Popular Drugs Used by Older Men for Urinary,
Prostate Problems Can Affect Sexual Health
Finasteride and
Dutasteride can cause persistent erectile dysfunction,
depression, loss of libido
March 7, 2011 -
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 – including persistent erectile dysfunction (ED) – due
to the use of 5a-reductase inhibitors to treat their problems, according
to a new study in The Journal of Sexual Medicine.
The drugs are
commonly used to treat urinary problems in patients with benign
prostatic hyperplasia (BPH) and found in popular medications to treat
hair loss. This therapy can also produce 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, and added, "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, notes
Goldstein, 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.
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