---
title: Finasteride Side Effects & Libido — What to Know (with Dutasteride Comparison)
description: Worried about finasteride side effects? Learn the facts about libido changes, long-term risks, and how finasteride compares to dutasteride.
image: https://www.flycatcher.men/hubfs/Photo%20Campaigns%20and%20Shoots/Slice%20of%20Life%202022/Dauss%20Miller%20Photographer_20220630_0196F.jpg
---

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Hair Restoration

 Oct 2, 2025

Flycatcher Team

# Finasteride Side Effects & Libido — What to Know (with Dutasteride Comparison)

Search “finasteride side effects” for five minutes and you’ll encounter two very different versions of the drug.

One says finasteride is a well-studied hair-loss medication with a small risk of side effects. The other makes it sound like taking a single pill could permanently wreck your sex drive.

Neither extreme is particularly useful if you’re simply trying to decide whether keeping your hair is worth taking a prescription medication every day.

Finasteride **can cause sexual side effects**, including lower libido, erectile dysfunction and changes in ejaculation. Those effects occurred more often with finasteride than placebo in clinical trials—but the absolute difference was fairly small. Persistent symptoms after stopping have also been reported and are acknowledged in U.S. prescribing information, although researchers still do not know exactly how often they occur or why some men may be more susceptible than others. [\[1\]](https://www.accessdata.fda.gov/drugsatfda_docs/label/2022/020788s030lbl.pdf)

There are also two wrinkles that deserve more attention than they usually get: topical finasteride is not automatically “side-effect free,” and dutasteride is not simply finasteride turned up to eleven.

Here’s what the evidence actually tells us.

## The Quick Answer: How Common Are Finasteride Sexual Side Effects?

In the original controlled hair-loss trials summarized in U.S. prescribing information, **3.8% of men taking finasteride 1 mg reported at least one drug-related sexual adverse effect during the first year, compared with 2.1% taking placebo.** [\[1\]](https://www.accessdata.fda.gov/drugsatfda_docs/label/2022/020788s030lbl.pdf)

Put another way, that’s a difference of about **17 additional men per 1,000 treated** in those trials.

| Sexual side effect | Finasteride 1 mg | Placebo |
| --- | --- | --- |
| Decreased libido | 1.8% | 1.3% |
| Erectile dysfunction | 1.3% | 0.7% |
| Ejaculation disorder | 1.2% | 0.7% |
| **At least one of these sexual effects** | **3.8%** | **2.1%** |

The prescribing information also reports that symptoms resolved in men who discontinued because of these effects and in most men who continued treatment. [\[1\]](https://www.accessdata.fda.gov/drugsatfda_docs/label/2022/020788s030lbl.pdf)

> “Resolution occurred in men who discontinued therapy with PROPECIA due to these side effects and in most of those who continued therapy.”
> 
> — FDA-approved PROPECIA prescribing information [\[1\]](https://www.accessdata.fda.gov/drugsatfda_docs/label/2022/020788s030lbl.pdf)

That doesn’t mean the risk is zero. It means the conversation is more nuanced than either “finasteride destroys your libido” or “the side effects are all in your head.”

A 2019 meta-analysis of 15 randomized, double-blind, placebo-controlled trials involving 4,495 men found that 5-alpha-reductase inhibitors were associated with an increased relative risk of sexual dysfunction. For finasteride specifically, the relative risk was 1.66. [\[2\]](https://pubmed.ncbi.nlm.nih.gov/30206635/)

A 2026 systematic review covering 41 studies reached a similarly nuanced conclusion: sexual side effects in controlled androgenetic-alopecia studies were generally uncommon and usually reversible, but individual susceptibility varies and better long-term research is still needed. [\[3\]](https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2026.1787706/full)

## First, What Does Finasteride Actually Do?

Male pattern hair loss—technically called **androgenetic alopecia**—is driven partly by genetics and partly by a hormone called dihydrotestosterone, or **DHT**.

Your body creates DHT from testosterone using an enzyme called 5-alpha reductase. In men who are genetically susceptible to hair loss, DHT gradually causes certain scalp follicles to shrink. Hair becomes finer and shorter until some follicles eventually stop producing visible hair.

