what's up my homies and my tunes good to be back with y'all so we talked about hair loss on my channel a lot and naturally that means we've also discussed finasteride and that is for good reason finasteride is after all the best treatment on the market for treating androgenic alopecia and crushing the slap head curse it is the only treatment on the market that has not only been clinically proven to be effective in the short term but also in the long term as it has been proven effective even after 10 years of continued use and
it is not uncommon to find people who have been on the drug for over 20 years and still maintain all of the wonderful benefits the drug has caused them my friends we are extremely blessed to be living in an era where solving hair loss is as simple as just taking a pill and forgetting about it and for the few people where taking finasteride is not enough there is also minoxidil and that is why despite all the research into alternative pharmaceutical treatments the finasteride and minoxidil stack is still the gold standard for treating hair loss now
as we all know the internet has been revolutionary in providing a plethora of information to the public about literally any subject but it has sadly through social media also given a platform to those who wish to cause harm to others for their own selfish reasons hair loss is a mentally and cosmetically debilitating condition and many who have lost the good fight against hair loss have taken it upon themselves to see as many other people fail as they possibly can simply due to the fact that misery loves company and it's easier to be a loser when
you're surrounded by other losers because you know that helps you cope these people cannot tolerate the fact that the overwhelming majority of men who use finasteride have had great success with the drug because every time someone uses finasteride and reports success with it it makes their own decision to not use finasteride come across as foolish the last thing a bald coper wants to hear is for someone to ask them why didn't you just use finasteride when you still had the chance they hate that question because deep down they know it is true it really resonates
with them painfully knowing that the side effects are rare that the horror stories people spread online are not substantiated by any evidence-based research and they know and they hate the fact that the majority of people who take finasteride will experience no adverse side effects and the few that do experience adverse side effects can easily mitigate them through titration adjustments so the next time you hear someone tell you to just shave it bro remember they're not saying that for your sake they're saying it for their own sake so in their desperation to see other people fail
like they have they've turned to a new tactic they are now claiming that finasteride will cause irreversible infertility as well as birth defects now it is medically known that women who are pregnant or trying to conceive should not use or handle finasteride since in that case it indeed can cause birth defects but not being satisfied with just that finasteride haters are now claiming finasteride will cause birth defects even if just men take it now you'd think with such outlandish claims they'd have some massive piece of conclusive research like you know a randomized control trial with
hundreds or thousands of subjects but no all they have here is a case report that was published in 2011. this particular case report involves a 48 year old man who had been trying to conceive with his 37 year old wife and had no success after four years of trying he'd been on finasteride at one milligram per day for many years they don't specify but we can assume it's been a long time so important note here is that the man had no side effects from finasteride including no erectile dysfunction they did a semen analysis a semen
analysis and it showed he had normal semen volume normal sperm concentration as well as normal sperm motility they did check what's called the sperm dna fragmentation index also known as dfi and this was 30 which was high so what does this dfi thing actually mean well dfi is a measurement of dna damage in the sperm and it can be a cause of infertility a dfi of 30 is considered abnormal and because of this the doctors advised that he stopped finasteride in order to see if it would stop the infertility problem three months after stopping finasteride
the dfi went down to 21 and three months later and went down to 16.5 which is considered normal it's worth mentioning that even after the dfi dropped down his wife still didn't get pregnant which raises the possibility that it was more of a problem with her rather than with him however the doctors who wrote the case report felt that the abnormal dfi the subject had before stopping finasteride was actually due directly to the finasteride so this does seem pretty concrete at first but one major problem with it is that we don't have any measurement of
the dfi before he started finasteride because keep in mind he had already been on finasteride for many years as they stated but the worst case scenario is that even if he did have an altered dfi for finasteride it's clear that the dfi rapidly returned to normal within three months after stopping treatment so based on this one case report it does seem that this 48 year old gentleman may have had fertility problems related to finasterides but it is noteworthy that this case report was published way back in 2011 and since then we've had no subsequent data
to back up the reliability of this research you know for all we know this could have just been an outlier and the dfi could have been due to some other cause that we can't identify at all i mean who knows maybe he worked with x-rays or he was drinking a lot of booze to cope with not being able to knock up his wife i mean there's many many factors that could have caused it that we don't know about so this is just another example of why a case study isn't usually considered strong research also we
know for a fact that finasteride certainly isn't birth control i mean there have been many healthy babies conceived by men who are on finasteride so even though there hasn't been another study or case report on dfi on finasteride there's more data on the effect of finasteride on male fertility in general fortunately so in fact this very case report actually references a study done in 2007 that involved 99 men who were randomized to a dutasteride 0.5 milligram group or a finasteride five milligram group versus a placebo control group so this is a much more uh thorough
study than the case report which just looked at one bloke for whom all we know was exposing his balls to radiation on a daily basis here we have an actual randomized double blind and controlled study with a fairly large sample size of patients 99 in fact so during this study semen samples were taken and various measures were made including sperm count seminal volume sperm morphology as well as sperm motility so basically they were just trying to assess fertility in general also they measured serum testosterone and dht levels in all subjects as far as how they
