Comparative Effects of Finasteride and Dutasteride on Semen Parameters in Young Men with Androgenic Alopecia: A Randomized Controlled Study

This study compared the effects of finasteride and dutasteride on semen parameters in 380 young men with androgenic alopecia. Results showed that prolonged treatment with these 5α-reductase inhibitors led to a significant decrease in semen volume, total motility, progressive motility, and vitality, with an increase in DNA fragmentation index over time. Dutasteride had a more pronounced negative impact, especially after 18 months, likely due to its dual inhibition of type I and II 5α-reductase. Sperm concentration and morphology remained unchanged, and hormone levels were stable. The findings suggest that clinicians should be cautious when prescribing these medications to young men concerned about future fertility, recommending periodic semen monitoring during extended use.