Finasteride and Fertility: 5 Great Studies

Something I don’t see talked about a lot is the impacts of finasteride and fertility (or dutasteride). I think especially for some of the younger guys interested in potentially having a family it’s an important topic to consider especially with long-term use or higher dosages.

Finasteride and Fertility

Table of Contents

As someone interested in having children one day, I feel this topic is something I’ve always wanted to look into – just to be sure.

I know others will feel the same way and I’m sure that this summary of a few studies on the topic will be of great value.

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Overview:

All of the hair loss telehealth providers I’ve spoken to about finasteride’s impacts on fertility seem to dismiss the notion that it is anything to worry about at all.

For the vast majority of guys that’s likely to be true even while using the medication and especially a few months after stopping use in preparing for a pregnancy.

From what I’ve looked into though, it seems like if you’re already susceptible to infertility or subfertility this may be a larger concern and is something to think about making a plan of action.

Long Term Data

The first study I looked at provided a case report of a patient who took 1 mg of finasteride for 10 years and was still able to conceive a healthy child after cessation of the medication for 4 months.

The man was presenting for primary infertility and showed severe oligospermia (low sperm). He had stopped finasteride 3 months before arrival at the clinic and 1 month after this he was able to conceive.

This is quite important because it shows at baseline having a child after 10 years on finasteride is possible – it might seem obvious but according to what that study said there weren’t any documented cases of pregnancy occurring with long-term use before this.

It’s a nice baseline data point to have.

General Data

Finasteride 1 mg

Another study (4) showed “There were no significant effects of 1 mg. finasteride on sperm concentration, total sperm per ejaculate, sperm motility or morphology. Ejaculate volume in subjects on finasteride decreased 0.3 ml. (-11%) compared to a decrease of 0.2 ml. (-8%) for placebo”.

This is an older study on 181 men with 79 submitting sperm samples for analysis.

Finasteride 5 mg, Dutasteride 0.5 mg

Study (6) tested three groups of 99 total men taking either 5 mg finasteride, 0.5 mg dutasteride, or placebo to view how the sperm quality was impacted. Finasteride is “F” and dutasteride is “D”.

The study results showed that “In both treatment groups, total sperm count, compared with baseline, was significantly decreased at 26 wk (D, -28.6%; F, -34.3%) but not at 52 wk (D, -24.9%; F, -16.2%) or the 24-wk follow-up (D, -23.3%; F, -6.2%). At 52 wk, semen volume was decreased (D, -29.7%; F, -14.5%, significantly for D) as was sperm concentration (D, -3.2%; [corrected] F, -7.4%, neither significant). There was a significant reduction of -6 to 12% in sperm motility during treatment with both D and F and at follow-up. Neither treatment had any effect on sperm morphology.”

The authors here concluded that most of the effects of 5ARIs appear reversible after you stop using the medication and I think that’s what you’ll find looking through a lot of this data in general.

Important to note here is that this study used fairly heavy doses, likely for use with prostate management, and is higher than what most will use for hair loss and the majority of the sperm parameters were fine in the year after use and even mostly fine during use (slight decrease).

My Thoughts

Those three studies I discussed were the ones that stood out most to me in terms of unique or interesting data points involving finasteride and fertility.

I still referenced all the studies I liked and found useful when reading about this topic below even if they weren’t touched on specifically.

General Conclusions:

Men already experiencing even moderate infertility at baseline should be more cautious when considering the use of finasteride & family planning as finasteride may worsen the condition.

Men considering families in the future should be aware of the potential impacts of finasteride but even long-term and heavy use of 5ARIs seems fine in regards to overall sperm quality and health.
Men using 5ARIs seem to mostly recover sperm markers after cessation of use.

Overall I hope you enjoyed this review of finasteride and fertility and while it’s not something I’m personally worried about it is something you should be aware of at some level.

You wouldn’t want to go into this as someone already not fully fertile and then need to invest extra time, money, etc into fertility treatments, techniques or not be able to have children at all.