Can finasteride cause infertility?

Summary

The video discusses finasteride as the gold standard for treating hair loss, addressing misconceptions about its side effects and fertility impact. It refutes the claim that finasteride causes irreversible infertility or birth defects, citing studies that show temporary fertility effects that normalize after discontinuation. The script also highlights the importance of finasteride in maintaining hair and dispelling myths spread by those who wish to see others fail.

Takeaways

• 💊 Finasteride is considered the best treatment for androgenic alopecia, effective both in the short and long term.
• 🌟 Many people have successfully used finasteride for over 20 years, maintaining its benefits.
• 🤔 Despite the effectiveness of finasteride, some individuals spread misinformation about its side effects out of jealousy or personal reasons.
• 🚫 Finasteride is not a birth control, and its presence in semen is minimal, posing no risk to fertility or causing birth defects.
• 🔍 A 2011 case report suggested a possible link between finasteride and sperm DNA fragmentation, but this was based on a single case and not substantiated by further research.
• 🧬 The sperm DNA fragmentation index (DFI) can indicate fertility issues, and in the case mentioned, it improved after stopping finasteride, but this was an isolated incident.
• 🧪 A 2007 study showed that finasteride had a mild negative impact on sperm formation in some men, but overall did not significantly affect fertility.
• 📈 The study found that sperm count initially decreased in finasteride users but returned to normal levels after 52 weeks, indicating reversible effects.
• 💪 Testosterone levels slightly increased in finasteride users, potentially due to the inhibition of DHT production, but this had no significant ergogenic effects.
• 🌱 Recovery of fertility after stopping finasteride is generally quick, with most effects reversing within three to six months.

Q & A

What is finasteride and why is it significant in treating hair loss?

Finasteride is a pharmaceutical drug used primarily for treating androgenic alopecia, commonly known as male pattern baldness. It is significant because it is clinically proven to be effective in both the short and long term, with benefits maintained even after 10 years of continued use.

What is the role of minoxidil in hair loss treatment?

Minoxidil is another medication used to treat hair loss, often used alongside finasteride. It is applied topically and helps stimulate hair growth. The combination of finasteride and minoxidil is considered the gold standard for treating hair loss.

How does the internet affect the perception of hair loss treatments like finasteride?

The internet has provided a wealth of information about hair loss treatments, but it has also given a platform to individuals who may spread misinformation or negative experiences to deter others from using effective treatments like finasteride.

What is the psychological impact of hair loss on individuals?

Hair loss can be mentally and cosmetically debilitating, affecting self-esteem and confidence. Some individuals who have experienced hair loss may try to see others fail as a way to cope with their own situation.

What are some of the false claims made against finasteride by its critics?

Critics have falsely claimed that finasteride causes irreversible infertility and birth defects. These claims are not supported by evidence-based research and are often based on anecdotal reports or isolated cases.

What is the significance of the sperm DNA fragmentation index (DFI) mentioned in the script?

The DFI is a measure of DNA damage in sperm, which can be a cause of infertility. A DFI of 30 is considered abnormal, and the script discusses a case where a man's DFI improved after stopping finasteride, suggesting a possible link.

What does the 2007 study involving 99 men tell us about the effects of finasteride on fertility?

The study showed that finasteride and dutasteride had a mild negative impact on sperm formation, but the effects were not clinically significant for most men. It also showed that any decreases in sperm count were temporary and reversible after stopping the medication.

How does the dosage of finasteride affect its impact on fertility according to the script?

The script suggests that the effects on fertility observed in studies may be dosage-dependent. Lower doses, such as the 1 mg daily used for treating androgenic alopecia, may have less impact on fertility than higher doses.

What is the conclusion of the script regarding the use of finasteride and its impact on fertility?

The script concludes that while finasteride may have a small effect on fertility in a small percentage of men, it does not cause fertility issues in the majority. Any temporary fertility issues can be resolved by adjusting the dosage or stopping treatment temporarily.

Is there a risk of finasteride in semen causing birth defects in women?

No, the amount of finasteride found in semen is minimal and studies have shown it to be unlikely to pose a risk to the developing fetus. There have been no credible reports of birth defects related to finasteride in semen.