Finasteride is only one tool. For the larger treatment picture, see our [guide to men’s hair loss and what actually works](https://www.flycatcher.men/blog/mens-hair-loss-causes-treatments).

Finasteride inhibits 5-alpha reductase and lowers DHT. The FDA-approved dose for male pattern hair loss is **1 mg taken orally once daily**. A higher 5 mg dose is used for benign prostatic hyperplasia, or BPH. [\[1\]](https://www.accessdata.fda.gov/drugsatfda_docs/label/2022/020788s030lbl.pdf)

That dosage distinction matters.

A surprising amount of finasteride information floating around online comes from studies involving older men taking **5 mg for prostate enlargement**. Those results shouldn’t automatically be applied to a younger or middle-aged man taking 1 mg for hair loss. Different dose, different population, different baseline likelihood of problems such as erectile dysfunction.

**Additional Reading:** [TRT and Hair Loss: What Every Man Should Know Before Starting Testosterone](https://www.flycatcher.men/blog/trt-and-hair-loss-what-every-man-should-know-before-starting-testosterone)

## So, Does Finasteride Really Lower Libido?

It can.

The controlled trials show an increase in decreased libido, erectile dysfunction and ejaculation problems compared with placebo. The 2019 meta-analysis of randomized hair-loss trials also found a statistically significant increase in the relative risk of sexual dysfunction with finasteride 1 mg. [\[2\]](https://pubmed.ncbi.nlm.nih.gov/30206635/)

But **relative risk and absolute risk aren’t the same thing**.

If a side effect rises from roughly 2 men out of 100 to roughly 4 men out of 100, the relative increase can sound dramatic while the actual number of additional men affected remains fairly small.

Both facts matter.

It is reasonable to say that finasteride increases the risk of sexual side effects. It is not accurate to imply that sexual dysfunction is inevitable—or even common among most men who take it.

![Dauss Miller Photographer\_20220630\_0208F](https://www.flycatcher.men/hs-fs/hubfs/Photo%20Campaigns%20and%20Shoots/Slice%20of%20Life%202022/Dauss%20Miller%20Photographer_20220630_0208F.jpg?width=900&height=1350&name=Dauss%20Miller%20Photographer_20220630_0208F.jpg)

## Why Do Clinical Trials and Internet Stories Sound So Different?

This is where the subject gets messy.

Randomized trials are designed to compare groups systematically. Online forums, social media and adverse-event databases capture something different: the experiences of people motivated enough to talk or report about them.

Both can tell us something, but they cannot answer the same questions.

For example, erectile dysfunction and changes in libido occur in men who don’t take finasteride at all. Stress, poor sleep, relationship issues, alcohol, other medications, cardiovascular health, hormone levels and age can all affect sexual function. That’s one reason placebo groups in finasteride studies also report sexual symptoms.

Expectations can influence symptom reporting as well. In one often-cited study of men taking 5 mg finasteride for BPH, men who were specifically warned about sexual side effects reported them considerably more often than men who were not given that information. [\[4\]](https://pubmed.ncbi.nlm.nih.gov/17655657/)

But that study involved an older BPH population taking five times the hair-loss dose. It should not be used as evidence that symptoms reported by men taking 1 mg are imaginary. It simply demonstrates that expectations can influence how symptoms are noticed and reported.

The reverse is also true: clinical trials aren’t perfect at detecting every uncommon or delayed adverse effect. That’s where postmarketing surveillance and patient reports can reveal signals that deserve further study.

The sensible position is to take symptoms seriously without pretending every symptom reported after starting a medication proves that the medication caused it.

**Additional Reading:** [Does Creatine Cause Hair Loss? What the Research Shows](https://www.flycatcher.men/blog/does-creatine-cause-hair-loss)

## Do Finasteride Side Effects Go Away After You Stop Taking It?

For most men who reported sexual adverse effects in the original clinical trials, symptoms resolved. Some men even reported resolution while continuing treatment. [\[1\]](https://www.accessdata.fda.gov/drugsatfda_docs/label/2022/020788s030lbl.pdf)

But that is not the whole story.

