Finasteride and Dutasteride for the Treatment of Male Androgenetic Alopecia: A Review of Efficacy and Reproductive Adverse Effects

    October 2023 in “ Georgetown medical review
    Mariah C. Estill, Avery Ford, Ruba Omeira, Matthew Rodman
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    TLDR Finasteride and Dutasteride can improve hair growth in male baldness but may cause temporary sexual dysfunction and possibly affect fertility.
    The review discusses the effectiveness of Finasteride and Dutasteride, two 5-α-reductase inhibitors, in treating male androgenetic alopecia (AGA). Both drugs reduce dihydrotestosterone (DHT) levels, improving hair growth, with Dutasteride being more potent. A study of 917 men found Dutasteride significantly improved hair growth more than Finasteride. However, both drugs have been linked to adverse sexual health effects, including erectile dysfunction and decreased libido. Some studies reported persistent sexual and psychological symptoms even after discontinuing Finasteride. A meta-analysis of 15 trials with 4495 participants found both drugs increased the risk of sexual dysfunction, but the increase was not statistically significant for Dutasteride. The impact of these drugs on fertility showed mixed results. The review concludes that while both drugs can cause sexual dysfunction and potentially impact fertility, these effects are often transient and can resolve after discontinuation of the drug. Further research is needed, particularly on Dutasteride due to the smaller number of relevant studies.
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