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5-alpha reductase inhibitors and erectile dysfunction: the connection

http://www.medworm.com/rss/search.php?q ... &r=Any&o=d

Erdemir F, Harbin A, and Hellstrom WJG. 5-alpha reductase inhibitors and erectile dysfunction: The connection.

Source: The Journal of Sexual Medicine - September 25, 2008
Category: Sexual Medicine

Authors: Fikret Erdemir, Andrew Harbin, Wayne JG Hellstrom Source

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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.

Another perspective from a different author/book.

http://books.google.ca/books?lr=&id=mhE ... #PPA383,M1

"However the possibility that a longer treatment period could adversely affect sexual functions in some men remains".

This is just unbelievable that the autor considers permanent adverse effects on a sex drive these drugs can provide, but you can find nothing about that from Merck or Glaxo. My God!

On the other hand what the author want to say(?), because it is not scientificaly explained. If the author consider such possibility he should explain the potential factor that may actually play a role in this, instead of writing about the possibility. I am terified anyway.

Finasteride in the treatment of clinical benign prostatic hyperplasia: A systematic review of randomised trials

http://www.biomedcentral.com/content/pd ... 0-2-14.pdf

http://www.jcdr.net/articles/PDF/112/00 ... REV_07_E(L)_F(G)_Pf_p.pdf

Link to article: http://www3.interscience.wiley.com/journal/121421728/abstract?CRETRY=1&SRETRY=0

Abstract below:

J Sex Med. 2008 Dec;5(12):2917-24.

5-alpha reductase inhibitors and erectile dysfunction: the connection.
Erdemir F, Harbin A, Hellstrom WJ.

Tulane University-Department of Urology, New Orleans, LA, USA.

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.

PMID: 19090946

John, the link above does not work.

Here are alternatives:

http://www.ncbi.nlm.nih.gov/sites/entre ... s=19090946

http://www.unboundmedicine.com/medline/ ... onnection_