U.S. prescribing information also includes postmarketing reports of sexual dysfunction that continued after finasteride was discontinued, including erectile dysfunction, libido disorders, ejaculation disorders and orgasm disorders. It also includes reports of male infertility or poor semen quality, with improvement or normalization reported after stopping finasteride. [\[1\]](https://www.accessdata.fda.gov/drugsatfda_docs/label/2022/020788s030lbl.pdf)

Here’s the important limitation: postmarketing reports come from an unknown population and aren’t collected like a randomized clinical trial. They can identify a possible problem, but they generally **cannot tell us how frequently it occurs or establish with certainty that the medication caused a particular case**.

So “persistent symptoms have never been documented” is incorrect.

So is quoting a precise percentage for the risk as though the science has settled it.

It hasn’t.

## What Is Post-Finasteride Syndrome?

**Post-finasteride syndrome**, usually shortened to PFS, is a term used to describe persistent sexual, physical, neurological or psychological symptoms reported by some people after discontinuing finasteride.

The subject has become unusually polarized. One side sometimes treats PFS as proof that finasteride is inherently dangerous. The other dismisses persistent symptoms entirely because the phenomenon is difficult to define and study.

The evidence supports a more careful position.

Persistent sexual symptoms after discontinuation have been reported and appear in U.S. prescribing information. At the same time, researchers have not established a reliable prevalence or clearly defined biological mechanism that explains persistent symptoms in every reported case. [\[1\]](https://www.accessdata.fda.gov/drugsatfda_docs/label/2022/020788s030lbl.pdf) [\[3\]](https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2026.1787706/full)

The 2026 systematic review noted that much of the evidence on persistent symptoms comes from self-selected, uncontrolled or survey-based populations, which makes it difficult to determine how representative those findings are of typical finasteride users. The authors concluded that the prevalence, causal relationship and underlying mechanisms remain uncertain. [\[3\]](https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2026.1787706/full)

In other words: persistent symptoms shouldn’t be dismissed. But neither should the highest numbers found online be presented as the average man’s risk.

## What About Depression, Anxiety and Mood Changes?

This part of the finasteride conversation has changed in recent years and deserves more than a footnote.

FDA-approved U.S. prescribing information lists **depression, suicidal ideation and suicidal behavior** among psychiatric events reported after finasteride reached the market. [\[1\]](https://www.accessdata.fda.gov/drugsatfda_docs/label/2022/020788s030lbl.pdf)

European regulators went further in 2025. Following an EU-wide safety review, the European Medicines Agency confirmed suicidal ideation as a side effect of oral finasteride 1 mg and 5 mg tablets. Most of the reported cases involved men taking 1 mg finasteride for androgenetic alopecia. [\[5\]](https://www.ema.europa.eu/en/medicines/human/referrals/finasteride-dutasteride-containing-medicinal-products)

That does not mean most—or even many—men taking finasteride will experience a psychiatric effect. It does mean mood changes deserve to be taken seriously.

A man who develops significant depression, mood changes or suicidal thoughts while taking finasteride should promptly seek medical care rather than simply assuming he needs to tough it out for the sake of his hair.

## Does Finasteride Affect Fertility or Sperm?

This is another subject where blanket statements don’t hold up particularly well.

A randomized placebo-controlled study of healthy young men found that taking finasteride 1 mg daily for 48 weeks did **not significantly affect sperm concentration, total sperm count, motility or morphology**. [\[6\]](https://pubmed.ncbi.nlm.nih.gov/10492183/)

On the other hand, a study involving men evaluated at a fertility clinic found that sperm counts increased substantially in some men after finasteride was discontinued, suggesting that a susceptible subgroup may experience reduced sperm counts while taking it. [\[7\]](https://pubmed.ncbi.nlm.nih.gov/24012200/)

Those aren’t necessarily contradictory findings. One looked at healthy men; the other looked at men already seeking evaluation for infertility.

For the average man, the evidence doesn’t support saying that 1 mg finasteride routinely causes infertility. But if you’re actively trying to conceive, already have a low sperm count or are undergoing a fertility evaluation, it’s worth putting finasteride on the list of medications you discuss with your physician.

## One Side Effect Men Over 40 Shouldn’t Overlook: Finasteride Lowers PSA

Sex gets nearly all the attention in discussions about finasteride, but this may be one of the more practical issues for men in their 40s and 50s.

