5a-reductase inhibitors for male health problems can affect sexual health

A new study published in The Journal of Sexual Medicine reveals that, for the first time, 5a-reductase inhibitors commonly used to treat urinary problems in patients with benign prostatic hyperplasia (BPH) and found in popular medications to treat hair loss, can produce, persistent erectile dysfunction (ED), depression and loss of libido, even after the medication has been discontinued.

Researchers led by Abdulmaged M. Traish, MBA, PhD, of Boston University School of Medicine, examined data reported in various clinical studies from the available literature concerning the side effects of the 5 alpha reductase inhibitors, finasteride and dutasteride.

Prolonged adverse side effects on sexual function, such as ED, depression and diminished libido, were reported by a subset of men. Drug-related reduction in libido occurred in 4.2% and 1.8% of patients in the dutasteride and placebo groups, respectively. Reduced ejaculation and semen volume were also reported and in some patients, these drugs were associated with depression.

“For these reasons, patients and doctors are urged to discuss these issues openly and candidly and assess the risk benefit ratio prior to commencing therapy with 5a-reductase inhibitors” Dr. Traish notes.

Dr. Irwin Goldstein, editor-in-chief of The Journal of Sexual Medicine, has seen and evaluated numerous such patients. He further explained the importance of this study. “Young men are being prescribed 5 alpha reductase inhibitors as hair loss treatments that may negatively impact their sexual life, possibly for a prolonged time after stopping the medication. Older men with symptoms of lower urinary tract symptoms or fearful of prostate cancer, now have to deal with new onset sexual and mental health problems. The growing use of 5 alpha reductase inhibitors is causing concerns.” Clearly more research is needed to better understand the basis for these drug-associated side effects but it is evident that 5 alpha reductase inhibitors prevent the synthesis of very critical central nervous system neurosteroids and lower a very important sex steroid hormone, dihydrotestosterone.

This study is published in The Journal of Sexual Medicine.

Full citation: Traish et al. Adverse side effects of 5a-reductase Inhibitors Therapy: Persistent Diminished Libido and Erectile Dysfunction and Depression in a Subset of Patients. The Journal of Sexual Medicine; DOI: 10.1111/j.1743-6109.2010.02157.x

About the Author: Abdulmaged M. Traish, MBA, PhD, is affiliated with Boston University School of Medicine.
To arrange an interview with an author, please contact Dr. Traish's media contact, Gina Digravio at [email protected]