TOPLINE

Among men with male pattern hair loss who developed sexual side effects during finasteride treatment, dose tapering resolved symptoms in 75% of the cases and allowed treatment continuation, a study found.

METHODOLOGY

• Researchers conducted a retrospective study of 100 men (mean age, 35.5 years) who received oral finasteride for male pattern hair loss at a dermatology clinic in Australia and experienced sexual side effects. 
• Based on management of their sexual side effects, patients were categorized into 3 groups: 48 had their dose tapered, 24 discontinued treatment, and 28 continued treatment at the same dose.
• Sexual side effects occurred a mean of 42 weeks after treatment began. Mean total follow-up duration was 143 weeks.

TAKEAWAY

• Reduced libido was the most commonly reported sexual side effect, affecting 83% of patients, erectile dysfunction affected 35% of men and 6% reported ejaculatory dysfunction.
• Sexual side effects resolved in 75% of patients who tapered finasteride, compared with 95.8% who discontinued and 50% who continued at the same dose. The mean time to symptom resolution was 31.6 weeks in the dose tapering group vs 20.2 weeks in the treatment discontinuation group.
• Among tapered patients, symptoms persisted in 25%, and 12 ultimately discontinued treatment after the first dose reduction failed.
• Another five patients could not tolerate the lowest oral dose and to topical finasteride (0.25%-0.5%), and none of them reported sexual side effects over a mean follow-up of 28.4 weeks.

IN PRACTICE

"Our findings suggest patients experiencing sexual side effects with oral finasteride, especially those taking 1 mg, may benefit from tapering to 0.5 mg daily, which resolved side effects in 75% of cases and enabled treatment continuation," the authors wrote.

SOURCE

The study was led by Daniella Kushnir-Grinbaum, MD, Sinclair Dermatology, East Melbourne, Victoria, Australia. It was published online on October 1 in the Journal of the American Academy of Dermatology.

LIMITATIONS

The limitations included small retrospective study design and variation in initial finasteride doses. Symptom assessment was based on patient reports rather than validated questionnaires.

DISCLOSURES

The study received no funding. Kushnir-Grinbaum and another author reported receiving investigator, advisory, and speaker fees, and honoraria from several pharmaceutical companies, including AbbVie, Eli Lilly, Sanofi, and Sun Pharma and being Director and Founder at a company and holding patents related to minoxidil. Other authors reported no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.