Investigation of the Plausibility of 5-Alpha-Reductase Inhibitor Syndrome

    January 2016 in “ Skin appendage disorders ”
    Raymond Fertig, Jerry Shapiro, Wilma F. Bergfeld, Antonella Tosti
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    TLDR The document concludes that sexual and psychiatric side effects from 5-alpha-reductase inhibitors are reported, but more high-quality research is needed to understand how often they occur.
    The document from January 1, 2016, reviews the evidence for persistent sexual dysfunction and mood changes associated with 5-alpha-reductase inhibitors (5aRIs) like finasteride and dutasteride. It reports that sexual side effects are well-documented, with one high-quality trial and two low-quality studies indicating that these effects can persist, with one study showing a mean duration of 40 months. Psychological effects such as depression and anxiety were also reported, with one study showing a significant increase in depression scores and another finding that 75% of users reported depression and 44% had suicidal thoughts after discontinuation. Physical side effects like gynecomastia and male breast cancer were less consistently reported. The document concludes that while sexual and psychiatric side effects are reported, high-quality studies are lacking, and more research is needed to establish the true incidence and frequency of these problems. It also notes that finasteride's labeling includes warnings about possible adverse effects.
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