The Effects Of Finasteride On Semen

Finasteride is commonly taken to help prevent hair loss in men suffering from male pattern baldness. Before starting the medication, patients should discuss with their Doctor the benefits and the risks of taking Finasteride. Whilst the medication has been proven to help stabilise hair loss it can cause side effects.

In this article, we will explore how Finasteride works and whether it affects a man’s semen.

How finasteride works

Before we take a look at how finasteride impacts semen quality and production, it’s important to first understand how Finasteride works to combat hair loss. 

Finasteride belongs to a class of medications known as 5-alpha-reductase inhibitors². 5-alpha-reductase plays a pivotal role in converting testosterone to dihydrotestosterone (DHT) – a hormone that, at high levels, can shrink hair follicles and shorten certain stages of the hair growth cycle³.

Finasteride works by inhibiting this enzyme’s activity, helping reduce levels of DHT to slow down hair loss and promote hair regrowth. The common dose of Finasteride is 1mg and is often taken daily, twice a week or three times a week. The mechanism of Finasteride is shown in the diagram below.

It can commonly take 6-12 months for Finasteride to start working to prevent hair loss. You can read more about this in our dedicated article here.

Finasteride and its effect on the Prostate

Finasteride is also an important medication that is used to treat enlarged prostates, otherwise known as benign prostate hyperplasia (BPH). By reducing DHT levels it affects the prostate gland, shrinking it in size and combatting a wide range of associated symptoms, such as having an increased need to urinate or a weaker stream⁴. Knowing this piece of information is important as it can affect the quality of the ejaculate for men. We will explain this phenomenon later in the article.

Finasteride and male pattern baldness

By reducing the level of DHT, Finasteride helps to treat patients suffering androgenic alopecia or male pattern baldness. This is a common condition with four out of five men experiencing some degree of hair loss or thinning by the age of 70¹. 

However, due to the way finasteride works in reducing the level DHT which is important in some physiological functions, patients often have concerns about how taking it might affect their semen quality and fertility. 

The link between finasteride & semen quality

While finasteride is an effective medication in reducing hair loss, its mechanism of action can also indirectly impact other bodily functions, such as semen production. 

Since finasteride interferes with the conversion of testosterone to DHT, this can have a variety of effects on the male reproductive system. These can include reductions in:

• Semen volume – as mentioned already, taking finasteride can reduce the size of the prostate – a gland responsible for producing seminal fluid. While this may be beneficial for preventing BPH, in normal-sized prostates, studies have shown that this effect can lead to a decrease in the volume of semen being produced⁵. 

• Sperm concentration – certain studies have suggested that, even at low doses, taking finasteride can result in a reduced sperm concentration and sperm count³. However, despite this impact, follow-up studies have shown that these reductions have no impact on sexual dysfunction or fertility in those men who have normal fertility levels⁶. 

• Sperm motility – finasteride has also been associated with reduced sperm motility – the ability of the sperm to reach and fertilise an egg when trying to get pregnant. However, these effects have also been shown to improve once you stop taking the medication in men with normal fertility levels³. Patients who naturally have a low fertility level before having used Finasteride, will return back to their usual low level of fertility if they stop Finasteride³. It is advisable for men who naturally have a low fertility level not to start Finasteride or seek guidance from their Fertility Doctor.

Finasteride: common myths and concerns

Here at the Treatment Rooms London, we see a lot of patients with preconceived notions and concerns about the impact that taking finasteride can have on the body. 

With this in mind, we believe it’s essential to address some of these common questions and concerns to help dispel some of the myths surrounding the medication’s impact on semen production and other fertility-related issues. 

Does finasteride cause permanent infertility? 

While studies have shown that taking finasteride can impact semen production, concentration and quality, there is no substantial evidence to support the claim that finasteride causes permanent infertility^3,5,6. 

In fact, many studies have actually found that all of these semen-related effects become reversed shortly after you stop taking the medication. Therefore, any minor fertility-related issues you experience while taking it should be undone once you stop^3,6. 

Will changes to my semen impact my sexual function and performance? 

Due to its impact on semen, many patients worry that reductions in semen volume and concentration will have a negative impact on sexual function, performance or pleasure. However, this simply isn’t true in most cases. 

Studies have shown that the semen-related changes caused by taking finasteride are very subtle⁷. As such, they should not impact your ability to have or enjoy having sex.

How long does it take for sperm count to return after stopping finasteride? 

Before taking finasteride, many men have questions surrounding how long it will take for their sperm count and quality to return once they stop taking it – if at all. 

Research has shown that sperm concentrations substantially increase within three to six months of stopping the medication, with only mild effects on semen seen in patients while taking it⁵. 

However, if you are already taking finasteride and are concerned about the impact it is having, speak to your healthcare professional as an alternative treatment may be available. 

Does taking finasteride impact pregnancy or the ability to get pregnant? 

Finasteride is not recommended for use in women, as it can cause birth defects if taken during pregnancy. You can read more about this topic here: Finasteride use in women.

Women who are looking to become pregnant should also avoid handling crushed or broken tablets of finasteride⁸.

