Finasteride in Young Men: Effects on Semen and Hormones?

A systematic review of 12 studies involving 3,927 men with androgenetic alopecia (AGA) confirmed that oral finasteride significantly improves hair count and appearance compared to placebo. However, the review highlights ongoing debates about finasteride's sexual adverse effects, particularly its impact on spermatogenesis. While a 1 mg daily dose showed no significant effects on sperm parameters, a 5 mg dose led to notable reductions in sperm volume, count, concentration, and motility, indicating a dose-dependent effect. The review also critiques a 2014 study by Irwig for methodological flaws, including selection bias and lack of a control group, which may have skewed findings on persistent sexual dysfunction. In contrast, a prospective study by Samplaski et al. found that most men experienced improved sperm counts after discontinuing finasteride, with no lasting effects on hormone levels or sperm motility. The review concludes that further large-scale research is needed to clarify finasteride's potential sexual side effects.