Outlines

00:00

💊 Finasteride: The Gold Standard for Hair Loss Treatment

This paragraph discusses the effectiveness of finasteride in treating androgenic alopecia, commonly known as male pattern baldness. It highlights that finasteride is not only proven to be effective in the short term but also maintains its benefits over long-term use, even after a decade. The speaker emphasizes the drug's success in preventing hair loss and the availability of minoxidil as an alternative for those who do not respond well to finasteride. The paragraph also addresses the negative impact of social media, where some individuals spread misinformation about finasteride, claiming it causes irreversible infertility and birth defects. The speaker refutes these claims by citing a 2011 case report involving a man whose sperm DNA fragmentation index (DFI) improved after discontinuing finasteride, but also notes the lack of subsequent research to support these concerns.

05:02

🧬 Finasteride and Fertility: Debunking Myths with Research

The second paragraph delves into the impact of finasteride on male fertility, countering the myth that it causes irreversible infertility. It references a 2007 study involving 99 men, comparing the effects of dutasteride, finasteride, and a placebo on various fertility parameters such as sperm count, volume, morphology, and motility. The study found that while finasteride and dutasteride initially reduced sperm count, these levels returned to normal within 52 weeks. The paragraph also discusses the temporary decrease in sperm concentration and motility observed in the finasteride group, which resolved over time. The speaker concludes that finasteride does not significantly affect fertility in the majority of men and that any negative effects are reversible upon discontinuation of the drug.

10:03

🚫 Finasteride in Semen: No Risk to Fertility or Birth Defects

In the final paragraph, the speaker addresses concerns about the presence of finasteride in semen and its potential to cause birth defects. The speaker reassures that the amount of finasteride found in seminal fluid is minimal (less than 0.001 percent of the one milligram dose per ejaculation) and poses no risk to the developing fetus. This is supported by studies on rhesus monkeys and the absence of credible reports linking finasteride in semen to birth defects. The speaker encourages viewers to dismiss unfounded fears and emphasizes that using finasteride does not compromise one's ability to have children, encouraging a future generation to continue the fight against hair loss stigma.

Keywords

💡Finasteride

Finasteride is a medication primarily used for treating male pattern hair loss (androgenetic alopecia) and benign prostatic hyperplasia. In the video, it is highlighted as the 'best treatment on the market' for hair loss, effective both in the short and long term, with people using it for over 20 years maintaining its benefits. The script discusses its clinical effectiveness and counters misinformation about its side effects, emphasizing its role in combating hair loss.

💡Androgenic Alopecia

Androgenic alopecia is a type of hair loss that results from a combination of genetics and hormonal changes, specifically the influence of androgens. The video discusses finasteride as a treatment for this condition, emphasizing its effectiveness in preventing hair loss and promoting hair growth.

💡Minoxidil

Minoxidil is another medication used to treat hair loss, often in combination with finasteride. The script mentions minoxidil as an alternative for those for whom finasteride alone is not sufficient, highlighting the 'finasteride and minoxidil stack' as the gold standard for treating hair loss.

💡Internet and Social Media

The video script discusses the role of the internet and social media in spreading both helpful information and misinformation about hair loss treatments. It criticizes those who use these platforms to discourage others from using effective treatments like finasteride, suggesting a negative impact on those seeking solutions for hair loss.

💡Fertility

Fertility in the context of the video refers to the ability to conceive children. The script addresses concerns about finasteride affecting fertility, citing a case report and a larger study to discuss the potential impact on sperm parameters and the reversibility of any effects upon discontinuation of the drug.

💡Sperm DNA Fragmentation Index (DFI)

DFI measures the degree of DNA damage in sperm, which can be a cause of infertility. The video uses a case report to discuss an instance where DFI was high in a man using finasteride, suggesting a potential link, but also noting the lack of pre-treatment DFI measurement and the rapid return to normal levels after stopping the drug.

💡Randomized Control Trial

A randomized control trial is a type of scientific experiment that aims to reduce bias when testing a new treatment. The script contrasts a single case report with a randomized control trial, emphasizing the need for more robust research to support claims about finasteride's effects on fertility.

💡Dutasteride

Dutasteride is a medication similar to finasteride, used to treat benign prostatic hyperplasia and hair loss. The video compares the effects of dutasteride and finasteride on sperm parameters in a study, noting that both drugs had a mild negative impact but that these effects were generally reversible.

💡Birth Defects

The video addresses rumors that finasteride can cause birth defects, particularly in the context of men using the drug and its potential presence in semen. It refutes these claims by citing studies and the UK drug database, which state that the amount of finasteride in semen is too small to pose a risk.

💡Dihydrotestosterone (DHT)

DHT is a hormone that plays a role in male sexual characteristics and is also associated with hair loss. The script discusses DHT as a 'trash hormone' that is not needed post-puberty, contrasting it with testosterone, which is essential for male characteristics. The video suggests that reducing DHT levels with finasteride is beneficial for hair retention.

