DOES FINASTERIDE CAUSE SEXUAL IMPOTENCE?
Finasteride is one of the most commonly used drugs in the treatment of androgenetic alopecia or male pattern baldness.
When a patient starts their baldness treatment with finasteride, the biggest fear is of having side effects. Like all medicines, finasteride can have side effects. The most feared is that finasteride causes sexual impotence.
The mechanism by which finasteride can cause sexual dysfunction is unknown, but there are two hypotheses:
- Finasteride can reduce the body’s production of neuro-steroids related to sexual function, thus causing a decrease in libido and sexual performance.
- The use of finasteride may cause a decrease in testosterone metabolism and hence an increase in estrogen metabolism (female hormone).
FINASTERIDE MECHANISM OF ACTION
Testosterone must be converted to dihydrotestosterone (DHT) in order to function in the body. Testosterone alone has no ability to act on the body.
An enzyme called 5 alpha reductase is required for the conversion of testosterone to dihydrotestosterone. Finasteride has the ability to block this enzyme and therefore reduces the production of DHT, the active form of testosterone.
Baldness occurs due to a change in DHT receptors, so reducing the production of this hormone will slow the development of hair loss.
STUDY ON THE EFFECT OF FINASTERIDE ON SEXUAL FUNCTION
A study was conducted in 762 patients to evaluate whether finasteride caused decreased sexual function. This study is currently published in the journal of the European Academy of Dermatiology in March 2019.
In this study, all patients were subjected to a standardized questionnaire evaluating sexuality. It is an international questionnaire called the “Arizona Sexual Experience Scale” (ASEX) . In addition to answering the questionnaire, patients also had to answer whether their libido decreased and their sexual performance decreased.