PMID- 19090946
OWN - NLM
STAT- MEDLINE
DCOM- 20090413
LR  - 20151119
IS  - 1743-6109 (Electronic)
IS  - 1743-6095 (Linking)
VI  - 5
IP  - 12
DP  - 2008 Dec
TI  - 5-alpha reductase inhibitors and erectile dysfunction: the connection.
PG  - 2917-24
LID - 10.1111/j.1743-6109.2008.01001.x [doi]
AB  - INTRODUCTION: Benign prostatic hyperplasia (BPH) is a common problem affecting 
      middle-aged and elderly men. First-line medical therapy includes alpha 1blockers 
      and 5alpha-reductase inhibitors (5ARIs), such as finasteride and dutasteride. 
      5ARI use has been associated with adverse sexual outcomes, including erectile 
      dysfunction (ED), ejaculatory dysfunction (EjD), and decreased libido. AIM: To 
      clarify the association between sexual adverse effects (AEs) and 5ARIs through 
      review of literature concerning 5ARIs and to review the proposed mechanisms of 
      these effects. METHODS: A comprehensive literature review, using MEDLINE and 
      PUBMED search engines, was conducted for all publications concerning 5ARIs and 
      sexual AEs. MAIN OUTCOME MEASURE: Sexual adverse effects, such as ED, EjD, and 
      decreased libido, were the measured outcomes of this literature review. RESULTS: 
      Sexual AEs are reported in clinical trials at rates of 2.1% to 38%. The most 
      common sexual AE is ED, followed by EjD and decreased libido. These effects occur 
      early in therapy and attenuate over time. A proposed mechanism for sexual 
      dysfunction involves decreased nitric oxide synthase activity due to decreased 
      dihydrotestosterone. CONCLUSIONS: The connection between 5ARIs and sexual 
      dysfunction is apparent upon review of the literature. Though theories have been 
      proposed, little is known about the exact mechanisms behind 5ARI-related sexual 
      dysfunction. Since the connection between 5ARIs and sexual AEs is established in 
      the literature, future research should be directed toward deciphering the 
      pathophysiologic mechanisms. When more basic science knowledge is attained in 
      this area, the focus can shift toward prevention and treatment.
FAU - Erdemir, Fikret
AU  - Erdemir F
AD  - Tulane University-Department of Urology, New Orleans, LA, USA.
FAU - Harbin, Andrew
AU  - Harbin A
FAU - Hellstrom, Wayne J G
AU  - Hellstrom WJ
LA  - eng
PT  - Journal Article
PT  - Review
PL  - Netherlands
TA  - J Sex Med
JT  - The journal of sexual medicine
JID - 101230693
RN  - 0 (5-alpha Reductase Inhibitors)
RN  - 0 (Adrenergic alpha-Antagonists)
RN  - 0 (Azasteroids)
RN  - 57GNO57U7G (Finasteride)
RN  - O0J6XJN02I (Dutasteride)
SB  - IM
MH  - *5-alpha Reductase Inhibitors
MH  - Adrenergic alpha-Antagonists/adverse effects/therapeutic use
MH  - Azasteroids/adverse effects/therapeutic use
MH  - Drug Therapy, Combination
MH  - Dutasteride
MH  - Ejaculation/drug effects
MH  - Erectile Dysfunction/*chemically induced
MH  - Finasteride/adverse effects/therapeutic use
MH  - Humans
MH  - Libido/drug effects
MH  - Male
MH  - Prostatic Hyperplasia/*drug therapy
RF  - 56
EDAT- 2008/12/19 09:00
MHDA- 2009/04/14 09:00
CRDT- 2008/12/19 09:00
PHST- 2008/12/19 09:00 [entrez]
PHST- 2008/12/19 09:00 [pubmed]
PHST- 2009/04/14 09:00 [medline]
AID - S1743-6095(15)31899-3 [pii]
AID - 10.1111/j.1743-6109.2008.01001.x [doi]
PST - ppublish
SO  - J Sex Med. 2008 Dec;5(12):2917-24. doi: 10.1111/j.1743-6109.2008.01001.x.