Risk of Erectile Dysfunction Associated with Use of 5-Alpha Reductase Inhibitors for Benign Prostatic Hyperplasia or Alopecia: Population-Based Studies Using the Clinical Practice Research Datalink

    September 2016 in “ BMJ ”
    Katrina Wilcox Hagberg, Hozefa A. Divan, Rebecca Persson, J. Curtis Nickel, Susan S. Jick
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    TLDR Taking 5-α reductase inhibitors for prostate enlargement or hair loss does not significantly raise the risk of erectile dysfunction.
    The study, using data from the Clinical Practice Research Datalink, evaluated the risk of erectile dysfunction (ED) in men using 5-α reductase inhibitors for benign prostatic hyperplasia (BPH) or alopecia. It included 71,849 men aged 40 or older with BPH and 12,346 men aged 18-59 with alopecia. The findings showed no significant increase in the risk of ED for users of 5-α reductase inhibitors, either alone or in combination with α blockers, compared to users of α blockers only. For men with BPH, the incidence rate ratio was 0.92 and the odds ratio was 0.94 for 5-α reductase inhibitors alone, and 1.09 and 0.92, respectively, for the combination with α blockers. In the alopecia group, the incidence rate ratio was 1.03 and the odds ratio was 0.95 for users of finasteride 1 mg compared to unexposed men. The study concluded that the use of 5-α reductase inhibitors does not significantly increase the risk of ED, but the risk of ED does increase with longer duration of BPH.
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