Editing Finasteride (section)

===Sexual adverse effects===
Use of finasteride is associated with an increased risk of [[sexual dysfunction]] including [[erectile dysfunction]], [[Hypoactive sexual desire disorder|decreased libido]] and ejaculatory dysfunction.<ref name="Lee2019">{{Cite journal |vauthors=Lee S, Lee YB, Choe SJ, Lee WS |year=2019 |title=Adverse Sexual Effects of Treatment with Finasteride or Dutasteride for Male Androgenetic Alopecia: A Systematic Review and Meta-analysis |journal=Acta Derm Venereol |volume=99 |issue=1 |pages=12–17 |doi=10.2340/00015555-3035 |pmid=30206635 |doi-access=free}}</ref><ref name="Zak2019" /> Sexual adverse effects of finasteride and dutasteride have been linked to lower [[quality of life]] and ability to maintain an intimate relationship, and can cause stress in relationships.<ref name="Gur2013">{{Cite journal |vauthors=Gur S, Kadowitz PJ, Hellstrom WJ |date=January 2013 |title=Effects of 5-alpha reductase inhibitors on erectile function, sexual desire and ejaculation |journal=Expert Opinion on Drug Safety |volume=12 |issue=1 |pages=81–90 |doi=10.1517/14740338.2013.742885 |pmid=23173718 |s2cid=11624116}}</ref>

The adverse effect profiles of finasteride are somewhat different for its indications of hair loss and BPH.{{cn|date=January 2025}}

====Finasteride for androgenetic alopecia (hair loss in men)====
The most common adverse effects of finasteride taken for hair loss are a decrease in sex drive, erectile dysfunction, and a decrease in the amount of semen.<ref name="fdapropecia2014" />{{rp|17}}

In addition, finasteride has been reported in [[case reports]] to cause sexual problems that persist after stopping the medication.<ref name=Tra2020/><ref name=Zax2019/> A 2012 update to the FDA label noted reports of decreased sex drive, problems with ejaculation and difficulty achieving an erection which continued after stopping the medication. The update also referenced reports of testicular pain and "male infertility and/or poor quality of semen."<ref name="fdapropecia2014" />{{rp|17}}<ref name="2014AArev" /><ref>{{Cite web |last=FDA |date=11 April 2012 |title=Questions and Answers: Finasteride Label Changes |url=https://www.fda.gov/Drugs/DrugSafety/InformationbyDrugClass/ucm299754.htm |url-status=dead |archive-url=https://web.archive.org/web/20140818144525/http://www.fda.gov/Drugs/DrugSafety/InformationbyDrugClass/ucm299754.htm |archive-date=18 August 2014 |access-date=26 October 2014 |publisher=US FDA}}</ref><ref name="pmid27784557">{{Cite journal |vauthors=Trost L, Saitz TR, Hellstrom WJ |year=2013 |title=Side Effects of 5-Alpha Reductase Inhibitors: A Comprehensive Review |journal=Sex Med Rev |volume=1 |issue=1 |pages=24–41 |doi=10.1002/smrj.3 |pmid=27784557}}</ref>

In 2025, the [[European Medicines Agency]] has confirmed that suicidal thoughts can occur as a side effect of the hair-loss treatment finasteride and its generic equivalents.<ref>{{Cite web |date=2025-05-08 |title=Measures to minimise risk of suicidal thoughts with finasteride and dutasteride medicines {{!}} European Medicines Agency (EMA) |url=https://www.ema.europa.eu/en/news/measures-minimise-risk-suicidal-thoughts-finasteride-dutasteride-medicines?utm_campaign=pharmalittle&utm_medium=email&_hsenc=p2ANqtz-9JLW6HNR5XFTP5FkII12F04t1_sJXOIjfq5ZdFFZcUQQDA1tzuHs2UawyLA3ivYCrJM8JBoFNEGMBSR0zTRxOLkSpYBw&_hsmi=360720080&utm_content=360720080&utm_source=hs_email |access-date=2025-05-10 |website=www.ema.europa.eu |language=en}}</ref> The majority of these reports involved patients taking the 1 mg dosage, typically prescribed for [[androgenetic alopecia]], a hormone-related form of hair loss.<ref>{{Cite news |date=8 May 2025 |title=EU drugs regulator confirms suicidal thoughts as side effect of hair loss drug |url=https://www.reuters.com/business/healthcare-pharmaceuticals/eu-drugs-regulator-confirms-suicidal-thoughts-side-effect-anti-hair-loss-drug-2025-05-08/ |work=Reuters}}</ref> However, the agency noted that the precise frequency of this adverse effect could not be determined from the data available. In October 2024, the EMA had initiated a review of both finasteride and dutasteride due to concerns over potential links to suicidal ideation.<ref>{{Cite web |date=2024-10-04 |title=Meeting highlights from the Pharmacovigilance Risk Assessment Committee (PRAC) 30 September-3 October 2024 {{!}} European Medicines Agency (EMA) |url=https://www.ema.europa.eu/en/news/meeting-highlights-pharmacovigilance-risk-assessment-committee-prac-30-september-3-october-2024 |access-date=2025-05-10 |website=www.ema.europa.eu |language=en}}</ref> While finasteride—marketed by [[Organon & Co.|Organon]] as Propecia—already includes warnings about possible psychiatric effects, the EMA stated that the evidence did not support a similar link for dutasteride, sold by GSK under the brand name [[Dutasteride|Avodart]].<ref>{{Cite web |date=2024-10-04 |title=Finasteride- and dutasteride-containing medicinal products - referral {{!}} European Medicines Agency (EMA) |url=https://www.ema.europa.eu/en/medicines/human/referrals/finasteride-dutasteride-containing-medicinal-products |access-date=2025-05-10 |website=www.ema.europa.eu |language=en}}</ref>

==== Finasteride for benign prostatic hyperplasia ====
The most common adverse sexual effects of finasteride for BPH are: trouble getting or keeping an erection, decrease in sex drive, decreased volume of ejaculate, and ejaculation disorders.<ref name="fdaproscar2010" />{{rp|16}}

A 2010 Cochrane review found that men taking finasteride for BPH (with a mean age of 62.4) are at increased risk for impotence, erectile dysfunction (ED), decreased libido, and ejaculation disorder for the first year of treatment. The rates became indistinguishable from placebo after 2–4 years and these side effects usually got better over time.<ref name="Cochrane2010" />