The probability of side effects from AGA treatment is ●●%! ? A University of Tokyo graduate doctor will provide a thorough explanation.

This time, we will explain ``Does AGA treatment lower libido and cause infertility?''

AGA treatment drugs and side effects

There are two main types of oral medications used to treat AGA.
The most basic treatment is ``finasteride and dutasteride,'' which have the effect of suppressing hair loss, and the other is ``minoxidil,'' which has the effect of promoting hair growth.
Finasteride and dutasteride have the potential for side effects such as decreased sexual desire and male infertility.

Rate of low libido

The rate at which low libido occurs varies between studies, butIt has been reported that finasteride is about 4% and dutasteride about 6%.A meta-analysis on sexual dysfunction caused by finasteride and dutasteride published in 2019 found that the risk of side effects such as decreased libido and erectile dysfunction was 1.57 times higher. However, in a survey published in 2019 of the same year, conducted on approximately 700 people in both groups who were taking finasteride and those who were not, more than 20% reported a decrease in sexual desire. It was concluded that there was no difference in the rate of decreased sexual desire between the group with and without. Therefore, it seems certain that a decrease in sexual desire occurs at a certain rate, but it is not clear whether this is really due to the effects of finasteride or a placebo effect.

Will the decrease in libido continue even after discontinuing oral medication?

There have been reports that erectile dysfunction caused by finasteride and dutasteride may persist even after discontinuing the drug, so some caution may be necessary.
A condition in which symptoms such as decreased sexual desire persist even after discontinuing the drug is sometimes called "post-finasteride syndrome." There is a study comparing sexual side effects between a finasteride group and a placebo group, and 6% of the finasteride group had side effects that persisted even 50 months after drug administration, compared to 59% of the finasteride group and the placebo group. There is also a report that the rate was XNUMX% in the treatment group, but it was actually higher in the placebo group, so there seems to be room for debate on this as well.
It's a sensitive issue, so there may be some people who are worried about it but can't bring it up.There are no cases where sexual function is affected to the extent that oral medication cannot be continued, so I think it is basically a fairly infrequent side effect.

AGA drugs and male infertility

Side effects related to male infertility have also been reported. Specifically, the side effect is a decrease in the number, quantity, and motility of sperm. However, I don't think you need to worry about this side effect. This is because, looking at the papers that have been reported so far, although a decline in the number, quantity, and motility of sperm can be seen, in most cases the increase or decrease remains within the normal range. Furthermore, it is said that the sperm count will recover while continuing to take the drug.Unless you are considering serious infertility treatment, there is no need to be too sensitive.
However, one thing to be aware of is the impact on women. In the first place, finasteride and dutasteride are not used because it has been proven that they have no effect on FAGA (female androgenetic alopecia), but if they are administered to pregnant women, male hormones will drop and the baby will be born. If there is a fetus, it may have an adverse effect on the development of the fetus's reproductive organs. Therefore,Administration to pregnant and lactating women is contraindicated.The active ingredients of finasteride and dutasteride can be absorbed through the skin.Care must be taken not to come into contact with the medicine during pregnancy.

Effects on fertility while taking oral medication

The number, quantity, and motility of sperm vary within normal limits, so if you are trying to get pregnant normally, there is no problem in continuing to take the drug.Of course, if you want to be on the safe side, you can stop taking the medication, but if you stop taking it, the effect on AGA will stop and hair thinning will progress. Therefore, I think you need to consult your partner often.
On the other hand, there are still cases where men taking finasteride were tested for male infertility and found to have an extremely low sperm count. However, in this case as well, it is known that the sperm count can be restored to more than 10 times by discontinuing oral finasteride, so in these cases it is necessary to stop taking finasteride.

AGA treatment drug withdrawal period

There is no medically established period for drug withdrawal, soPlease consult with your doctor for AGA treatment and your doctor for infertility treatment.By the way, the half-life of the blood concentration of finasteride after oral administration is approximately 4 hours, and it drops to almost 24 after 0 hours. On the other hand, the half-life of dutasteride in the blood after oral administration is long, 3 to 4 weeks, so if the drug is to be discontinued to coincide with the timing of fertilization, theoretically the drug discontinuation period will be shorter with finasteride. It will be.

Summary

Finasteride and dutasteride can cause decreased libido, erectile dysfunction, and decreased sperm count and quality, but a clear cause-and-effect relationship has not been proven.
Although it is unlikely to cause infertility, it is a good idea to discuss this with your partner when undergoing infertility treatment, and in some cases, you may consider discontinuing the medication.