Sexual Problems of Men With Androgenic Alopecia Treated With 5-Alpha Reductase Inhibitors

Introduction: 5-Alpha reductase inhibitors (5-ARIs) are widely used in the treatment of benign prostatic hyperplasia (BPH) and androgenic alopecia (AGA). Aim: To examine all available data on the effects of 5-ARIs on sexual functioning in AGA treatment and to assess whether 5-ARIs increase the risk of sexual dysfunction. Methods: A literature review of publications at PubMed related to the subject was used. Main Outcome Measure: We assessed erectile dysfunction, ejaculation impairment, and decreased libido. Results: 5-ARIs may cause side effects such as erectile dysfunction, ejaculation problems, and decreased libido in patients. Their long-term impact and precise mechanism have not been clarified. Data from studies on 5-ARIs are important for drug selection and patient counseling. More training and awareness is needed for clinicians and patients to recover many patients from sexual adverse effects. Results: 5-ARIs may cause side effects such as erectile dysfunction, ejaculation problems, and decreased libido in patients. Their long-term impact and precise mechanism have not been clarified. Data from studies on 5-ARIs are important for drug selection and patient counseling. More training and awareness is needed for clinicians and patients to recover many patients from sexual adverse effects. Conclusion: 5-ARIs used in the treatment of AGA have well-defined side effects, which can negatively affect sexual life. It is unknown and unpredictable which men using these drugs may be subject to these side effects and when these effects may appear. Studies have been insufficient to provide a clear answer to this question. Copyright (C) 2018, International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.