Effects of 5-Alpha Reductase Inhibitors on Erectile Function, Sexual Desire, and Ejaculation

The document from November 22, 2012, reviews the sexual side effects of 5-alpha reductase inhibitors (5ARIs), specifically finasteride and dutasteride, which are used to treat benign prostatic hyperplasia (BPH) and androgenic alopecia (AA). It reports that these drugs are associated with a prevalence of de novo erectile dysfunction (5-9%), reduced sexual desire, and orgasmic issues, with some studies indicating persistent sexual dysfunction after discontinuation. The document cites clinical trials and regulatory agency updates, noting that sexual dysfunction rates with finasteride range from 0.8% to 15.8%, and persistent effects can last over 6 years for some patients. Ejaculatory dysfunction is less studied. The need for future research to understand the mechanisms and develop prevention and treatment strategies is emphasized, as well as the importance of informed patient counseling regarding these potential adverse effects.