Sexual Dysfunction in Men Taking Systemic Dermatologic Medication: A Systematic Review

    George A. Zakhem, Julia E. Goldberg, Catherine C. Motosko, Beverly S. Cohen, Roger S. Ho
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    TLDR Some men taking finasteride for hair loss may experience sexual problems like erectile dysfunction and decreased sex drive, which can persist even after stopping the medication.
    In 2019, a systematic review analyzed the sexual adverse effects of systemic dermatologic medications in men, reviewing 59 articles that met their inclusion criteria from an initial pool of 5497. The review provided level 1 evidence for sexual dysfunction, particularly erectile dysfunction and decreased libido, in patients taking 1 mg of finasteride for androgenic alopecia. While most patients' sexual adverse effects resolved after stopping finasteride, some reported persistent issues. The review highlighted the need for dermatologists to screen for sexual dysfunction in male patients on these medications, especially when taking NSAIDs and finasteride together. Despite the evidence, the review noted limitations due to varied sample sizes and methodologies in the studies, and called for more comprehensive trials to better understand the issue.
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