Effect of 5α-Reductase Inhibitors on Sexual Function: New Contributions

    April 2017 in “ Actas urológicas españolas ”
    A. Alcántara Montero
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    TLDR 5-alpha reductase inhibitors increase the risk of sexual dysfunction in patients treating enlarged prostate but not in those treating hair loss.
    A meta-analysis including 17 randomized clinical trials with 17,494 patients evaluated the effects of 5-alpha reductase inhibitors (5-ARI) on sexual function in patients treated for benign prostatic hyperplasia (BPH) and androgenic alopecia. The patients had a mean age of 60.10 years and underwent treatment for an average of 17.6 months. The study found that 5-ARI significantly increased the risk of sexual dysfunction in patients with BPH, with a relative risk (RR) of 2.56 for sexual dysfunction overall. Erectile dysfunction and decreased libido were the most common adverse effects, with RRs of 1.55 and 1.69, respectively. However, patients treated for androgenic alopecia did not show an increased risk of these adverse effects. When comparing the two drugs, dutasteride had a higher risk of sexual dysfunction than finasteride (RR=4.09 vs. RR=1.54). The risk of adverse effects was significant only in patients treated for more than one year and with doses of 0.5 mg of dutasteride and 5 mg of finasteride.
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