Pallotti Francesco, Senofonte Giulia, Pelloni Marianna, Cargnelutti Francesco, Carlini Tania, Radicioni Antonio F, Rossi Alfredo, Lenzi Andrea, Paoli Donatella, Lombardo Francesco
Laboratory of Seminology-Sperm Bank "Loredana Gandini", Department of Experimental Medicine, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy.
Hormone Laboratory, Department of Experimental Medicine, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy.
Endocrine. 2020 Jun;68(3):688-694. doi: 10.1007/s12020-020-02219-2. Epub 2020 Feb 12.
Androgenetic Alopecia (AGA) is a common non-cicatricial alopecia. AGA treatment with finasteride was reported to have sexological side effects and its induced hormonal alterations could damage spermatogenesis. Thus, in patients affected by AGA undergoing oral therapy with Finasteride 1 mg/die, we aimed to evaluate the presence of modification in sperm parameters, hormone profile and sexual function.
We retrospectively evaluated 55 male subjects aged 18-45 years with AGA who underwent systemic therapy with Finasteride 1 mg/die. Each subject underwent semen and blood hormone analysis, IIEF15 questionnaire administration at baseline (T0) at 6 (T6) and 12 (T12) months after the beginning of therapy and 1 year after treatment discontinuation (TD).
At T6 we detected a statistically significant worsening of total sperm number (232.4 ± 160.3 vs. 133.2 ± 82.0; p = 0.01 vs. T0) and abnormal forms (79.8 ± 6.0 vs. 82.7 ± 5.7; p < 0.05 vs. T0). No difference was found for all sperm parameters at T12 and T24, except for the percentage of abnormal forms (79.8 ± 6.0 vs. 82.6 ± 4.8; p < 0.05 T24 vs. T0). Testosterone levels were increased at T0 vs. T6 (22.1 ± 7.1 vs. 28.0 ± 8.0 ng/mL; p < 0.05). No significant differences of IIEF15 questionnaire were detected across the study.
Finasteride is associated with significant seminological and testosterone alterations, but no sexual dysfunctions were reported during treatment of these andrologically healthy subjects. Although, sperm parameters seem to return comparable to baseline after treatment discontinuation, it is advisable to perform a careful andrological evaluation before treatment.
雄激素性脱发（AGA）是一种常见的非瘢痕性脱发。据报道，非那雄胺治疗AGA有性方面的副作用，其引起的激素变化可能损害精子发生。因此，对于接受1mg/天非那雄胺口服治疗的AGA患者，我们旨在评估精子参数、激素谱和性功能的改变情况。
我们回顾性评估了55名年龄在18 - 45岁的AGA男性受试者，他们接受了1mg/天非那雄胺的全身治疗。每位受试者在治疗开始时的基线（T0）、治疗6个月（T6）、12个月（T12）以及停药1年后（TD）进行精液和血液激素分析，并填写IIEF15问卷。
在T6时，我们检测到精子总数有统计学意义的恶化（232.4±160.3 vs. 133.2± 82.0；与T0相比，p = 0.01）以及异常形态精子比例增加（79.8±6.0 vs. 82.7±5.7；与T0相比，p < 0.05）。在T12和T24时，除了异常形态精子比例（79.8±6.0 vs. 82.6±4.8；T24与T0相比，p < 0.05）外，所有精子参数均未发现差异。与T0相比，T6时睾酮水平升高（22.1±7.1 vs. 28.0±8.0 ng/mL；p < 0.05）。在整个研究过程中，IIEF15问卷未检测到显著差异。
非那雄胺与显著的精液学和睾酮改变有关，但在这些男性健康受试者的治疗过程中未报告性功能障碍。尽管停药后精子参数似乎恢复到与基线相当的水平，但在治疗前进行仔细的男科评估是可取的。
