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Tag Archive: Change in Semen from Medication

Finasteride and Fertility

Q: I have been finasteride for several years. My wife and I are currently trying to conceive our first child and it is unclear to me if it is safe to continue taking finasteride during this period. Unfortunately, I have not been able to get a clear position via the Internet. Most people commenting on it are on blogs and the response goes both ways – some say it’s ok, others say stop. While I know that it’s imperative that a pregnant woman not touch the medicine, can you please let me know if I can continue taking the medicine while trying to conceive? — M.K., Edgeworth, PA

A: It is OK for you to continue finasteride while your wife is trying to conceive. However, there is some data to suggest that it may slightly decrease fertility since, by shrinking the prostate (the prostate produces 25-30% of semen volume) it slightly changes the overall composition of semen. These effects appear to be temporary and finasteride has no direct effect on sperm. If you and your wife were to have difficulty conceiving, at that point is might be reasonable to temporarily discontinue the medication.

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Posted by Robert M. Bernstein M.D. Updated 2017-12-11

Summary Of Finasteride Label Changes

On April 11, 2012, the U.S. Food and Drug Administration (FDA) announced changes to the professional labels for Propecia (finasteride 1 mg) and Proscar (finasteride 5 mg) to expand the list of sexual adverse events reported to FDA as some of these events have been reported to continue after the drug is no longer being used (note that erectile dysfunction after stopping use of these drugs was added as a known event in 2011). The new label changes include:

A revision to the Propecia label to include libido disorders, ejaculation disorders, and orgasm disorders that continued after discontinuation of the drug.
A revision to the Proscar label to include decreased libido that continued after discontinuation of the drug.
A revision to both the Propecia and Proscar labels to include a description of reports of male infertility and/or poor semen quality that normalized or improved after drug discontinuation.

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Posted by Robert M. Bernstein M.D. Updated 2014-07-30

Can Propecia in Semen Harm Fetus upon Conception?

Q: Although I was prescribed Propecia, I have not yet started to take it. I would like to take it now, but my wife wants me to wait until after we have our second baby so as to avoid having the drug in my system when we conceive. She’s concerned that if it’s so harmful to pregnant women, that having it in my sperm is an issue. — L.V., Bellmore, New York

A: There is no evidence that if you take the medication it will affect the fetus. However, your wife should not ingest the drug or handle broken pills during pregnancy.

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Posted by Robert M. Bernstein M.D. Updated 2017-12-11

Can Finasteride Change the Consistency of My Ejaculate?

Q: I’ve now been taking finasteride for just over 5 months. I have noticed that my semen quality has changed just in the last 3 months, and it seems now much less in quantity and is quite watery and clear in color. I think the current problems are due to the finasteride, what do you think? — S.F., Rolling Hills, California

A: Finasteride, the active drug in Propecia, can change the quality of the semen, since it is decreasing the component of seminal fluid that is secreted by the prostate. You may want to consider having your sperm counts checked, as finasteride can lower this. If the symptoms are not bothering you, and your sperm counts are normal, it should be OK to continue the medication. If you were having difficulty conceiving, then I would stop the medication.