The drug finasteride, commonly known by its brand names Propecia and Proscar, is widely used to treat male pattern baldness and benign prostatic hyperplasia (BPH).
Now, a new study from the University of Illinois Urbana-Champaign suggests it may also reduce cholesterol levels and help lower the risk of cardiovascular disease.
The research, published in the *Journal of Lipid Research*, found that men taking finasteride had significantly lower cholesterol levels compared to non-users, based on data from the National Health and Nutrition Examination Survey (NHANES) from 2009 to 2016.
Additionally, in mouse models, high doses of finasteride led to reduced cholesterol, delayed atherosclerosis progression, and decreased liver inflammation.
Lead study author Jaume Amengual, assistant professor at the University of Illinois, noted, “When we looked at the men taking finasteride in the survey, their cholesterol levels averaged 30 points lower than men not taking the drug.” Although observational, this surprising pattern prompted further investigation in animal models.
In the follow-up study, doctoral student Donald Molina Chaves administered four levels of finasteride to genetically predisposed mice on a high-fat diet.
The highest dose yielded significantly reduced cholesterol and fewer arterial plaques, though researchers caution that mice metabolize drugs differently than humans. While the doses used were much higher than those prescribed to humans (1–5 mg daily), the human data already showed notable benefits.
Finasteride works by blocking the enzyme 5-alpha-reductase, which converts testosterone to dihydrotestosterone (DHT)—a hormone linked to hair loss, prostate growth, and potentially cardiovascular risk. Given the role of testosterone in atherosclerosis, the study opens new questions about the hormonal regulation of cardiovascular disease.
Researchers now hope to see clinical trials that monitor cholesterol levels in finasteride users, including transgender individuals who are often prescribed the drug and may also be at increased cardiovascular risk.
Amengual concludes that while the findings are promising, people should consult their healthcare providers, as finasteride is not without risks.
The study is published in Journal of Lipid Research.
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