💡Semen Analysis

Semen analysis is a test used to assess male fertility by examining sperm count, concentration, motility, and morphology. The video uses the results of a semen analysis in a case report to discuss the potential impact of finasteride on fertility, noting that sperm parameters can return to normal after discontinuing the drug.

Highlights

Finasteride is considered the best treatment for androgenic alopecia, with long-term effectiveness proven even after 10 years of use.

People who have been on finasteride for over 20 years still maintain its benefits, debunking the myth of hair loss inevitability.

The combination of finasteride and minoxidil is the gold standard for treating hair loss, despite research into alternative treatments.

The internet provides a wealth of information but also platforms for those with harmful intentions regarding hair loss treatments.

Some individuals spread misinformation about finasteride's side effects, possibly due to personal insecurities or a desire to see others fail.

A case report from 2011 suggests a potential link between finasteride and sperm DNA fragmentation, but lacks broader evidence to support the claim.

The 2011 case report involved a 48-year-old man with a high sperm DNA fragmentation index, which improved after stopping finasteride.

A 2007 study with 99 men showed finasteride's temporary impact on sperm count, which returned to normal after treatment cessation.

Finasteride and dutasteride mildly affected sperm formation but did not cause clinically significant fertility issues in the majority of men.

A small percentage of men may be more sensitive to finasteride, experiencing more severe decreases in sperm count, but this is reversible.

The recovery of fertility after stopping finasteride is generally quick, with most effects reversing within six months.

The standard dose of finasteride for androgenic alopecia is less likely to affect fertility compared to higher doses used for other conditions.

Finasteride is not a form of birth control, as evidenced by healthy babies conceived by men using the drug.

The amount of finasteride found in semen is minimal and not considered a risk to developing fetuses.

Misconceptions about finasteride causing irreversible infertility and birth defects are largely unfounded and not supported by substantial research.

The video aims to dispel fears about finasteride's impact on fertility, encouraging informed decision-making about hair loss treatments.

Transcripts

what's up my homies and my tunes good to

be back with y'all

so we talked about hair loss on my

channel a lot and naturally that means

we've also discussed finasteride and

that is for good reason

finasteride is after all the best

treatment on the market for treating

androgenic alopecia

and crushing the slap head curse it is

the only treatment on the market that

has not only been clinically proven to

be effective in the short term

but also in the long term as it has been

proven effective even after

10 years of continued use and it is not

uncommon to find people who have been on

the drug for over 20 years

and still maintain all of the wonderful

benefits the drug has caused them

my friends we are extremely blessed to

be living in an era where solving hair

loss is as simple as just taking a pill

and forgetting about it

and for the few people where taking

finasteride is not enough there is also

minoxidil

and that is why despite all the research

into alternative pharmaceutical

treatments

the finasteride and minoxidil stack is

still the gold standard for treating

hair loss now as we all

know the internet has been revolutionary

in providing a

plethora of information to the public

about literally any subject

but it has sadly through social media

also given a platform to those who wish

to cause harm to others

for their own selfish reasons hair loss

is a mentally and cosmetically

debilitating condition

and many who have lost the good fight

against hair loss have taken it upon

themselves to see as many other people

fail as they possibly can simply due to

the fact that misery loves company

and it's easier to be a loser when

you're surrounded by other losers

because you know that helps you cope

these people cannot tolerate the fact

that the overwhelming majority of men

who use finasteride

have had great success with the drug

because every time someone

uses finasteride and reports success

with it it makes their own decision to

not use finasteride

come across as foolish the last thing a

bald coper wants to hear

is for someone to ask them why didn't

you just use finasteride when you still

had the chance

they hate that question because deep

down they know it is true

it really resonates with them painfully

knowing that the side effects are rare

that the horror stories people spread

online are not substantiated by any

evidence-based research

and they know and they hate the fact

that the majority of people who take

finasteride

will experience no adverse side effects

and the few that do experience adverse

side effects can easily mitigate them

through titration adjustments

so the next time you hear someone tell

you to just shave it bro

remember they're not saying that for

your sake they're saying it for their

own sake

so in their desperation to see other

people fail like they have

they've turned to a new tactic they are

now claiming that finasteride will cause

irreversible infertility

as well as birth defects now it is

medically known that women who are

pregnant or trying to conceive should

not use or handle finasteride since in

that case

it indeed can cause birth defects but

not being satisfied with just

that finasteride haters are now claiming

finasteride will cause birth defects

even if just men take it now you'd think

with such outlandish claims

they'd have some massive piece of

conclusive research like you know a

randomized control trial

with hundreds or thousands of subjects

but no all they have here is a case

report that was published in 2011.

