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.
Any discussion of erectile dysfunction and the use of prescribed medication is incomplete without mentioning a common form of erectile dysfunction known as Peyronies Disease (PD). This disease, for which there is no satisfactory treatment, results from formation of penile scar tissue, makes erectile functioning difficult or impossible and is often accompanied by excruciating pain. Approximately 6% of middle age men have this condition. According to Medical News Today, July 2008, almost 20% of men who undergo prostate cancer treatment develop this condition.
When I developed this condition, I was unaware that a disease like this even existed. In frustration, I started an informational website, http://www.curepeyronies.net Every email I get describes a man in a desperate situation with nowhere to turn. Urologists must do a better job of informing patients about this disorder and its relationship to prescribed medication and there should be additional research efforts to find an effective treatment.