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Androgenetic alopecia: effects of oral finasteride on hormone profile, reproduction and sexual function

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Abstract

Purpose

Androgenetic Alopecia (AGA) is a common non-cicatricial alopecia. AGA treatment with finasteride was reported to have sexological side effects and its induced hormonal alterations could damage spermatogenesis. Thus, in patients affected by AGA undergoing oral therapy with Finasteride 1 mg/die, we aimed to evaluate the presence of modification in sperm parameters, hormone profile and sexual function.

Methods

We retrospectively evaluated 55 male subjects aged 18–45 years with AGA who underwent systemic therapy with Finasteride 1 mg/die. Each subject underwent semen and blood hormone analysis, IIEF15 questionnaire administration at baseline (T0) at 6 (T6) and 12 (T12) months after the beginning of therapy and 1 year after treatment discontinuation (TD).

Results

At T6 we detected a statistically significant worsening of total sperm number (232.4 ± 160.3 vs. 133.2 ± 82.0; p = 0.01 vs. T0) and abnormal forms (79.8 ± 6.0 vs. 82.7 ± 5.7; p < 0.05 vs. T0). No difference was found for all sperm parameters at T12 and T24, except for the percentage of abnormal forms (79.8 ± 6.0 vs. 82.6 ± 4.8; p < 0.05 T24 vs. T0). Testosterone levels were increased at T0 vs. T6 (22.1 ± 7.1 vs. 28.0 ± 8.0 ng/mL; p < 0.05). No significant differences of IIEF15 questionnaire were detected across the study.

Conclusions

Finasteride is associated with significant seminological and testosterone alterations, but no sexual dysfunctions were reported during treatment of these andrologically healthy subjects. Although, sperm parameters seem to return comparable to baseline after treatment discontinuation, it is advisable to perform a careful andrological evaluation before treatment.

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Funding

This work was supported by a grant from the Italian Ministry of Education and Research (MIUR-PRIN 2015XCR88M_006) and the University of Rome “Sapienza” Faculty of Medicine.

Author contributions

Conception and design of the work: F.P., F.L., D.P.; Carried out semen analysis: D.P; Hormonal analysis: A.F.R; Draughting the article: F.P., G.S; Final approval of the version to be published: F.L., D.P; Acquisition and analysis of data: M.P., T.C., F.C., F.P.; Patients recruitment: F.L., A.R.; Revising the paper critically: A.L. All authors read and approved the final paper.

Author information

Correspondence to Donatella Paoli.

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The authors declare that they have no conflict of interest.

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“All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards”.

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Pallotti, F., Senofonte, G., Pelloni, M. et al. Androgenetic alopecia: effects of oral finasteride on hormone profile, reproduction and sexual function. Endocrine (2020). https://doi.org/10.1007/s12020-020-02219-2

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Keywords

  • AGA
  • Finasteride
  • Total sperm number
  • Erectile function
  • IIEF
  • Testosterone