PMID- 27784557
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220310
IS  - 2050-0521 (Electronic)
IS  - 2050-0521 (Linking)
VI  - 1
IP  - 1
DP  - 2013 May
TI  - Side Effects of 5-Alpha Reductase Inhibitors: A Comprehensive Review.
PG  - 24-41
LID - S2050-0521(15)30061-5 [pii]
LID - 10.1002/smrj.3 [doi]
AB  - INTRODUCTION: 5alpha-reductase inhibitors (5ARI) include finasteride and dutasteride, 
      and are commonly prescribed in the treatment of benign prostatic hyperplasia and 
      androgenic alopecia. 5ARIs are associated with several known adverse effects 
      (AEs), with varying reported prevalence rates. AIM: The aim was to review and 
      summarize findings from published literature detailing AEs associated with 5ARI 
      use. A secondary aim was to review potential mechanisms of action, which may 
      account for these observed and reported AEs. METHODS: A PubMed search was 
      conducted on articles published from 1992 to 2012, which reported AEs with 5ARIs. 
      Priority was given to randomized, placebo-controlled trials. Studies 
      investigating potential mechanisms of action for 5ARIs were included for review. 
      MAIN OUTCOME MEASURES: AE data reported from available trials were summarized and 
      reviewed. RESULTS: Reported AEs with 5ARIs include sexual dysfunction, 
      infertility, mood disorders, gynecomastia, high-grade prostate cancer, breast 
      cancer, and cardiovascular morbidity/risk factors, although their true 
      association, prevalence, causality, and clinical significance remain unclear. A 
      pooled summary of all randomized, placebo-controlled trials evaluating 5ARIs 
      (N = 62,827) revealed slightly increased rates over placebo for decreased libido 
      (1.5%), erectile dysfunction (ED) (1.6%), ejaculatory dysfunction (EjD) (3.4%), 
      and gynecomastia (1.3%). The limited data available on the impact of 5ARIs on 
      mood disorders demonstrate statistically significant (although clinically 
      minimal) differences in rates of depression and/or anxiety. Similarly, there are 
      limited reports of reversible, diminished fertility among susceptible 
      individuals. Post-marketing surveillance reports have questioned the actual 
      prevalence of AEs associated with 5ARI use and suggest the possibility of 
      persistent symptoms after drug discontinuation. Well-designed studies evaluating 
      these reports are needed. CONCLUSIONS: 5ARIs are associated with slightly 
      increased rates of decreased libido, ED, EjD, gynecomastia, depression, and/or 
      anxiety. Further studies directed at identifying prevalence rates and persistence 
      of symptoms beyond drug discontinuation are required to assess causality. Trost 
      L, Saitz TR, and Hellstrom WJG. Side effects of 5-alpha reductase inhibitors: A 
      comprehensive review. Sex Med Rev 2013;1:24-41.
CI  - Copyright (c) 2013, International Society for Sexual Medicine. Published by 
      Elsevier Inc. All rights reserved.
FAU - Trost, Landon
AU  - Trost L
AD  - Mayo Clinic, Rochester, MN, USA.
FAU - Saitz, Theodore R
AU  - Saitz TR
AD  - Department of Urology, Section of Andrology, Tulane University School of 
      Medicine, New Orleans, LA, USA.
FAU - Hellstrom, Wayne J G
AU  - Hellstrom WJ
AD  - Department of Urology, Section of Andrology, Tulane University School of 
      Medicine, New Orleans, LA, USA. Electronic address: whellst@tulane.edu.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20151021
PL  - Netherlands
TA  - Sex Med Rev
JT  - Sexual medicine reviews
JID - 101614773
OTO - NOTNLM
OT  - Adverse Events
OT  - Dutasteride
OT  - Finasteride
OT  - Prostate
OT  - Sexual Dysfunction
EDAT- 2013/05/01 00:00
MHDA- 2013/05/01 00:01
CRDT- 2013/05/01 00:00
PHST- 2013/05/01 00:00 [pubmed]
PHST- 2013/05/01 00:01 [medline]
PHST- 2013/05/01 00:00 [entrez]
AID - S2050-0521(15)30061-5 [pii]
AID - 10.1002/smrj.3 [doi]
PST - ppublish
SO  - Sex Med Rev. 2013 May;1(1):24-41. doi: 10.1002/smrj.3. Epub 2015 Oct 21.