Sexual, Physical, And Overall Adverse Effects In Patients Treated With 5α-Reductase Inhibitors: A Systematic Review And Meta-Analysis

October 2021 in “ Asian Journal of Andrology ”

Junjie Zhang, Xiao Shi, Ting Wu, Mengda Zhang, Jin Tang, Guangming Yin, Zhi Li, Leye He, Lin Qi, Long Wang

5α-reductase inhibitors androgenetic alopecia benign prostatic hyperplasia post-finasteride syndrome finasteride dutasteride 5ARIs AGA BPH PFS Propecia Avodart

TLDR Medications for hair loss and prostate issues can significantly increase the risk of sexual side effects and other negative symptoms.

This systematic review and meta-analysis of 34 studies with 25,696 subjects found that 5α-reductase inhibitors (5ARIs), used for treating androgenetic alopecia (AGA) and benign prostatic hyperplasia (BPH), significantly increase the risk of post-finasteride syndrome (PFS)-like adverse effects, particularly sexual adverse effects. The overall use of 5ARIs was associated with a 1.87-fold risk of PFS-like adverse effects. Specific types of 5ARIs, such as 5 mg/day finasteride, 1 mg/day finasteride, and 0.5 mg/day dutasteride, had a 1.85-fold, 2.08-fold, and 2.01-fold risk respectively. Patients treated for AGA or BPH had a 1.49-fold risk of PFS-like adverse effects compared to placebo. The study suggests that clinicians should assess the risk of preexisting mental health issues and potential sexual dysfunction before 5ARI treatment, and consider alternative treatments to protect patients from the immediate and persistent adverse effects of 5ARIs.

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