Finasteride and Fertility

Crystal Schwanke
Could Finasteride be affecting your fertility?

Could there be a link between Finasteride and fertility? Finasteride, a drug used to prevent enlarged prostate glands as well as treat male pattern baldness, has been put under the microscope. The question is whether or not it decreases fertility.

About Finasteride and Fertility

Studies argue that there's not a significant link between Finasteride and fertility. In the past, there have been concerns about sexual dysfunction as a result of taking Finasteride, a drug used as a preventative measure against benign prostatic hyperplasia (enlargement of the prostate gland) and, maybe eventually, prostate cancer (the FDA has still not approved the drug for prevention of prostate cancer). When weighing the benefits of preventing benign prostatic hyperplasia against the odds of causing sexual dysfunction, it's important to do your homework and consult with your doctor.

Finasteride works by slowing down the enzyme that transforms testosterone into dihydrotestosterone. The dihydrotestosterone (DHT) is the hormone that causes enlargement of the prostate.

Medical News Today reported on a study about Finasteride and fertility where 17,000 men ages 55 and up were given either Finasteride or a placebo drug. The ones who had the real medication did report more sexual dysfunction than the ones who received the placebo, but that effect didn't last forever. Over the course of the seven years of the study, the effects declined.

In this particular study, researchers did not seem to take into account the age of the subjects, pre-existing medical conditions, or lifestyle habits. This study shows there's not a significant long-term risk to fertility.

Not without Risks, though

One of the main warnings on Finasteride has to do with pregnant women. While it's not to be taken by pregnant or breastfeeding women at all, even handling the broken or crushed pills can cause damage to a male fetus.

While the jury's still apparently out on whether or not Finasteride causes fertility problems and sexual dysfunction, other warnings you'll find with the medication include:

  • Impotence
  • Loss of interest in sex
  • Decreased amounts of semen

You will be instructed to report these symptoms to your doctor, especially if they are severe or persistent. The good news for your fertility according to the Mayo Clinic's website is that a decrease in the volume of semen you produce does not necessarily signal a change in your fertility. It seems that Finasteride's effect on fertility is minute.

Another serious side effect has to do with lumps or pain in the breast or discharge. This side effect should be dealt with immediately if it occurs.

Other side effects that patients may experience don't have to do with fertility, per se, but can still be uncomfortable. They include:

  • Abdominal or back pain
  • Diarrhea
  • Dizziness
  • Headache

Other Uses of the Medication

Finasteride may also be used to treat male pattern baldness. One study showed an increase of hair growth over the course of 48 weeks. The placebo group lost a similar amount of hair. It was not reported to have the same result in women.

Propecia and Fertility

Another name for Finasteride is Propecia. Side effects such as decreased libido, decreased semen production, and difficulty achieving an erection have been reported by a small number (about 2 percent) of male patients on the drug.

Other Options

While all signs concerning Finasteride and fertility say there's not enough of an effect to cause worry, some people may still not feel comfortable taking the drug. There are alternatives, though, both for the prevention of benign prostatic hyperplasia and the treatment of male pattern baldness.

For Prevention of Benign Prostatic Hyperplasia

  • Saw palmetto is a natural product that may help in the prevention and treatment of an enlarged prostate. There are no negative sexual side effects reported; in fact, it is said to increase libido. It is recommended to give saw palmetto 1-3 months to produce results in the shrinkage of the prostate gland and, if none are reported, to discontinue its use.
  • A quicker alternative is heat therapy. It's not as easy as using a heating pad, that's for sure, but it's an out-patient medical procedure that is rapid and easy to recover from.
  • Surgery, though it's not common since there are other effective ways to deal with an enlarged prostate.

For Treatment of Baldness

  • Rogaine, a drugstore solution.
  • Corticosteriods, monthly injections of cortisone into the scalp. Creams can be used but they tend to be less effective.
  • Anthralin (Drithocreme) is something you'd have to commit to daily. It's tarry and used for other skin conditions more often, but it can also help instigate hair growth.
  • Surgical options like hair transplants or scalp reduction.

Final Word

The consensus is, Finasteride doesn't decrease fertility in enough patients to be considered much of a risk. Your doctor may discuss it with you anyway, however. If you're still uncomfortable at the prospect of becoming less fertile, impotent, losing your libido, or having trouble achieving an erection, investigate other solutions first.

Finasteride and Fertility