Inhibitors of 5α-Reductase-Related Side Effects in Patients Seeking Medical Care for Sexual Dysfunction

The study examined the effects of 5α-reductase inhibitors (5ARIs) on 3837 men with pre-existing sexual dysfunction. It found that 78.7% had erectile dysfunction, 51.1% had hypoactive sexual desire (HSD), 86.7% had reduced sleep-related erections, and 19.1% had premature ejaculation. The use of 5ARIs was linked to an increased risk of HSD and reduced sleep-related erections but was not associated with worsening erectile dysfunction or ejaculation issues. Users of 5ARIs also had a higher incidence of gynecomastia, lower sex hormone-binding globulin (SHBG), and higher free testosterone levels. These findings were supported by a case-control study. The study concluded that 5ARIs might worsen sexual dysfunction by reducing sexual drive and spontaneous erections but do not exacerbate pre-existing erectile or ejaculatory problems. However, the study's retrospective nature and specific clinical setting may limit the generalizability of the results.