Adverse Side Effects of 5 alpha-Reductase Inhibitors Therapy: Persistent Diminished Libido and Erectile Dysfunction and Depression in a Subset of Patients

作者：Traish Abdulmaged M^*; Hassani John; Guay Andre T; Zitzmann Michael; Hansen Michael L

来源：The Journal of Sexual Medicine, 2011, 8(3): 872-884.

DOI：10.1111/j.1743-6109.2010.02157.x

• Finasteride
• Dutasteride
• Alopecia
• Benign Prostatic Hyperplasia
• Sexual Dysfunction Depression
• Gynecomastia

Introduction.
5 alpha-reductase inhibitors (5 alpha-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 5 alpha-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 5 alpha-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 5 alpha-reductase inhibitors therapy: Persistent diminished libido and erectile dysfunction and depression in a subset of patients. J Sex Med 2011;8:872-844.

• 出版日期2011-3