follow a vegan or vegetarian diet, this forms a central part of their identity.

So, should I adopt a vegan or vegetarian diet?

If you are thinking about a vegan or vegetarian diet, here are some things to consider:

• eating more plant foods does not automatically mean you are eating a healthier diet. Hot chips, biscuits and soft drinks can all be vegan or vegetarian foods. And many plant-based alternatives, such as plant-based sausages, can be high in added salt
• meeting the nutrient intake targets for vitamin B12, iron, calcium, and iodine requires more careful planning while on a vegan or vegetarian diet. This is because meat, seafood and animal products are good sources of these vitamins and minerals
• eating a plant-based diet doesn’t necessarily mean excluding all meat and animal products. A healthy flexitarian diet prioritises eating more whole plant-foods, such as vegetables and beans, and less processed meat, such as bacon and sausages
• the Australian Dietary Guidelines recommend eating a wide variety of foods from the five food groups (fruit, vegetables, cereals, lean meat and/or their alternatives and reduced-fat dairy products and/or their alternatives). So if you are eating animal products, choose lean, reduced-fat meats and dairy products and limit processed meats.

Katherine Livingstone, NHMRC Emerging Leadership Fellow and Senior Research Fellow at the Institute for Physical Activity and Nutrition, Deakin University

This article is republished from The Conversation under a Creative Commons license. Read the original article.