title: Adverse side effects of 5α-reductase inhibitors therapy: persistent diminished libido and erectile dysfunction and depression in a subset of patients.
abstract: BACKGROUND
  5α-reductase inhibitors (5α-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.
  
  
  OBJECTIVE
  The goal of this review is to discuss 5α-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.
  
  
  METHODS
  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 5α-RIs before commencing therapy. Alternative therapies may be considered in the discussion, especially when treating androgenetic alopecia.
authors.affiliation: Department of Biochemistry, Boston University School of Medicine, Boston, MA, USA.
authors.forename: Abdulmaged M
authors.initials: AM
authors.lastname: Traish
authors.forename: John
authors.initials: J
authors.lastname: Hassani
authors.forename: Andre T
authors.initials: AT
authors.lastname: Guay
authors.forename: Michael
authors.initials: M
authors.lastname: Zitzmann
authors.forename: Michael L
authors.initials: ML
authors.lastname: Hansen
mesh_terms: D058891:5-alpha Reductase Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D003863:Depression / Q000139:chemically induced*; D007172:Erectile Dysfunction / Q000139:chemically induced* / Q000188:drug therapy; D018120:Finasteride / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D007989:Libido / Q000187:drug effects*; D008297:Male
chemical_list: D058891:5-alpha Reductase Inhibitors; D018120:Finasteride