Propecia & Risks in Pregnancy

My husband has been taking Propecia (finasteride) for more than two years. I have never touched a tablet. Unexpectedly, I find I am pregnant. We have subsequently had unprotected sex. What are the risks to the fetus? I am seven weeks along.

S.P.

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Mark Perloe, MD

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The hair-loss treatment Propecia (finasteride) blocks the conversion of the male hormone testosterone to its more active form DHT, which is responsible for hair loss. There is concern that if a male fetus is exposed to Propecia, the lower DHT levels will result in genital malformation.

I am aware of no evidence that significant levels of this medication are found in the semen of a man who uses Propecia, or that it can be absorbed through intercourse in sufficient quantities to cause concern. Even so, the absence of evidence does not ensure an absence of risk. I would suggest that your husband contact the pharmaceutical company to determine whether it has tested levels of the drug in seminal fluid or has received any reports of abnormal offspring in the wives of men on Propecia.

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