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5α-Reductase Inhibitors Tied to Adverse Male Sexual Health

Side effects include loss of libido, erectile dysfunction, and depression

THURSDAY, March 17 (HealthDay News) -- 5α-reductase inhibitors (5α-RIs), used to treat symptoms of benign prostatic hyperplasia (BPH) and hair loss in men, may cause persistent erectile dysfunction, depression, and loss of libido, even after discontinuing the medication, according to a review published in the March issue of The Journal of Sexual Medicine.

Abdulmaged M. Traish, Ph.D., of the Boston University School of Medicine, and colleagues examined the data from various clinical studies concerning the potential adverse side effects of the 5α-RIs finasteride and dutasteride. Potential persistent side effects and their suggested mechanisms were evaluated.

The researchers found that a subset of men reported persistent adverse effects on sexual function, including erectile dysfunction and decreased libido. In one study, drug-related reduction in libido occurred in 4.2 percent of patients taking dutasteride compared to 1.8 percent of patients taking a placebo. In several trials, approximately 6 to 8 percent of patients reported erectile dysfunction. Some patients also experienced negative effects on ejaculatory function, gynecomastia, and depression.

"Extreme caution should be exercised prior to prescribing 5α-RIs therapy to patients for hair growth or for BPH symptoms," the authors write. "In some patients, these adverse effects are persistent and may be prolonged and patients do not recover well after discontinuation from drug use."

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