Effect of 5α-Reductase Inhibitors on Sexual Function: A Meta-Analysis and Systematic Review of Randomized Controlled Trials

The 2016 meta-analysis and systematic review by Liu et al. included 17 randomized controlled trials with 17,494 patients to assess the impact of 5α-reductase inhibitors (5ARIs) on sexual function in men with benign prostatic hyperplasia (BPH) and androgenetic alopecia (AGA). The study found that 5ARIs significantly increased the risk of sexual dysfunction, erectile dysfunction, and decreased libido in men with BPH, with relative risks of 2.56, 1.55, and 1.69 respectively. However, for men with AGA, the increase in risk was not statistically significant. The risk of sexual dysfunction was also found to be higher with dutasteride than with finasteride in men with BPH and varied by geographic location. The study concluded that there is a need for further research to understand the mechanisms and effects of 5ARIs on sexual function, and for clinicians and patients to be aware of the potential sexual adverse effects, especially in men with BPH.