Your Hair-Loss Treatment May Affect Your Fertility

Minoxidil (Rogaine) and finasteride (Propecia) are widely used male hair-loss treatments. Minoxidil is primarily used to stimulate hair growth and slow the balding process, while finasteride is used to prevent hair loss. However, finasteride works differently than minoxidil in that it blocks testosterone from converting to an enzyme that causes hair loss; this same conversion will decrease prostate size (and affect sperm count), so the treatment may interfere with a man's sexual health and his ability to conceive.

How does finasteride work?

Finasteride belongs to a class of medications called 5-alpha reductase inhibitors. According to the National Library of Medicine, finasteride prevents testosterone from converting to dihydrotestosterone (DHT), an enzyme in the scalp that stops hair growth and also causes the prostate to grow. In addition to being used to treat male-pattern baldness, finasteride is approved by the U.S. Food and Drug Administration (FDA) for the treatment of benign prostate hyperplasia (BPH), also known as an enlarged prostate.

According to the FDA and the manufacturer of Propecia (the brand name for finasteride), the most common adverse reactions associated with this hair-loss treatment are erectile dysfunction (about 2 to 4 percent of users), ejaculation disorder and decreased sexual libido.

Finasteride may also decrease the volume of ejaculate and cause gynecomastia (male breast growth). All of these side effects can make it difficult for a man to conceive. However, these effects will occur only for as long as you use the medication; stopping the medication can usually reverse these related sexual effects and cause your body to resume converting testosterone to DHT after several months.

Trying to conceive on finasteride

If you're using finasteride and want to conceive, consider stopping the medication for as long as you're trying to conceive. Talk with your doctor about your options for other hair-loss treatments, such as products and formulas that contain minoxidil, or hair transplant surgery, that won't cause adverse sexual effects.

It is unknown exactly how long it may take for your sperm concentration and motility (movement) to improve after you stop using finasteride. A case study published in the Journal of Human Reproductive Services indicates that it may take about four months, while other sources of anecdotal evidence say it could take between six and nine months for a noticeable improvement.

If you stop using finasteride and still can't conceive with your partner after several months, see your doctor or a fertility specialist for further treatment. Your doctor may have you undergo a semen analysis to evaluate the volume, motility and quality of your sperm, and run other tests to identify why you haven't been able to conceive.

Fertility problems can stem from a wide range of factors, such as hormonal imbalances, stress, depression, diet and physical activity level. Your doctor or fertility specialist can give you the best advice on how to proceed with conception, and treat you based on the root causes of your fertility problems.