How effective is finasteride? would you recommend finasteride as a safe alternative to spironolactone for someone with pcos & urinary incontinence?

Finisteride: The use in women is "off label", but it is used with PCOS b/c it is an anti-testosterone medication, and with PCOS, testosterone is commonly increased in women , which accounts for inhibition of ovulation. Ask your gyn provider, as a better remedy at least temporarily for women is low dose oral contraceptives, with ovulation induction if pregnancy is desired.