Adverse Effects of 5-Alpha-Reductase Inhibitors: A Narrative Review

This narrative review discusses adverse effects associated with 5-ARI treatments for male-pattern baldness and benign prostate hyperplasia, including sexual health, neurological, endocrine, metabolic, and cardiovascular impacts, and emphasizes careful prescription assessment.

This review discusses sexual side effects in men with androgenic alopecia treated with 5-alpha reductase inhibitors and reports no new clinical findings.

This review suggests that while finasteride for male pattern hair loss was previously considered safe, there is now evidence associating 5-α reductase inhibitors with significant sexual and reproductive side effects.

In a randomized study, men treated with dutasteride for androgenetic alopecia experienced sexual adverse events at twice the rate of those on placebo during 24 weeks, but these events were mild, moderate, and resolved after treatment.

This review discusses the adverse events associated with 5-alpha reductase inhibitors, finding them generally well-tolerated but noting potential risks like sexual side effects and psychological effects in men, and sparse data on use in women.

This review discusses persistent adverse effects of 5α‐reductase inhibitors, like diminished libido and erectile dysfunction, in some patients and highlights the need for patient discussions before therapy, especially for androgenetic alopecia.

This review highlights that sexual dysfunction associated with 5-alpha-reductase inhibitors is recognized in clinical literature, with erectile dysfunction being the most common adverse effect, followed by ejaculatory dysfunction and decreased libido.