Finasteride lowers **prostate-specific antigen, or PSA**, the blood marker commonly used as part of prostate-cancer screening.

In a randomized trial of 355 men ages 40 to 60 taking the 1 mg hair-loss dose, median PSA fell approximately **40% among men ages 40–49 and 50% among men ages 50–60 after 48 weeks**. [\[8\]](https://pubmed.ncbi.nlm.nih.gov/17196507/)

U.S. prescribing information likewise warns that finasteride decreases PSA and that this effect needs to be considered when interpreting a man’s results. [\[1\]](https://www.accessdata.fda.gov/drugsatfda_docs/label/2022/020788s030lbl.pdf)

The practical takeaway is simple: **make sure the clinician interpreting your PSA knows you’re taking finasteride.**

That’s the kind of information that can get lost when hair-loss medication is treated as completely separate from the rest of a man’s health.

![Dauss Miller Photographer\_20220630\_0005](https://www.flycatcher.men/hs-fs/hubfs/Dauss%20Miller%20Photographer_20220630_0005.jpg?width=900&height=600&name=Dauss%20Miller%20Photographer_20220630_0005.jpg)

## Is Topical Finasteride Safer Than Oral Finasteride?

Potentially—but this requires a very large asterisk.

A Phase III trial involving 458 men compared a standardized topical finasteride spray with placebo and oral finasteride. At 24 weeks, hair-count improvement with topical finasteride was significantly greater than placebo and numerically similar to oral finasteride. [\[9\]](https://pmc.ncbi.nlm.nih.gov/articles/PMC9297965/)

Systemic exposure, however, was dramatically lower. Maximum plasma finasteride concentrations were more than **100 times lower with the topical formulation**. Average serum DHT decreased about **34.5% with topical finasteride versus 55.6% with oral finasteride**. [\[9\]](https://pmc.ncbi.nlm.nih.gov/articles/PMC9297965/)

Treatment-related sexual adverse events occurred in **2.8% of the topical group, 3.3% of the placebo group and 4.8% of the oral-finasteride group**. [\[9\]](https://pmc.ncbi.nlm.nih.gov/articles/PMC9297965/)

That makes topical finasteride interesting for men concerned about systemic exposure.

It does **not** prove that every bottle labeled “topical finasteride” carries the same risk.

### The Important U.S. Caveat

There is currently **no FDA-approved topical finasteride product in the United States**. Most topical finasteride prescribed in the U.S. is compounded, and compounded formulations may use different concentrations, vehicles and dosing instructions from the standardized formulation studied in clinical trials. [\[10\]](https://www.fda.gov/drugs/human-drug-compounding/fda-alerts-health-care-providers-compounders-and-consumers-potential-risks-associated-compounded)

> “Currently, there is no FDA-approved topical formulation of finasteride.”
> 
> — U.S. Food and Drug Administration [\[10\]](https://www.fda.gov/drugs/human-drug-compounding/fda-alerts-health-care-providers-compounders-and-consumers-potential-risks-associated-compounded)

In April 2025, the FDA issued a specific warning about compounded topical finasteride. The agency reported receiving 32 adverse-event reports between 2019 and 2024 and emphasized that finasteride is expected to be absorbed through the skin into the bloodstream. Reported events included erectile dysfunction, decreased libido, anxiety, depression, suicidal ideation, fatigue and other symptoms. The FDA also warned about local skin reactions and accidental transfer of topical finasteride to another person. [\[10\]](https://www.fda.gov/drugs/human-drug-compounding/fda-alerts-health-care-providers-compounders-and-consumers-potential-risks-associated-compounded)

Those 32 reports do **not** tell us the incidence of side effects or prove causality. But they do knock down one popular misconception:

**Topical does not mean purely local.**

Topical finasteride may reduce systemic exposure compared with oral medication, depending on the formulation. It shouldn’t be marketed—or understood—as a version of finasteride with zero systemic risk.

## Finasteride vs. Dutasteride: Is Stronger Necessarily Riskier?

Dutasteride and finasteride belong to the same family of medications: 5-alpha-reductase inhibitors.

