Department of Obstetrics and Gynecology, University of California, Davis, USA.
Source
J Urol, 162(4):1295-300 1999 Oct
Abstract
PURPOSE: Finasteride , an oral type 2, 5alpha-reductase inhibitor, is used in 1 mg.
daily doses for the treatment of male pattern hairloss. A dose of 5 mg. finasteride daily
reduces ejaculate volume by approximately 25%, and reduces prostate volume by
approximately 20% and serum prostate specific antigen (PSA) by approximately 50% in men
with benign prostatic hyperplasia. To our knowledge no data exist on the effect of 1 mg.
finasteride daily on ejaculate volume or other semen parameters, or on the prostate in
young men. Therefore, we studied the potential effect and reversibility of effect of 1 mg.
finasteride daily on spermatogenesis, semen production, the prostate and serum PSA in
young men. MATERIALS AND METHODS: In this double-blind, placebo controlled multicenter
study 181 men 19 to 41 years old were randomized to receive 1 mg. finasteride or placebo
for 48 weeks followed by a 60-week off-drug period. Of the 181 men 79 were included in a
subset for the collection and analysis of sequential semen samples. RESULTS: There were no
significant effects of 1 mg. finasteride on sperm concentration, total sperm per
ejaculate, sperm motility or morphology. Ejaculate volume in subjects on finasteride
decreased 0.3 ml. (-11%) compared to a decrease of 0.2 ml. (-8%) for placebo, with a
median between treatment group difference of -0.03 ml. (1%, 90% confidence interval -10.4
to 13.1, p = 0.915). There were significant but small decreases in prostate volume (-2.6%)
and serum PSA (-0.2 ng./ml.) in the finasteride group, which reversed on discontinuation
of the drug. CONCLUSIONS: Treatment with 1 mg. finasteride daily for 48 weeks did not
affect spermatogenesis or semen production in young men. The effects of 1 mg. finasteride
daily on prostate volume and serum PSA in young men without benign prostatic hyperplasia
were small and reversible on discontinuation of the drug.