Safety Concerns Regarding 5α Reductase Inhibitors for the Treatment of Androgenetic Alopecia

April 2015 in “ Current Opinion in Endocrinology, Diabetes and Obesity ”

Michael S. Irwig

5α reductase inhibitors finasteride androgenetic alopecia adverse sexual effects reproductive organs sperm concentration sperm motility neuroactive steroids Propecia

TLDR 5α reductase inhibitors treat hair loss but may cause sexual side effects and risks.

This document from 7 years ago discusses safety concerns regarding the use of 5α reductase inhibitors, specifically finasteride, for the treatment of androgenetic alopecia. The paper highlights potential adverse sexual effects, changes to reproductive organs, altered sperm concentration and motility, and altered levels of neuroactive steroids. The study concludes that while 5α reductase inhibitors can be effective in treating androgenetic alopecia, patients and physicians should be aware of potential side effects and risks.

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Research cited in this study

19 / 19 results

A Pharmacogenetic Survey of Androgen Receptor (CAG)N and (GGN)N Polymorphisms in Patients Experiencing Long-Term Side Effects After Finasteride Discontinuation

research A Pharmacogenetic Survey of Androgen Receptor (CAG)N and (GGN)N Polymorphisms in Patients Experiencing Long-Term Side Effects After Finasteride Discontinuation

16 citations, December 2014 in “International Journal of Biological Markers”

Longer CAG and GGN repeats increase alopecia risk, but no significant link to post-finasteride syndrome found.

Immunohistochemical Evaluation of Androgen Receptor and Nerve Structure Density in Human Prepuce from Patients with Persistent Sexual Side Effects after Finasteride Use for Androgenetic Alopecia

research Immunohistochemical Evaluation of Androgen Receptor and Nerve Structure Density in Human Prepuce from Patients with Persistent Sexual Side Effects after Finasteride Use for Androgenetic Alopecia

36 citations, June 2014 in “PLOS ONE”

Finasteride, a hair loss drug, may cause long-term sexual side effects due to changes in hormone receptor levels.

Patients Treated for Male Pattern Hair Loss with Finasteride Show Altered Levels of Neuroactive Steroids in Cerebrospinal Fluid and Plasma After Discontinuation

research Patients Treated for Male Pattern Hair Loss with Finasteride Show Altered Levels of Neuroactive Steroids in Cerebrospinal Fluid and Plasma After Discontinuation

61 citations, April 2014 in “The Journal of Steroid Biochemistry and Molecular Biology”

Finasteride affects brain and blood steroids, causing lasting sexual and emotional side effects.

research Finasteride Use in the Male Infertility Population: Effects on Semen and Hormone Parameters

54 citations, September 2013 in “Fertility and Sterility”

Finasteride can reduce fertility in some men, but stopping it increases sperm count.

Long-Term Oral Administration of 5α-Reductase Inhibitor Attenuates Erectile Function by Inhibiting Autophagy and Promoting Apoptosis of Smooth Muscle Cells in Corpus Cavernosum of Aged Rats

research Long-Term Oral Administration of 5α-Reductase Inhibitor Attenuates Erectile Function by Inhibiting Autophagy and Promoting Apoptosis of Smooth Muscle Cells in Corpus Cavernosum of Aged Rats

34 citations, September 2013 in “Urology”

Long-term use of a certain medication can worsen erectile function in aged rats by damaging penile muscle cells.

research Decreased Alcohol Consumption Among Former Male Users of Finasteride with Persistent Sexual Side Effects: A Preliminary Report

27 citations, June 2013 in “Alcoholism: Clinical and Experimental Research”

Finasteride use may lead to less alcohol consumption in men with lasting sexual side effects.

research Depressive Symptoms and Suicidal Thoughts Among Former Users of Finasteride With Persistent Sexual Side Effects

134 citations, August 2012 in “The Journal of Clinical Psychiatry”