Dutasteride inhibits both major 5-alpha-reductase isoenzymes involved in DHT production, while finasteride is more selective. The result is stronger DHT suppression.

That can translate into more hair growth.

In a randomized trial involving 917 men with androgenetic alopecia, **dutasteride 0.5 mg produced greater improvements in hair count and hair width than finasteride 1 mg at 24 weeks**. [\[11\]](https://pubmed.ncbi.nlm.nih.gov/24411083/)

But there are two important catches.

First, **dutasteride is not FDA-approved for male pattern hair loss in the United States**. Its approved U.S. indication is benign prostatic hyperplasia, so using it for hair loss is off-label. [\[12\]](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=947644ea-bc35-41df-8a7a-874360c90192)

Second, greater DHT suppression does not give us a neat equation where twice the potency automatically equals twice the sexual side effects.

The 2019 meta-analysis of randomized hair-loss trials found a significant increase in sexual dysfunction risk with finasteride. The estimate for dutasteride was also elevated but did not reach statistical significance, in part because far fewer dutasteride studies were available. [\[2\]](https://pubmed.ncbi.nlm.nih.gov/30206635/)

The newer 2026 systematic review found higher ranges of sexual adverse events in several dutasteride trials, but it also characterized the comparative evidence as less consistent than the evidence for finasteride. [\[3\]](https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2026.1787706/full)

There is another practical difference: **dutasteride sticks around much longer**.

Its terminal half-life is approximately five weeks, and measurable drug can remain in the bloodstream for four to six months after it is discontinued. [\[12\]](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=947644ea-bc35-41df-8a7a-874360c90192)

So if a man does experience an adverse effect, dutasteride cannot be cleared from the body nearly as quickly as finasteride.

The takeaway isn’t that dutasteride is “bad” and finasteride is “safe.” It’s that dutasteride offers potentially greater hair-growth efficacy with a different pharmacologic profile and more uncertainty around its use for hair loss in the United States.

## What Should You Do If You Notice Side Effects?

Don’t quietly change doses, start stacking supplements or diagnose yourself from Reddit.

Talk with the clinician prescribing the medication.

The timing of the symptom matters. So does your baseline sexual function, other medications, overall health, stress, sleep, fertility plans and whether anything else changed around the same time.

That conversation can help determine whether continuing, stopping or considering another approach makes sense.

The same principle applies before you start. A useful finasteride conversation isn’t simply, “Do you want the pill or not?”

It should include your diagnosis, how quickly your hair loss is progressing, what you realistically expect from treatment, your tolerance for risk, your sexual and mental-health history, fertility plans and any other medical factors that may affect the decision.

And it starts by confirming what is actually causing the hair loss. Male pattern hair loss is common, but it isn’t the only explanation for thinning or shedding. [Learn about other causes of hair loss besides genetics](https://www.flycatcher.men/blog/what-causes-hair-loss-besides-genetics).

## Is Finasteride Worth the Trade-Off?

There isn’t one answer that applies to every man.

For someone with clearly diagnosed androgenetic alopecia who wants to preserve as much existing hair as possible, finasteride has a substantial body of evidence behind it. For another man who is highly uncomfortable with even a small possibility of sexual side effects—or who has other health or fertility considerations—the trade-off may feel different.

A useful decision comes down to a few things:

- Confirm that the hair loss actually is androgenetic alopecia rather than assuming every thinning scalp is caused by DHT.
- Understand both the expected benefit and the **absolute—not merely relative—risk** of adverse effects.
- Consider baseline sexual function, mood, fertility plans and PSA screening when relevant.
- Understand that hair-loss medication generally requires ongoing use to maintain its benefit.
- Compare medication with other evidence-based hair-loss options rather than treating finasteride as the only choice.

That’s informed consent—not fear, and not a sales pitch.

