Adverse Side Effects of 5α-Reductase Inhibitors Therapy: Persistent Diminished Libido, Erectile Dysfunction, and Depression in a Subset of Patients

    March 2011 in “ The Journal of Sexual Medicine
    Abdulmaged M. Traish, John Hassani, André T. Guay, Michael Zitzmann, Michael Hansén
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    TLDR Some patients taking finasteride or dutasteride may have ongoing sexual problems and depression even after stopping the medication.
    The document from 2011 reviews the adverse side effects of 5α-reductase inhibitors (5α-RIs), specifically finasteride and dutasteride, which are used to treat benign prostatic hyperplasia and androgenetic alopecia. It reports that a subset of patients experience persistent sexual dysfunction, including diminished libido and erectile dysfunction, as well as depression, which may continue even after stopping the medication. The Prostate Cancer Prevention Trial (PCPT) involving 18,882 men over 7 years indicated higher sexual adverse effects in the finasteride group, with 36.8% discontinuing due to side effects compared to 28.9% in the placebo group. The document stresses the need for patient awareness of these risks before starting therapy and suggests that further research is required to understand the prolonged effects in some patients. It advises extreme caution in prescribing 5α-RIs and underscores the importance of patient education regarding the potential for serious and persistent adverse effects.
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