title: Persistent sexual side effects of finasteride for male pattern hair loss.
abstract: BACKGROUND
  Finasteride has been associated with reversible adverse sexual side effects in multiple randomized, controlled trials for the treatment of male pattern hair loss (MPHL). The Medicines and Healthcare Products Regulatory Agency of the United Kingdom and the Swedish Medical Products Agency have both updated their patient information leaflets to include a statement that "persistence of erectile dysfunction after discontinuation of treatment with Propecia has been reported in post-marketing use."
  
  
  OBJECTIVE
  We sought to characterize the types and duration of persistent sexual side effects in otherwise healthy men who took finasteride for MPHL.
  
  
  METHODS
  We conducted standardized interviews with 71 otherwise healthy men aged 21-46 years who reported the new onset of sexual side effects associated with the temporal use of finasteride, in which the symptoms persisted for at least 3 months despite the discontinuation of finasteride.
  
  
  METHODS
  The types and duration of sexual dysfunction and the changes in perceived sexual frequency and sexual dysfunction score between pre- and post-finasteride use.
  
  
  RESULTS
  Subjects reported new-onset persistent sexual dysfunction associated with the use of finasteride: 94% developed low libido, 92% developed erectile dysfunction, 92% developed decreased arousal, and 69% developed problems with orgasm. The mean number of sexual episodes per month dropped and the total sexual dysfunction score increased for before and after finasteride use according to the Arizona Sexual Experience Scale (P<0.0001 for both). The mean duration of finasteride use was 28 months and the mean duration of persistent sexual side effects was 40 months from the time of finasteride cessation to the interview date. Study limitations include a post hoc approach, selection bias, recall bias for before finasteride data, and no serum hormone levels.
  
  
  CONCLUSIONS
  Physicians treating MPHL should discuss the potential risk of persistent sexual side effects associated with finasteride.
authors.affiliation: Center for Andrology and Division of Endocrinology, The George Washington University, Washington, DC 20037, USA. mirwig@mfa.gwu.edu
authors.forename: Michael S
authors.initials: MS
authors.lastname: Irwig
authors.forename: Swapna
authors.initials: S
authors.lastname: Kolukula
mesh_terms: D058891:5-alpha Reductase Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D000328:Adult; D000505:Alopecia / Q000188:drug therapy*; D002908:Chronic Disease; D004305:Dose-Response Relationship, Drug; D007172:Erectile Dysfunction / Q000139:chemically induced* / Q000453:epidemiology; D018120:Finasteride / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D011358:Product Surveillance, Postmarketing; D012735:Sexual Dysfunction, Physiological / Q000139:chemically induced* / Q000453:epidemiology; D055815:Young Adult
chemical_list: D058891:5-alpha Reductase Inhibitors; D018120:Finasteride