**Additional Reading:** [Red Light Therapy for Hair Growth: Benefits, Best Options & Costs](https://www.flycatcher.men/blog/red-light-therapy-for-hair-growth)

## Frequently Asked Questions

### Does Finasteride Lower Testosterone?

Finasteride primarily reduces the conversion of testosterone into DHT rather than suppressing testosterone production itself. Its target is DHT, the androgen particularly important to male pattern hair loss. [\[1\]](https://www.accessdata.fda.gov/drugsatfda_docs/label/2022/020788s030lbl.pdf)

### Can Finasteride Permanently Lower Libido?

Persistent loss of libido and other sexual symptoms after discontinuation have been reported and are included in U.S. prescribing information. What is not well established is **how often persistent symptoms occur or why they happen in some men**. Most sexual adverse events reported in controlled hair-loss trials were reversible. [\[1\]](https://www.accessdata.fda.gov/drugsatfda_docs/label/2022/020788s030lbl.pdf) [\[3\]](https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2026.1787706/full)

### Does Topical Finasteride Cause Sexual Side Effects?

It can. A standardized topical formulation produced much lower blood levels of finasteride and fewer treatment-related sexual adverse events than oral finasteride in one large Phase III trial. But systemic absorption still occurs, and compounded topical finasteride products sold in the United States are not FDA-approved. [\[9\]](https://pmc.ncbi.nlm.nih.gov/articles/PMC9297965/) [\[10\]](https://www.fda.gov/drugs/human-drug-compounding/fda-alerts-health-care-providers-compounders-and-consumers-potential-risks-associated-compounded)

### Is Dutasteride More Likely Than Finasteride to Cause Erectile Dysfunction?

Possibly, but the evidence isn’t strong enough to make that a simple rule. Dutasteride suppresses DHT more strongly, and some studies report higher sexual adverse-event rates, but comparative evidence remains limited. What is clear is that dutasteride stays in the body far longer and is used off-label for hair loss in the United States. [\[3\]](https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2026.1787706/full) [\[12\]](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=947644ea-bc35-41df-8a7a-874360c90192)

### Can Finasteride Affect Fertility?

Most healthy men taking 1 mg have not shown meaningful changes in sperm production in controlled research, but reduced sperm counts have been reported in some men evaluated for infertility, with improvement after discontinuation. Men who are trying to conceive or already have fertility concerns should discuss that context with their physician. [\[6\]](https://pubmed.ncbi.nlm.nih.gov/10492183/) [\[7\]](https://pubmed.ncbi.nlm.nih.gov/24012200/)

### What Happens to Your Hair If You Stop Taking Finasteride?

Finasteride doesn’t permanently “cure” androgenetic alopecia. Its benefit generally requires continued treatment. U.S. prescribing information states that withdrawal leads to reversal of treatment effect within roughly 12 months. [\[1\]](https://www.accessdata.fda.gov/drugsatfda_docs/label/2022/020788s030lbl.pdf)

## The Bottom Line on Finasteride

The smartest position on finasteride isn’t pro-finasteride or anti-finasteride.

**It’s pro-good information.**

Finasteride has strong evidence for treating male pattern hair loss. Sexual side effects are real, but controlled studies suggest they affect a minority of users. Persistent sexual symptoms have been reported and shouldn’t be dismissed, even though their true frequency remains uncertain. Mood-related risks deserve serious attention. Topical finasteride may reduce systemic exposure, but it isn’t a risk-free loophole. And dutasteride may be more powerful for hair growth without being automatically “better” for every man.

The point isn’t to take a medication because you’re afraid of losing your hair—or avoid one because of the scariest story you found online.

**Understand the benefit. Understand the trade-offs. Then make the decision that fits you.**

For men in the Austin area trying to sort through hair-loss options, Flycatcher takes the same approach: first understand **why** you’re losing hair, then decide which combination of medication and non-invasive treatments makes sense for your goals. You can learn more about our [non-surgical hair restoration program](https://www.flycatcher.men/solutions/hair-loss-restoration-specialist-men-austin-tx) or [schedule a Scalp & Hair Health Consultation](https://flycatcher.zenoti.com/webstoreNew/services?serviceid=e99815ab-7d2d-4008-85b6-c6c53aa1c75d).

