Finasteride and sperm concentration: Rapid systematic review

Abdulmajeed M Alajlan, Suliman Alfaraj


Background Finasteride is approved treatment for androgenic alopecia and benign prostatic hypertrophy. It may have an effect on sperm, however the data is lacking. Few published papers described the association between 1mg/day of finasteride treatment for androgenic alopecia and sperm.


Objective Reviewing all articles describing the association between treatment of finasteride (1mg/day) for androgenic alopecia and sperm concentration.


Methods Comprehensive literature review using PubMed as a search engine from 1980 till present.

Main outcome measures: Sperm concentrations during treatment and after treatment are the main outcome measures of this analysis.


Results Seven papers were found on PubMed using the mentioned keywords on the management of androgenic alopecia giving a total of 113 subjects in all papers. No baseline sperm concentration was measured except for one paper. All papers but one (n=22) showed increase in sperm concentration after cessation of finasteride. However, the largest study (n=91) had baseline, during and post treatment measurements of sperm and showed no change in sperm concentration level.


Conclusion The analysis of reviewed papers showed that long-term treatment with finasteride is safe on sperm concentration. However, there are some signs of short-term effect during treatment.



Finasteride, Sperm, Concentration, Fertility, Sexual, Spermatogenesis.

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