TLDR Androgen Deprivation Therapy for prostate cancer often reduces sexual function but intermittent therapy may be more tolerable.
The document reviewed the impact of Androgen Deprivation Therapy (ADT) on sexual side effects in prostate cancer patients, noting that while ADT can improve disease-free and overall survival in certain cases, it is associated with increased cardiovascular problems and a negative impact on sexual health, including reduced libido and erectile, ejaculatory, and orgasmic disorders. It discussed the "saturation hypothesis" and the timing of therapy, suggesting that intermittent ADT may have better tolerability regarding sexual function. The document also examined the role of testosterone in sexual function, indicating that testosterone replacement therapy can moderately improve sexual function in hypogonadal men. It highlighted that ADT is linked to a significant decrease in quality of life due to sexual side effects, and patients should be counseled about these effects and the possibility of intermittent therapy. Additionally, the document reviewed the effects of chemoprevention with 5-alpha-reductase inhibitors on sexual function, concluding that while ADT is essential for advanced prostate cancer, its potential misuse should be avoided, and patients must be informed of all possible side effects.
93 citations,
February 2009 in “Annals of the New York Academy of Sciences” 5α‐reductase isozymes are crucial for prostate development and health, and targeting them can help prevent and treat prostate issues.
31 citations,
September 2008 in “International Journal of Andrology” 5-alpha-reductase inhibitors may cause a low incidence of erectile dysfunction that decreases over time.
225 citations,
July 2007 in “The Journal of Sexual Medicine” Knowing about finasteride's sexual side effects increases reported dysfunction.
44 citations,
July 2004 in “Archives of Dermatology” Finasteride for hair loss has minimal impact on sexual function.
36 citations,
September 2001 in “Journal of The European Academy of Dermatology and Venereology” Finasteride doesn't reduce sexual function in people with hair loss.
1040 citations,
October 1992 in “The New England Journal of Medicine” Finasteride effectively treats BPH but may increase sexual dysfunction risk.
31 citations,
January 2017 in “Advances in Experimental Medicine and Biology” Low testosterone and 5α-reductase inhibitors can harm men's metabolic and sexual health; testosterone therapy may help, but discussing 5α-RIs' side effects is important.
9 citations,
May 2021 in “Dermatologic Therapy” Possible link between androgens and COVID-19 severity; more research needed.
34 citations,
July 2020 in “Frontiers in immunology” Androgens may influence T cells, contributing to higher autoimmune liver disease risk in women.
10 citations,
October 2012 in “Andrology” Prostate cancer can progress even with low testosterone due to internal hormone production in the tumor.
5 citations,
May 2018 in “Therapeutic advances in drug safety” Androgen use may increase the risk of stroke, but more research is needed.