Sometimes due the anxieties around hair loss and using Finasteride, the medication can put an added strain on relationships, especially when trying to get pregnant. Therefore, if you’re concerned about your hair loss but are looking to start a family, you and your partner should speak to a fertility healthcare professional. They will be best placed to help you find the right dosage and treatment options for your exact circumstances. 

Finasteride and side effects

Finasteride has other side effects that patients should be counselled on. These can include an effect on mood and sexual dysfunction. You can read more about these side effects in our dedicated article: Finasteride Side Effects.

Managing your concerns

If you are considering using finasteride to treat your hair loss, but are worried about the impact it could have on your body, day-to-day life or relationships, it’s crucial to address any of these concerns in advance. 

As with any other type of hair loss medication or surgical procedure, it’s important to know as much as possible so that you can make a more informed decision. Here are a few top tips to help: 

• Consult a professional – having an open dialogue and feeling comfortable with your healthcare professional is crucial. Here at the Treatment Rooms London, for example, our team have extensive expertise in a wide range of hair loss treatments and would be more than happy to answer any questions you might have to alleviate your fears.  

• Arrange regular follow-up appointments – once you start taking finasteride, arranging routine follow-up appointments can help monitor any changes in your semen quality and assess any other potential side effects. Doing so can then ensure any potential side effects or issues are dealt with promptly, reducing their impact on your day-to-day life or relationships.

• Maintain a healthy lifestyle – while finasteride may impact semen quality and fertility, maintaining a good diet, exercising regularly and managing your overall level of stress can all have an effect too. Therefore, making healthier lifestyle choices both before and while taking the medication could help reduce any potential side effects.

• Seek alternative treatment options – if you are still concerned about the side effects that taking finasteride can have, there are a variety of alternative hair loss treatments that could be used instead. A hair transplant, for example, could combat your hair loss issues a lot more quickly, without impacting your semen or fertility in any way. However it requires careful consideration as the ongoing risk of hair loss remains high and this could impact your hair transplant result. Visit our dedicated page to find out whether you are a suitable candidate. 

• Combine hair loss treatments – if you suffer from a condition called androgenic alopecia, taking a dual-treatment option could be the best option. Combining finasteride with another medication called minoxidil, for example, could provide greater benefits more quickly.

Book a consultation for further advice

While finasteride may be associated with reduced levels of semen quality, production and fertility, many studies suggest that these effects are generally mild and reversible over time³. 

Therefore, when dealing with hair loss issues like male pattern baldness, finasteride remains a highly valuable medication for patients to use. 

However, it’s also important for you to be aware of the potential side effects of finasteride, maintaining an open dialogue with your dedicated healthcare professional both before and while taking it. 

If you have any further questions or concerns about taking finasteride, we can help. 

Here at the Treatment Rooms London, we have already helped hundreds of patients combat the effects of hair loss, restoring their confidence and getting them back to feeling their best. So, why not let us do the same for you? 

Simply book a consultation with us to get started.  

References

1. Aumann, M. (2022) What Causes Hair Loss in Men? WebMD. Available at: https://www.webmd.com/skin-problems-and-treatments/hair-loss/men-hair-loss-causes (Accessed 15th September 2023)
2. NHS. (2023). Finasteride: Common questions about finasteride. Available at: https://www.nhs.uk/medicines/finasteride/common-questions-about-finasteride/ (Accessed 15th September 2023)
3. Samplaski, M., Lo, K., Grober, E. & Jarvi, K. (2013). Finasteride use in the male infertility population: effects on semen and hormone parameters. Fertil Steril. 100(6): 1542 – 1546. Available at: https://pubmed.ncbi.nlm.nih.gov/24012200/ 
4. NHS. (2023). Benign prostate enlargement: Treatment. Available at: https://www.nhs.uk/conditions/prostate-enlargement/ (Accessed 15th September 2023)
5. Liu, K., Binsaleh, S. & Jarvi, K. (2007). Propecia may induce spermatogenic failure. Fertility and sterility. 88(1): 394. Available at: https://www.fertstert.org/article/S0015-0282(07)02167-X/fulltext 
6. Pallotti, F., Senofonte, G., Pellon, M., Cargnelutti, F., et al. (2020). Androgenetic alopecia: effects of oral finasteride on hormone profile, reproduction and sexual function. Endocrine. 68(3): 688 – 694. Available at: https://www.researchgate.net/publication/339212047_Androgenetic_alopecia_effects_of_oral_finasteride_on_hormone_profile_reproduction_and_sexual_function 
7. Anitha, B., Inamadar, A., Ragunatha, S. (2009) Finasteride-Its Impact on Sexual Function and Prostate Cancer. J Cutan Aesthet Surg. 2(1): 12 – 16. Available at: https://www.researchgate.net/publication/42345913_Finasteride-Its_Impact_on_Sexual_Function_and_Prostate_Cancer 
8. NICE (2023) Finasteride. National Institute for Health and Care Excellence. Available at: https://bnf.nice.org.uk/drugs/finasteride/ (Accessed 15th September 2023)