Psychosocial Impairment as a Possible Cause of Sexual Dysfunction among Young Men with Mild Androgenetic Alopecia: A Cross-sectional Crowdsourcing Web-based Study

Finasteride 1 mg, one of the main treatments for male androgenetic alopecia (MAGA), may produce sexual dysfunction, but young men with MAGA could experience high psychosocial impairment because of changes in body image. Dissatisfaction with body image has been linked to an increase in problems with sexual function. To date no study has considered the possible effect of psychological impairment on sexual function of men with MAGA. Aim of our study was to explore the effect of psychosocial impairment produced by hair loss on the sexual function of men with MAGA. Patients and methods: Cross-sectional design. In total, 190 men with MAGA ranging 18-40 years old were recruited from an Internet online community. Participants completed an online survey comprising the SKINDEX-29 and the Massachusetts General Hospital Sex Functioning Questionnaire. Individuals with MAGA and moderate to severe psychosocial impairment had a higher risk of sexual dysfunction – adjusted odds ratio 2.1 (1.2-4.0; P=0.02) – compared with subjects with mild to absent impairment. Sexual desire and sexual arousal were the most affected elements of sexual response, but an increase in erectile dysfunction and reduced global satisfaction were also reported. We present the first study exploring the influence of MAGA psychosocial impairment on sexual function. Men between 18 and 40 years of age with moderate to severe MAGA psychosocial morbidity were found to have an increased risk of sexual dysfunction. Assessment of psychological morbidity and sexual function could be critical in patients with MAGA, particularly when considering treatment with finasteride.  </p