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5ARIs Associated with Sexual Dysfunction (2017-04-11)

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 a placebo.

The participantsí average age was 60 years and they were on the study treatment for an average of 17.6 months.

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 ejaculation.

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 discontinuation.

See also
Male pattern baldness may increase risk of colon cancer (2016-02-15)
Link...

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
Link...

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