The Effect of 5α-Reductase Inhibition with Dutasteride and Finasteride on Semen Parameters and Serum Hormones in Healthy Men
Abstract
CONTEXT: Dutasteride and finasteride are 5alpha-reductase inhibitors (5ARIs) that dramatically reduce serum levels of dihydrotestosterone (DHT). OBJECTIVE: Because androgens are essential for fertility, we sought to determine the impact of 5ARI administration on serum testosterone (T), DHT, and spermatogenesis. DESIGN, SETTING, SUBJECTS, AND INTERVENTION: We conducted a randomized, double-blinded, placebo-controlled trial in 99 healthy men randomly assigned to receive dutasteride (D; 0.5 mg) (n = 33), finasteride (F; 5 mg) (n = 34), or placebo (n = 32) once daily for 1 yr. MAIN OUTCOME MEASURES: Blood and semen samples were collected at baseline and 26 and 52 wk of treatment and 24 wk after treatment and were assessed for T, DHT, and semen parameters. RESULTS: D and F significantly (P < 0.001) suppressed serum DHT, compared with placebo (D, 94%; F, 73%) and transiently increased serum T. In both treatment groups, total sperm count, compared with baseline, was significantly decreased at 26 wk (D, -28.6%; F, -34.3%) but not at 52 wk (D, -24.9%; F, -16.2%) or the 24-wk follow-up (D, -23.3%; F, -6.2%). At 52 wk, semen volume was decreased (D, -29.7%; F, -14.5%, significantly for D) as was sperm concentration (D, -3.2%; [corrected] F, -7.4%, neither significant). There was a significant reduction of -6 to 12% in sperm motility during treatment with both D and F and at follow-up. Neither treatment had any effect on sperm morphology. CONCLUSIONS: This study demonstrates that the decrease in DHT induced by 5ARIs is associated with mild decreases in semen parameters that appear reversible after discontinuation.
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Estradiol, dihydrotestosterone, and 3-alpha androstanediol have established roles in reproductive, bone, hepatic, renal, cardiovascular, dermatologic, prostatic, penile, and central nervous system functions.
“Estradiol, DHT, and the DHT product, 3-alpha androstanediol have established roles in reproductive, bone, hepatic, renal, cardiovascular, dermatologic, prostatic, penile, and central nervous system functions, among others.”
From Challenges in Testosterone Measurement, Data Interpretation, and Methodological Appraisal of Interventional Trials (2016) · cites this paper as [18]
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- Authors
- Amory, J. K., Wang, C., Swerdloff, R. S., Anawalt, B. D., Matsumoto, A. M., Bremner, W. J., Walker, S. E., Haberer, L. J., & Clark, R. V.
- Affiliations
- University of Washington (US)
- University of California, Los Angeles (US)
- GlaxoSmithKline (United States) (US)
- ORCID
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2007-05-01
- Volume
- 92
- Issue
- 5
- Pages
- 1659-1665
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W2106349605
- Cited by
- 244
- References
- 43
- Citations by year
- 2026: 12 · 2025: 11 · 2024: 12 · 2023: 13 · 2022: 11 · 2021: 7 · 2020: 19 · 2019: 8 · 2018: 14 · 2017: 20 · 2016: 11 · 2015: 14 · 2014: 15 · 2013: 19 · 2012: 12
- FWCI
- 13.25
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Sperm and Testicular Function
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
- Health Sciences › Medicine › Urology › Urinary Bladder and Prostate Research
- Keywords
- 5-alpha reductase inhibitors, dutasteride, finasteride, dihydrotestosterone, testosterone, semen parameters, sperm count, sperm motility, spermatogenesis, male fertility, androgens, healthy men
- MeSH terms
- Dutasteride, Adolescent, Adult, Azasteroids, Double-Blind Method, Enzyme Inhibitors, Hormones, Humans, Male, Middle Aged, Semen, Sperm Count, Sperm Motility, Spermatozoa, Finasteride, 5-alpha Reductase Inhibitors
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