Originally Posted by www.uptodate.com Adverse effects — Occasionally, finasteride has deleterious effects on sexual function. These include erectile dysfunction, decreased libido, and ejaculatory dysfunction. A systematic review of nine trials with a total of 3570 patients found an overall absolute increase in sexual dysfunction of 1.5 percent [3]. The risk for sexual side effects increases with age [8].
Sexual side effects related to finasteride usually resolve after discontinuation of the medication [9]. However, persistent sexual dysfunction after the discontinuation of finasteride was reported in a survey-based study of 71 men who associated their symptoms of sexual dysfunction with the use of finasteride for hair loss. The mean age of the study participants was 26 years and the mean duration of finasteride use was 28 months. Twenty percent of these men reported continued symptoms for greater than six years after cessation of the medication [10]. Moreover, a follow-up study of 54 of the interviewed men found that 9 to 16 months after the initial survey, 96 percent continued to report sexual side effects [11]. Additional studies are needed to validate these findings and evaluate the frequency with which persistent sexual dysfunction might occur.
Reductions in sperm count also may occur during treatment with finasteride [12,13]. This effect reverses after drug discontinuation.
Other rare side effects of finasteride include gynecomastia, testicular pain, and depression [14]. Side effects are more likely to occur with the typical 5 mg dose used to treat benign prostatic hypertrophy. Although finasteride is teratogenic, the finasteride concentration in semen does not pose a risk to women trying to conceive.
References:
3. Mella JM, Perret MC, Manzotti M, et al. Efficacy and safety of finasteride therapy for androgenetic alopecia: a systematic review. Arch Dermatol 2010; 146:1141.
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8. Olsen EA, Whiting DA, Savin R, et al. Global photographic assessment of men aged 18 to 60 years with male pattern hair loss receiving finasteride 1 mg or placebo. J Am Acad Dermatol 2012; 67:379.
9. Finasteride Male Pattern Hair Loss Study Group. Long-term (5-year) multinational experience with finasteride 1 mg in the treatment of men with androgenetic alopecia. Eur J Dermatol 2002; 12:38.
10. Irwig MS, Kolukula S. Persistent sexual side effects of finasteride for male pattern hair loss. J Sex Med 2011; 8:1747.
11. Irwig MS. Persistent sexual side effects of finasteride: could they be permanent? J Sex Med 2012; 9:2927.
12. Amory JK, Wang C, Swerdloff RS, et al. The effect of 5alpha-reductase inhibition with dutasteride and finasteride on semen parameters and serum hormones in healthy men. J Clin Endocrinol Metab 2007; 92:1659.
13. Samplaski MK, Lo K, Grober E, Jarvi K. Finasteride use in the male infertility population: effects on semen and hormone parameters. Fertil Steril 2013; 100:1542.
14. Rahimi-Ardabili B, Pourandarjani R, Habibollahi P, Mualeki A. Finasteride induced depression: a prospective study. BMC Clin Pharmacol 2006; 6:7.
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