Men with longer exposure to the drugs finasteride and dutasteride have a higher risk of persistent erectile dysfunction than do men with less exposure, a new study suggests.
The persistent erectile dysfunction continued despite stopping these drugs, in some cases for months or years.
There is a stronger relationship between taking these drugs and having PED than having diabetes, hypertension, or smoking.
Finasteride is prescribed to some men with prostate enlargement or baldness. Dutasteride is prescribed to some men with prostate enlargement. Propecia and Proscar are brand names for finasteride. Avodart is a brand name for dutasteride. Jalyn is a combination drug containing dutasteride and tamsulosin.
Among young men, prolonged exposure to the drugs poses a greater risk of persistent erectile dysfunction (PED) than all other assessed risk factors. This means there is a stronger relationship between taking these drugs and having PED than having diabetes, hypertension, or smoking, which are other risk factors.
Erectile dysfunction is difficulty achieving and maintaining a sufficient erection to have sex. The study shows that persistent erectile dysfunction continues despite stopping the drug and despite taking sildenafil (Viagra) or similar drug.
Prior to the new study, there was no strong evidence that finasteride and dutasteride cause sexual problems that continue after men stop taking them. There also was no strong evidence that taking these drugs for a longer time increases the chance of experiencing sexual problems.
“Our study shows men who take finasteride or dutasteride can get persistent erectile dysfunction, in which they will not be able to have normal erections for months or years after stopping finasteride or dutasteride,” says Steven Belknap, a research assistant professor of dermatology at Northwestern University Feinberg School of Medicine and lead author of the study in PeerJ.
The two drugs block the conversion of testosterone to its more active form, 5 alpha dihydrotestosterone.
The new findings of an association between debilitating sexual dysfunction and exposure to finasteride or dutasteride should be of particular interest to prescribers and patients considering medical management of androgenic alopecia (hair loss) or symptomatic treatment of enlarged prostate, Belknap says.
Among the men studied, 167 of 11,909 (1.4 percent) developed persistent erectile dysfunction that continued for a median of 1,348 days after stopping the drugs.
Young men younger than 42 years old who had more than 205 days of finasteride or dutasteride exposure had 4.9-fold higher risk of persistent erectile dysfunction than men with shorter exposure.
The study evaluated data from 11,909 men for PED. Eligible subjects for evaluation for new PED were men 16 to 89 years old with at least one clinical encounter and one diagnosis from January 1992 to September 2013.
The findings follow a 2015 JAMA Dermatology study that showed published reports of clinical trials provide insufficient information to adequately establish the safety of finasteride for treatment of hair loss in men. This was the first meta-analysis of the quality of safety reporting in clinical trials of finasteride for treatment of male hair loss.
The National Institutes of Health and the Post-Finasteride Syndrome Foundation supported the study.
Source: Northwestern University