TLDR Finasteride, dutasteride, and silodosin have the highest risk for causing sexual dysfunction.
The study analyzed the FDA Adverse Event Reporting System database to assess the risk of sexual dysfunction (SD) associated with the top 60 drugs. It identified 79,022 SD-related adverse drug events involving 61,722 patients, predominantly males aged 18-65. Finasteride, dutasteride, and silodosin showed the highest risk signals for SD. Multivariate regression indicated that being male, aged 31-45, and using 34 specific drugs, including finasteride, are risk factors for drug-related SD. The study highlights the need for clinicians to consider the potential for SD when prescribing these drugs, although causality could not be established due to the study's retrospective nature.
1 citations
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August 2023 in “Andrology” Finasteride changes hormone levels and certain proteins in rats, but these effects can be reversed after stopping the drug.
2 citations
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July 2022 in “Sexual Medicine” Certain medications, especially 5-α reductase inhibitors and neuropsychiatric drugs, are often linked to erectile dysfunction.
54 citations
,
May 2018 in “International journal of risk & safety in medicine” Antidepressants, 5α-reductase inhibitors, and isotretinoin can cause long-lasting sexual dysfunction.
15 citations
,
November 2015 in “Pharmacopsychiatry” α-Blockers and 5-ARIs for BPH can cause sexual dysfunction, including erectile and ejaculatory issues.
20 citations
,
June 2015 in “Hormone Molecular Biology and Clinical Investigation” Finasteride worsens erectile dysfunction and lowers testosterone in men with enlarged prostates, unlike tamsulosin.
125 citations
,
January 1999 in “Drugs” Finasteride effectively treats baldness but may cause sexual side effects.
2 citations
,
December 2021 in “Korean Journal of Clinical Pharmacy” 
11 citations
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August 2014 in “Current Urology Reports” Medications for enlarged prostate can cause sexual side effects like reduced libido, erectile dysfunction, and ejaculatory problems.
77 citations
,
June 2015 in “Nature Reviews Urology” Some common medications can harm male fertility, but many effects can be reversed.
2 citations
,
March 2018 in “Current Opinion in Urology” 5-alpha reductase inhibitors can cause sexual, neurologic, endocrine, and cardiovascular side effects, but these are rare and usually stop after ending treatment.
35 citations
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May 2020 in “Frontiers in Pharmacology” Different drugs for prostate-related urinary symptoms work but have various side effects, and treatment should be tailored to the individual.
