Adverse Side Effects of 5α-Reductase Inhibitors Therapy: Persistent Diminished Libido and Erectile Dysfunction and Depression in a Subset of Patients
Article first published online: 22 DEC 2010
© 2010 International Society for Sexual Medicine
The Journal of Sexual Medicine
Volume 8, Issue 3, pages 872–884, March 2011
How to Cite
Traish, A. M., Hassani, J., Guay, A. T., Zitzmann, M. and Hansen, M. L. (2011), Adverse Side Effects of 5α-Reductase Inhibitors Therapy: Persistent Diminished Libido and Erectile Dysfunction and Depression in a Subset of Patients. Journal of Sexual Medicine, 8: 872–884. doi: 10.1111/j.1743-6109.2010.02157.x
- Issue published online: 24 FEB 2011
- Article first published online: 22 DEC 2010
- Benign Prostatic Hyperplasia;
- Sexual Dysfunction Depression;
Introduction. 5α-reductase inhibitors (5α-RIs), finasteride and dutasteride, have been approved for treatment of lower urinary tract symptoms, due to benign prostatic hyperplasia, with marked clinical efficacy. Finasteride is also approved for treatment of hair loss (androgenetic alopecia). Although the adverse side effects of these agents are thought to be minimal, the magnitude of adverse effects on sexual function, gynecomastia, depression, and quality of life remains ill-defined.
Aim. The goal of this review is to discuss 5α-RIs therapy, the potential persistent side effects, and the possible mechanisms responsible for these undesirable effects.
Methods. We examined data reported in various clinical studies from the available literature concerning the side effects of finasteride and dutasteride.
Main Outcome Measures. Data reported in the literature were reviewed and discussed.
Results. Prolonged adverse effects on sexual function such as erectile dysfunction and diminished libido are reported by a subset of men, raising the possibility of a causal relationship.
Conclusions. We suggest discussion with patients on the potential sexual side effects of 5α-RIs before commencing therapy. Alternative therapies may be considered in the discussion, especially when treating androgenetic alopecia. Traish AM, Hassani J, Guay AT, Zitzmann M, and Hansen M. Adverse side effects of 5α-reductase inhibitors therapy: Persistent diminished libido and erectile dysfunction and depression in a subset of patients. J Sex Med 2011;8:872–844.