this particular case report involves a

48 year old man

who had been trying to conceive with his

37 year old wife and had no success

after four years of trying

he'd been on finasteride at one

milligram per day for

many years they don't specify but we can

assume it's been a long time

so important note here is that the man

had no side effects from finasteride

including no erectile dysfunction they

did a semen analysis

a semen analysis and it showed he had

normal semen volume

normal sperm concentration as well as

normal sperm motility

they did check what's called the sperm

dna fragmentation index also known as

dfi and this was 30 which was high

so what does this dfi thing actually

mean well

dfi is a measurement of dna damage in

the sperm

and it can be a cause of infertility a

dfi of 30

is considered abnormal and because of

this the doctors advised that he stopped

finasteride in order to see if it would

stop the infertility problem

three months after stopping finasteride

the dfi went down to 21

and three months later and went down to

16.5

which is considered normal it's worth

mentioning that even after the dfi

dropped down

his wife still didn't get pregnant which

raises the possibility

that it was more of a problem with her

rather than with him

however the doctors who wrote the case

report felt that the abnormal dfi the

subject had before stopping finasteride

was actually due directly to the

finasteride so

this does seem pretty concrete at first

but one major problem with it is that we

don't have

any measurement of the dfi before he

started finasteride because keep in mind

he had already been on finasteride for

many years as they stated

but the worst case scenario is that even

if he did have an altered dfi for

finasteride it's clear that the dfi

rapidly returned to normal

within three months after stopping

treatment so based on this

one case report it does seem that this

48 year old gentleman may have had

fertility problems related to

finasterides but it is noteworthy that

this case report was published way back

in 2011

and since then we've had no subsequent

data to back up the reliability of this

research you know for all we know this

could have just been an outlier and the

dfi could have been due to some other

cause that we can't

identify at all i mean who knows maybe

he worked with x-rays or he was drinking

a lot of booze to cope with not being

able to knock up his wife i mean there's

many many

factors that could have caused it that

we don't know about so this is just

another example of why

a case study isn't usually considered

strong research also we know for a fact

that finasteride certainly isn't birth

control

i mean there have been many healthy

babies conceived by men who are on

finasteride so

even though there hasn't been another

study or case report on dfi

on finasteride there's more data on the

effect of finasteride

on male fertility in general fortunately

so in fact this very case report

actually references a study done in 2007

that involved 99 men who were randomized

to a dutasteride 0.5 milligram group

or a finasteride five milligram group

versus a placebo control group

so this is a much more uh thorough study

than the case report which just looked

at one bloke for whom all we know was

exposing his balls to radiation on a

daily basis

here we have an actual randomized double

blind and controlled study

with a fairly large sample size of

patients 99 in fact

so during this study semen samples were

taken and various measures were made

including sperm count

seminal volume sperm morphology as well

as sperm motility so basically they were

just trying to assess fertility in

general

also they measured serum testosterone

and dht levels in all subjects

as far as how they extracted the sperm

from the patients it's probably better

not to ask that

so we know the methodology here is good

because they're measuring fertility

across several

several parameters but what were the

results of the actual study

well as expected dutasteride and

finasteride lowered serum dht levels

with dutasteride serum dht levels were

lowered by 93

at 26 weeks and with finasteride the dht

was lowered

by 70 percent although keep in mind

we're talking about serum dh here

dht here we're not talking about scalp

dht now as far as serum testosterone

goes

uh they rose by about 25 and the

dutasteride and finasteride groups after

eight weeks of treatment but after that

they returned

close to baseline but they are still

slightly elevated and this is expected

because you're preserving the good

hormone testosterone by preventing the

five

ar enzyme from turning it into the trash

hormone dihydrotestosterone dht

and effectively wasting it this slight

increase in testosterone won't have any

ergogenic benefit from a sports

performance standpoint

but it might be why some people report

things like slightly elevated libido

while they're on five ar inhibitors

so looking at the semen parameters of

this study's outcome

after 24 weeks the total sperm count was

reduced by about 34

34 in the finasteride group and 29

percent in the dutasteride group

so that sounds bad right well stay with

me here because after 52 weeks the sperm

count had risen yet again

to the point where the difference

between baseline levels was no longer

statistically significant

and additionally there was further

improvement in sperm count after

stopping the drug for 20 to 24 weeks

another measured parameter was semen

volume which was reduced in both the

dutasteride

and the finasteride group after 26 weeks

and remained reduced in the due castrate

group after 52 weeks

although if you look at these graphs

here uh the difference really

