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

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.