Benign prostatic hyperplasia (BPH) and androgenic
alopecia (AGA), are two conditions commonly treated
with a class of drugs considered safe and effective
called 5a-reductase inhibitors (5ARIs).
A recent meta-analysis by Chinese researchers
suggests that BPH patients who take them could be at
risk for sexual side effects.
To review all the available data on the effect of
5ARIs on sexual function and assess whether 5ARIs
increase the risk of sexual dysfunction a systematic
search of the literature was conducted using the
Medline, Embase, and Cochrane databases. The search
was limited to articles published in English and up
to October 2015.
About 55% of the patients took 5ARIs; the rest took
The participantsí average age was 60 years and they
were on the study treatment for an average of 17.6
Researchers included 10 trials (6,779 patients) on
the efficacy and safety of finasteride, 4 trials
(6,222 patients) on the safety and tolerability of
dutasteride, and 3 trials (4,493 patients) using
finasteride and dutasteride for AGA.
Evidence from the randomized controlled trials
suggested that 5ARIs were associated with increased
adverse effects on sexual function in men with BPH
compared with placebo.
The most common sexual issues were erectile
dysfunction, diminished sex drive, and trouble with
Medication dose and length of treatment appeared to
play a role as well.
Men who took 5 mg/d of finasteride or 0.5 mg/d of
dutasteride and were on treatment for longer than a
year were at higher risk for sexual dysfunction.
Men taking 5ARIs for BPH were at higher risk of
sexual side effects overall, the researchers noted.
However, the risk for those who took the drugs for
AGA was not statistically significant.
The authors explained that men with BPH are usually
older than those with AGA and, therefore, more prone
to sexual dysfunction.
In addition, 5ARIs are generally taken at lower
doses for AGA than for BPH, and studies have shown
fewer side effects with lower doses.
The authors recommended further research to
determine what the long term effects of such
treatment may be.
The study did not address the question as to whether
these changes were reversible upon drug
Male pattern baldness may increase risk of colon
For more information
The Journal of Sexual Medicine
Effect of 5a-Reductase Inhibitors on Sexual
Function: A Meta-Analysis and Systematic Review of
Randomized Controlled Trials