extracted the sperm from the patients it's probably better not to ask that so we know the methodology here is good because they're measuring fertility across several several parameters but what were the results of the actual study well as expected dutasteride and finasteride lowered serum dht levels with dutasteride serum dht levels were lowered by 93 at 26 weeks and with finasteride the dht was lowered by 70 percent although keep in mind we're talking about serum dh here dht here we're not talking about scalp dht now as far as serum testosterone goes uh they rose by about
25 and the dutasteride and finasteride groups after eight weeks of treatment but after that they returned close to baseline but they are still slightly elevated and this is expected because you're preserving the good hormone testosterone by preventing the five ar enzyme from turning it into the trash hormone dihydrotestosterone dht and effectively wasting it this slight increase in testosterone won't have any ergogenic benefit from a sports performance standpoint but it might be why some people report things like slightly elevated libido while they're on five ar inhibitors so looking at the semen parameters of this study's outcome
after 24 weeks the total sperm count was reduced by about 34 34 in the finasteride group and 29 percent in the dutasteride group so that sounds bad right well stay with me here because after 52 weeks the sperm count had risen yet again to the point where the difference between baseline levels was no longer statistically significant and additionally there was further improvement in sperm count after stopping the drug for 20 to 24 weeks another measured parameter was semen volume which was reduced in both the dutasteride and the finasteride group after 26 weeks and remained reduced
in the due castrate group after 52 weeks although if you look at these graphs here uh the difference really doesn't seem to be that uh it's clinically significant it looks pretty mild to me and you know it's not like any of these drugs could be considered effective birth control or anything of the sort but um anyways that's just semen uh volume we're looking at here so let's look at actual sperm concentration the sperm average uh concentration remained relatively constant in all the treatment groups throughout the study except in the finasteride group at 26 weeks where
it decreased significantly at 22 percent however the good news about that is that by 52 weeks the sperm concentrations of the finasteride group had gone back to normal and this result really correlates with the rest of finasteride's supposed side effects because it has been shown that even when people do get side effects from finasteride they usually will get better over time with continued use and that applies to fertility as well it seems so for the last observed parameters the researchers looked at sperm motility which showed a small decrease in both the dutasteride and finasteride groups
of about 10 percent sperm morphology was not changed with either the finasteride or dutasteride group though so being that fertility is a multifactorial equation that is contingent on several parameters how do we put this all into perspective well the authors of the study concluded that the two drugs had a mild negative impact in sperm formation in men the average effect on the parameters affecting fertility did not actually fall below the thresholds for clinical significance in the drugs except for one point in time when the total sperm count of finasteride was low at 26 weeks but
if you remember that resolved by itself by 52 weeks so the bottom line is that none of these changes from finasteride or dutastride are enough to cause fertility issues in the vast majority of people they did point out that approximately five percent of the subjects on treatment had more severe decreases in sperm count so it may be that there are some individuals that are more sensitive to these drugs than others but even if you are one of those five percent we know that stopping the drug causes a relatively quick reversal of the problem six months
at the very most also keep in mind that this is based on five milligrams of finasteride the authors note that in a previous study there was no effect found on finasteride uh of finasteride on sperm production whatsoever however the dose in that study was one milligram daily which of course is the standard dose for treating androgenic alopecia so it is likely that the result of the current study would be even more optimistic if the dosage were equivalent to what is used to treat androgenic alopecia instead of enlarged prostate the authors also note that the recovery
after stopping treatment was quicker in the finasteride group which may be due to the shorter half-life of finasteride compared to tenastride so since both drugs have a pretty market effect on serum dht levels the authors felt that this suggests that quote testosterone alone may be sufficient to maintain qualitatively normal spermatogenesis in most normal men unquote so this is yet another reason in the very long list of reasons as to why dht is a trash hormone you don't need it post puberty testosterone is what makes you a man dht just makes you an ugly old bald
man and if you're bald you're probably not going to find a woman who will let you put a baby in her to begin with so pretty much the only outlet you'll have for being a father as a bald man is donating your semen to clinical research like in the trial we just reviewed so what can we conclude from all this can finasteride have a small effect on fertility and a small percentage of men who use it yes but in the majority of men it doesn't make any difference and even if fertility is affected it usually
goes back to normal with continued use and even in the worst case scenario scenario where fertility stays low while on treatment you can either reduce your dosage and failing that you can just temporarily drop the treatment and just give it the good old college try with your old lady for a maximum of three to six months and anything you lose in terms of hair during that time you'll likely be able to get back once you get on treatment again so i wouldn't sweat it and also you can temporarily switch to topical anti-antigens like fluoridal or
alpha dial to kind of tide you over while you're doing the nasty with your lady so that pretty much covers everything regarding fertility but one final question that people often ask me that i want to address is whether there is enough finasteride in the semen to cause birth defects in women when they get pregnant well the answer to this is no but in case you want more details the uk drug database site on finasteride states quote a small amount of finasteride less than 0.001 percent of the one milligram dose per ejaculation has been detected in
the seminal fluid of men taking propecia studies and rhesus monkeys have indicated that this amount is unlikely to constitute a risk to the developing male fetus unquote in addition no credible reports of birth effects have have ever been found related to finasteride in semen so unsurprisingly this is just yet another manufactured controversy intended to frighten people out of using finasteride but hopefully after this video you'll cast your fears aside and know that saving your hair doesn't mean you have to abandon your progeny after all the world will need a new generation of people to fight
against the slap head propaganda in the future and with that i'm out homies see you next time