The Impact of the 5α-Reductase Inhibitors on Male Sexual Function and Psychological Well-Being

The 2015 document reviewed the adverse effects of 5α-reductase inhibitors (5α-RIs) like finasteride and dutasteride on male sexual function and psychological well-being. It reported that these drugs, used for benign prostatic hyperplasia (BPH) and androgenetic alopecia (AGA), are linked to serious sexual side effects such as loss of libido, erectile dysfunction (ED), and ejaculatory dysfunction, which may be persistent or irreversible. The document also highlighted the potential for these drugs to interfere with neurosteroid biosynthesis, possibly leading to depression. Clinical studies have shown a significant incidence of sexual dysfunction in patients treated with 5α-RIs, and preclinical studies suggest that the molecular mechanisms involved could have lasting effects. The document concluded that the safety of 5α-RIs is questionable and that physicians have an ethical responsibility to inform patients about these risks before prescribing the medication.