Does Propecia Cause More Harms than Good: Assessing Reproductive and Non-Reproductive Effects of Finasteride on Male Health

Abstract

Finasteride (marketed as Propecia) is a potent 5α-reductase inhibitor used as first-line treatment for male pattern baldness. Despite finasteride’s efficacy in promoting hair growth, there is concern about its impact on male reproduction because finasteride use has been linked to reduced libido, erectile dysfunction, and potential spermatogenic failure. The drug has also been documented to induce nonreproductive adverse effects such as depression. Current research suggests that finasteride’s alteration of neurosteroid hormone levels may be contributing to these adverse effects. This article used evidence-based research to evaluate finasteride’s short- and long-term effects on male reproductive health. In summary, there appears to be contradictory evidence within the literature with data both in support and in opposition of finasteride’s adverse effects. There does, however, seem to be consensus on the incidence of these cases being quite low within both research and clinical settings.