Negative Impact of Testosterone Deficiency and 5α-Reductase Inhibitors Therapy on Metabolic and Sexual Function in Men

    Abdulmaged M. Traish
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    TLDR Low testosterone and 5α-reductase inhibitors can harm men's metabolic and sexual health; testosterone therapy may help, but discussing 5α-RIs' side effects is important.
    The 2017 document outlines the negative consequences of testosterone deficiency (TD) and the use of 5α-reductase inhibitors (5α-RIs) on men's metabolic and sexual health. TD is associated with various health issues, including metabolic syndrome, insulin resistance, obesity, type 2 diabetes mellitus, reduced lean body mass, increased fat mass, lower bone mineral density, anemia, sexual dysfunction, and decreased quality of life. Testosterone therapy is suggested to be beneficial for men with TD, improving metabolic and cardio-metabolic functions, as well as sexual health. However, the use of 5α-RIs, such as finasteride and dutasteride, for treating benign prostatic hyperplasia and androgenetic alopecia, may lead to adverse metabolic effects like fat accumulation in the liver, insulin resistance, and erectile dysfunction. The document emphasizes the need for physicians to discuss potential side effects of 5α-RIs with patients and suggests that testosterone is the best selective androgen receptor modulator (SARM) for addressing these issues. The number of participants in the studies mentioned within the document is not provided, so the strength of the conclusions cannot be assessed based on the number of subjects.
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