The Urologic Impact of Long-Term Finasteride-1 Mg Use for Androgenic Alopecia: A Matched-Cohort Database Analysis

April 2025 in “ The Journal of Urology ”

Perry Xu, Amir Patel, Ariel Roane, C. Parker Gibbs, Danit Mechlovich, Remi Bucko, Laura Stock, Amy E. Krambeck

finasteride androgenic alopecia PDE5 inhibitors benign prostatic hyperplasia elevated PSA prostate cancer Propecia

TLDR Long-term finasteride use may lower prostate cancer risk but increase the need for erectile dysfunction medication.

The study analyzed the urologic impact of long-term finasteride-1 mg (F1) use in 3,470 men with androgenic alopecia, compared to a matched cohort of 3,470 men not using F1. Results showed that F1 users were more likely to be prescribed PDE5 inhibitors and received them approximately 230 days earlier than non-users. There were no significant differences in benign prostatic hyperplasia diagnosis or treatment rates between the groups. However, F1 use was associated with lower rates of elevated PSA and prostate cancer diagnoses. The study suggests that while F1 may influence certain urologic outcomes, further research is needed to fully understand its long-term effects.

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Why androgenic alopecia affects the scalp rather than other body parts, potential explanations for this phenomenon, treatments available to combat hair loss, and the implications of male attractiveness in modern society.

community Everyone is ignoring that plasma finasteride levels are 100x lower with topical compared to oral.

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Topical finasteride results in plasma levels 100 times lower than oral finasteride, potentially reducing systemic side effects. Users report similar efficacy with fewer side effects, suggesting a preference for topical application.

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community The no BS guide to saving your hair without finasteride (improvement in 90% of patients in the study) with a low side effect profile or improvement in 100% of patients but a higher side effect profile and increased dosage. The future is here?

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community I am a dermatologist with a clinical interest in alopecia. AMA

in Will treatment work for me? 2 years ago

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