Research paper published by Drs. Katrina Wilcox Hagberg, Hozefa A Divan, Rebecca Persson, J Curtis Nickel & Susan S Jick, looks into side effects of Finasteride on sexual disfunction.
We know that Erectile dysfunction and other sexual dysfunctions have been reported as adverse effects of 5-α reductase inhibitors in clinical trial settings.
Benign prostatic hyperplasia, one of the indications for use of 5-α reductase inhibitors, is a risk factor for erectile dysfunction and other sexual dysfunctions.
What this study adds
The study results provide evidence that 5-α reductase inhibitors do not increase the risk of clinically meaningful incident erectile dysfunction or non-erectile dysfunction sexual dysfunction in men who are free of sexual dysfunction and major risk factors (eg, prostate, genital, or urinary cancers, surgical procedures), regardless of indication for use (benign prostatic hyperplasia or alopecia).
The risk of erectile dysfunction increased with longer duration of benign prostatic hyperplasia independent of exposure which should be accounted for in the design of future studies evaluating the safety of 5-α reductase inhibitors.
Results
In the population with benign prostatic hyperplasia (n=71 849), the risk of erectile dysfunction was not increased with use of 5-α reductase inhibitors only (incidence rate ratio 0.92, 95% confidence interval 0.85 to 0.99; odds ratio 0.94, 95% confidence interval 0.85 to 1.03) or 5-α reductase inhibitors+α blocker (1.09, 0.99 to 1.21, 0.92; 0.80 to 1.06) compared with α blockers only, and remained null regardless of number of prescriptions or timing of use.
The risk of erectile dysfunction increased with longer duration of benign prostatic hyperplasia, regardless of exposure. For the alopecia population (n=12 346), the risk of erectile dysfunction was not increased for users of finasteride 1 mg compared with unexposed men with alopecia (1.03, 0.73 to 1.44; 0.95, 0.64 to 1.41).
Conclusion
5-α reductase inhibitors do not seem to significantly increase the risk of incident erectile dysfunction, regardless of indication for use. Risk of erectile dysfunction increased with longer duration of benign prostatic hyperplasia.
