Sexual Problems of Men With Androgenic Alopecia Treated With 5-Alpha Reductase Inhibitors

    October 2018 in “ Sexual medicine reviews ”
    Enis Rauf Coskuner, Burak Ozkan, Mehmet Gokhan Culha
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    TLDR Men using hair loss drugs like finasteride may experience sexual side effects like erectile dysfunction, but it's unclear who will be affected and when. Treating depression and sexual symptoms is suggested, as these men often have higher rates of both. More research is needed to understand why these side effects occur.
    In 2019, a study examined the effects of 5-Alpha reductase inhibitors (5-ARIs), including finasteride, used in treating androgenic alopecia (AGA) on sexual functioning. The study found that these drugs could cause side effects like erectile dysfunction, ejaculation problems, and decreased libido. However, it was unclear which men might experience these side effects and when they might appear. The study also found that men with persistent symptoms after discontinuing finasteride showed no evidence of androgen insufficiency, low peripheral androgen activity, or persistent peripheral inhibition of 5-alpha reductase. The study suggested focusing on depression and sexual symptoms for treatment, as men seeking treatment for AGA have a higher prevalence of depression and sexual dysfunction. The study concluded that more research was needed to understand the pathways leading to the onset and continuation of side effects in men who have used finasteride.
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