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

Hagberg et al. conducted a study using the Clinical Practice Research Datalink to investigate whether 5α-reductase inhibitors (5-ARIs), such as finasteride, used for treating androgenetic alopecia (AGA) and benign prostatic hyperplasia (LUTS/BPH), increase the risk of erectile dysfunction (ED) or sexual dysfunction (SD). The study included a large alopecia population of over 12,000 men and found no significant increase in the risk of ED for users of finasteride 1 mg compared to unexposed men with alopecia. The study concluded that finasteride does not significantly increase the risk of incident ED, regardless of the indication for its use. This conclusion is supported by other well-designed studies, which also found no evidence of a link between ED and previous finasteride exposure. The study emphasizes the importance of controlling for baseline demographic and clinical characteristics that can contribute to sexual dysfunction when assessing the risk of SD associated with medications.