*This article is for educational purposes and is not a substitute for individualized medical advice from a qualified healthcare professional.*

**References**

**1.** U.S. Food and Drug Administration. *PROPECIA (finasteride) tablets, prescribing information.* 2022. [https://www.accessdata.fda.gov/drugsatfda\_docs/label/2022/020788s030lbl.pdf](https://www.accessdata.fda.gov/drugsatfda_docs/label/2022/020788s030lbl.pdf)

**2.** Lee S, Lee YB, Choe SJ, Lee WS. Adverse sexual effects of treatment with finasteride or dutasteride for male androgenetic alopecia: a systematic review and meta-analysis. *Acta Derm Venereol.* 2019;99(1):12-17. [https://pubmed.ncbi.nlm.nih.gov/30206635/](https://pubmed.ncbi.nlm.nih.gov/30206635/)

**3.** Złotowska A, Jastrząb-Miśkiewicz B, Krajewski PK. Sexual dysfunction associated with 5α-reductase inhibitors in the treatment of androgenetic alopecia: a systematic review. *Frontiers in Medicine.* 2026;13. [https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2026.1787706/full](https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2026.1787706/full)

**4.** Mondaini N, Gontero P, Giubilei G, et al. Finasteride 5 mg and sexual side effects: how many of these are related to a nocebo phenomenon? *J Sex Med.* 2007;4(6):1708-1712. [https://pubmed.ncbi.nlm.nih.gov/17655657/](https://pubmed.ncbi.nlm.nih.gov/17655657/)

**5.** European Medicines Agency. Finasteride- and dutasteride-containing medicinal products: measures to minimise risk of suicidal thoughts. 2025. [https://www.ema.europa.eu/en/medicines/human/referrals/finasteride-dutasteride-containing-medicinal-products](https://www.ema.europa.eu/en/medicines/human/referrals/finasteride-dutasteride-containing-medicinal-products)

**6.** Overstreet JW, Fuh VL, Gould J, et al. Chronic treatment with finasteride daily does not affect spermatogenesis or semen production in young men. *J Urol.* 1999;162(4):1295-1300. [https://pubmed.ncbi.nlm.nih.gov/10492183/](https://pubmed.ncbi.nlm.nih.gov/10492183/)

**7.** Samplaski MK, Lo K, Grober E, Jarvi K. Finasteride use in the male infertility population: effects on semen and hormone parameters. *Fertil Steril.* 2013;100(6):1542-1546. [https://pubmed.ncbi.nlm.nih.gov/24012200/](https://pubmed.ncbi.nlm.nih.gov/24012200/)

**8.** D'Amico AV, Roehrborn CG. Effect of 1 mg/day finasteride on concentrations of serum prostate-specific antigen in men with androgenic alopecia: a randomised controlled trial. *Lancet Oncol.* 2007;8(1):21-25. [https://pubmed.ncbi.nlm.nih.gov/17196507/](https://pubmed.ncbi.nlm.nih.gov/17196507/)

**9.** Piraccini BM, Blume-Peytavi U, Scarci F, et al. Efficacy and safety of topical finasteride spray solution for male androgenetic alopecia: a phase III, randomized, controlled clinical trial. *J Eur Acad Dermatol Venereol.* 2022;36(2):286-294. [https://pmc.ncbi.nlm.nih.gov/articles/PMC9297965/](https://pmc.ncbi.nlm.nih.gov/articles/PMC9297965/)

**10.** U.S. Food and Drug Administration. FDA alerts health care providers, compounders and consumers of potential risks associated with compounded topical finasteride products. April 22, 2025. [https://www.fda.gov/drugs/human-drug-compounding/fda-alerts-health-care-providers-compounders-and-consumers-potential-risks-associated-compounded](https://www.fda.gov/drugs/human-drug-compounding/fda-alerts-health-care-providers-compounders-and-consumers-potential-risks-associated-compounded)

**11.** Gubelin Harcha W, Barboza Martínez J, Tsai TF, et al. A randomized, active- and placebo-controlled study of the efficacy and safety of different doses of dutasteride versus placebo and finasteride in the treatment of male subjects with androgenetic alopecia. *J Am Acad Dermatol.* 2014;70(3):489-498.e3. [https://pubmed.ncbi.nlm.nih.gov/24411083/](https://pubmed.ncbi.nlm.nih.gov/24411083/)

**12.** DailyMed. *Dutasteride capsules: U.S. prescribing information.* Revised December 2025. [https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=947644ea-bc35-41df-8a7a-874360c90192](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=947644ea-bc35-41df-8a7a-874360c90192)

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