Former finasteride users with persistent sexual side effects have higher rates of depression and suicidal thoughts.

research Incomplete Recovery of Erectile Function in Rats After Discontinuation of Dual 5-Alpha Reductase Inhibitor Therapy

29 citations, July 2012 in “The Journal of Sexual Medicine”

Rats had lasting erectile problems after stopping a certain medication.

research Effects of Oral Finasteride on Erectile Function in a Rat Model

25 citations, May 2012 in “The Journal of Sexual Medicine”

Finasteride reduces corpus cavernosum weight but doesn't affect erectile response in rats.

research Alteration of Ethanol Drinking in Mice via Modulation of the GABAA Receptor with Ganaxolone, Finasteride, and Gaboxadol

34 citations, November 2011 in “Alcoholism: Clinical and Experimental Research”

Three drugs change mice's alcohol drinking patterns by affecting GABAA receptors.

research Persistent Sexual Side Effects of Finasteride for Male Pattern Hair Loss

185 citations, March 2011 in “The Journal of Sexual Medicine”

Finasteride for hair loss can cause long-lasting sexual side effects like low libido and erectile dysfunction.

research Finasteride-Induced Secondary Infertility Associated with Sperm DNA Damage

36 citations, February 2011 in “Fertility and Sterility”

Finasteride use may cause sperm damage and infertility, stopping it can improve sperm health.

Adverse Side Effects of 5α-Reductase Inhibitors Therapy: Persistent Diminished Libido, Erectile Dysfunction, and Depression in a Subset of Patients

research Adverse Side Effects of 5α-Reductase Inhibitors Therapy: Persistent Diminished Libido, Erectile Dysfunction, and Depression in a Subset of Patients

223 citations, December 2010 in “The Journal of Sexual Medicine”

Some patients taking finasteride or dutasteride may have ongoing sexual problems and depression even after stopping the medication.

research The Effect of 5α-Reductase Inhibition with Dutasteride and Finasteride on Semen Parameters and Serum Hormones in Healthy Men

195 citations, February 2007 in “The Journal of Clinical Endocrinology and Metabolism”

Dutasteride and finasteride may reduce sperm count and volume but don't affect movement or shape; effects are reversible after stopping.

research Spermatozoa and Chronic Treatment with Finasteride: A TEM and FISH Study

23 citations, January 2007 in “Archives of Andrology”

Finasteride may negatively affect male fertility.

The Importance of Dual 5α-Reductase Inhibition in the Treatment of Male Pattern Hair Loss: Results of a Randomized Placebo-Controlled Study of Dutasteride Versus Finasteride

research The Importance of Dual 5α-Reductase Inhibition in the Treatment of Male Pattern Hair Loss: Results of a Randomized Placebo-Controlled Study of Dutasteride Versus Finasteride

215 citations, November 2006 in “Journal of The American Academy of Dermatology”

Dutasteride more effective for hair growth, but has more side effects than finasteride.

research Finasteride-Associated Male Infertility

34 citations, January 2004 in “Revista do Hospital das Clínicas”

Finasteride may worsen infertility in men with existing issues, but stopping it can improve sperm health.

research Chronic Treatment with Finasteride Daily Does Not Affect Spermatogenesis or Semen Production in Young Men

104 citations, October 1999 in “The Journal of Urology”

Finasteride doesn't harm male fertility or sperm quality, but may slightly reduce ejaculate volume.

research Finasteride in the Treatment of Men with Androgenetic Alopecia

581 citations, October 1998 in “Journal of The American Academy of Dermatology”

Finasteride safely and effectively treats male pattern hair loss, but may cause reversible sexual issues and harm male fetuses.

Related Research

1 / 1 results

research Effect of Finasteride, a 5 Alpha-Reductase Inhibitor, on Serum Gonadotropins in Normal Men

30 citations, August 1992 in “The Journal of Clinical Endocrinology and Metabolism”

Finasteride doesn't affect hormone levels in normal men.