doesn't seem to be that uh it's

clinically significant it looks pretty

mild to me

and you know it's not like any of these

drugs could be considered effective

birth control or anything of the sort

but um anyways that's just semen uh

volume we're looking at here so let's

look at actual sperm concentration

the sperm average uh concentration

remained relatively constant in all the

treatment groups throughout the study

except in the finasteride group at 26

weeks where it decreased significantly

at 22 percent

however the good news about that is that

by 52 weeks the sperm concentrations of

the finasteride group had gone back to

normal

and this result really correlates with

the rest of finasteride's supposed side

effects

because it has been shown that even when

people do get side effects from

finasteride they usually will get better

over time with continued use and that

applies to fertility as well it seems

so for the last observed parameters the

researchers looked at sperm motility

which showed a

small decrease in both the dutasteride

and finasteride groups of about 10

percent

sperm morphology was not changed with

either the finasteride or dutasteride

group though

so being that fertility is a

multifactorial equation that

is contingent on several parameters how

do we put this all into perspective

well the authors of the study concluded

that the two drugs had a

mild negative impact in sperm formation

in men

the average effect on the parameters

affecting fertility did not actually

fall below the thresholds for clinical

significance in the drugs

except for one point in time when the

total sperm count of finasteride was low

at 26 weeks but if you remember

that resolved by itself by 52 weeks so

the bottom line is that none of these

changes from finasteride or dutastride

are enough to cause fertility issues in

the vast majority of people

they did point out that approximately

five percent of the subjects on

treatment had more severe decreases in

sperm count

so it may be that there are some

individuals that are more sensitive to

these drugs than others

but even if you are one of those five

percent we know that stopping the drug

causes a relatively quick reversal of

the problem

six months at the very most also keep in

mind that this is based on

five milligrams of finasteride the

authors note that in a previous study

there was no effect

found on finasteride uh of finasteride

on sperm production whatsoever

however the dose in that study was one

milligram daily

which of course is the standard dose for

treating androgenic alopecia

so it is likely that the result of the

current study would be even more

optimistic if the dosage were equivalent

to what is used to treat androgenic

alopecia

instead of enlarged prostate the authors

also note that the recovery after

stopping treatment was quicker in the

finasteride group

which may be due to the shorter

half-life of finasteride compared to

tenastride

so since both drugs have a pretty market

effect on serum dht levels the authors

felt that this suggests that

quote testosterone alone may be

sufficient to maintain

qualitatively normal spermatogenesis in

most normal men

unquote so this is yet another reason in

the very long list of reasons

as to why dht is a trash hormone

you don't need it post puberty

testosterone is what makes you a man

dht just makes you an ugly old bald man

and if you're bald you're probably not

going to find a woman who will let you

put a baby in her to begin with so

pretty much the only outlet you'll have

for being a father

as a bald man is donating your semen to

clinical research

like in the trial we just reviewed so

what can we conclude from all this

can finasteride have a small effect on

fertility and a small percentage of men

who use it

yes but in the majority of men it

doesn't make any difference and even if

fertility is affected

it usually goes back to normal with

continued use and even in the

worst case scenario scenario where

fertility stays low while on treatment

you can either reduce your dosage and

failing that you can just temporarily

drop the treatment and just give it the

good old college try with your old lady

for a maximum of three to six months

and anything you lose in terms of hair

during that time you'll likely be able

to get back once you get on treatment

again so i wouldn't sweat it and also

you can temporarily switch to

topical anti-antigens like fluoridal or

alpha dial to kind of tide you over

while you're doing the nasty with your

lady

so that pretty much covers everything

regarding fertility

but one final question that people often

ask me that i want to address is whether

there is enough finasteride in the semen

to cause birth defects in women when

they get pregnant well

the answer to this is no but in case you

want more details

the uk drug database site on finasteride

states

quote a small amount of finasteride less

than 0.001 percent

of the one milligram dose per

ejaculation has been detected in the

seminal fluid of men taking propecia

studies and rhesus monkeys have

indicated that this amount is

unlikely to constitute a risk to the

developing male fetus unquote

in addition no credible reports of birth

effects have

have ever been found related to

finasteride in semen

so unsurprisingly this is just yet

another manufactured controversy

intended to frighten people out of using

finasteride but hopefully after this

video

you'll cast your fears aside and know

that saving your hair doesn't mean you

have to abandon your progeny

after all the world will need a new

generation of people to fight against

the slap head propaganda in the future

and with that i'm out homies see you

next time