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Sexual Adverse Effects of Finasterid 1mg for Treatment of Androgenic Alopecia in Men

Malwin Werner, Nikoo Rahimy, Stefanka Racheva

Abstract

Introduction: Finasterid is a 5-alpha reductase inhibitor which is considered as first-line treatment for androgenetic hair loss in men. Patients are required to take the medications indefinitely to maintain its effect despite the lack of research regarding long-term adverse effects. Concerns arise regarding the adverse effects of these medications potentially causing long-term sexual adverse effects in men even after discontinuation of drug intake. In our presentation, we want to provide a review of the safety and the risks regarding the sexual side effects for men with long-term intake of Finasterid 1mg.

Materials and Methods: A PubMed database search was conducted for recent English language publications from 2010 to February 2017. Abstracts and articles were then screened to identify the relevant publications.

Results: The manufacturer Merck&Co conducted several trials about the sexual adverse effect of Finasterid 1mg and 5mg especially regarding sexual dysfunctions. Three controlled trials with 1,879 study participants concluded that only a few more participants experienced a decrease of libido, erectile dysfunction and ejaculation disorders compared to the control placebo group (1.4% sexual dysfunction in Finasterid group compared to 0.9% in placebo group). In contrast to this result, another trial by an independent source reviewed 4,910 reports from young men using finasteride in the United States Food and Drug Administration Adverse Event Reporting System (FAERS) and found that 11.8% reported sexual dysfunction after Finasterid treatment. On average, sexual dysfunction occurred 1.8 years after starting Finasteride 1mg daily and lasted 5.4 months after stopping the medication.

Conclusion: Sexual adverse effects, such as a decreased libido, erectile dysfunction, and decreased ejaculate, have been reported in varying percentage of men depending on the study. The studies usually describe mild effects, with large studies suggesting the symptoms improve over time.  Further trials and studies are vital to rule out short- and long-lasting sexual adverse effects.


Keywords

Finasterid, hair loss, androgenic alopecia, sexual adverse effects


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