Hair Loss, Prostate Drugs Could Increase Persistent Erectile Dysfunction Risk in Men

Longer exposure to drugs like finasteride and dutasteride for treating hair loss and prostate enlargement may increase the risk of erectile dysfunction; this could last for many years in men, finds a new study from the Northwestern Medicine. The research study was published in the journal PeerJ.

Erectile dysfunction is a common type of male sexual dysfunction. Men may face difficulty in keeping the erection firm enough to have intercourse, and affects the reproductive health.

While assessing the risk factors for erectile dysfunction, prolonged exposure to drugs is linked to a high risk for persistent erectile dysfunction.

The research study provided strong evidence that exposure to finasteride or dutasteride may cause sexual problems that may continue even after men stop taking the drugs.

Dr. Steven Belknap, research assistant professor of dermatology at Northwestern University Feinberg School of Medicine, said, "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."

He also added that, the findings of the study which links the exposure of finasteride or dutasteride drugs to persistent erectile dysfunction might benefit the prescribing physicians and patients to consider treatment options for androgenic alopecia (hair loss) or prostate enlargement.

Link Between Prolonged Exposure of Drugs and Persistent Erectile Dysfunction

The research study was conducted by evaluating the data obtained from 11,909 men for persistent erectile dysfunction. The men who were evaluated were found to age between 16 years to 89 years old and also had at least one clinical encounter and one diagnosis from January 1992 to September 2013.

The data was collected from the Northwestern Medicine Electronic Data Warehouse, where electronic medical record data is stored for patients of Northwestern Medicine.

Findings of the Study

• Out of the 11,909 men, 167 of them were found to develop persistent erectile dysfunction that continued for about 1,348 days after discontinuing the drugs.
• Men under the age of 42 years and who had more than 205 days of finasteride or dutasteride exposure may have a 4.9-fold higher risk of erectile dysfunction when compared to men without exposure.

These findings were followed by a study published by Belknap in the 2015 JAMA Dermatology. The paper published the reports of the clinical trials which had insufficient information on how to adequately find out the safety of using finasteride drug for hair loss in men.

5-alpha reductase inhibitors

Finasteride and dutasteride drugs belong to a class of medications called 5-alpha reductase inhibitors. These drugs are male hormone blockers.

They act by blocking the conversion of the testosterone (male hormone) to its more active form (5-alpha dihydrotestosterone).

Finasteride Drug

The drug is sold under the brand name Propecia and Proscar. It is used for the treatment of enlarged prostate gland (a condition called as the Benign Prostatic Hypertrophy).

Finasteride drug is also used for the treatment of male pattern hair loss, by blocking the body’s production of a hormone in the scalp that stops hair growth. 

Dutasteride Drug

Dutasteride is sold under the brand name Avodart. It is used either alone or in combination along with Tamsulosin to treat Benign Prostatic Hyperplasia.

The drug acts by blocking the natural substance that enlarges the prostate gland and may reduce the need for performing prostate surgery. 

Side effects of finasteride and dutasteride may lead to decreased sex drive, inability to maintain erection and problems with ejaculation.

Facts on Erectile Dysfunction

• One out of ten men in the world suffer from erectile dysfunction.
• Erectile dysfunction is the main cause for 20% of breakdown in relationships.
• Most of the men who have diabetes are prone to erectile dysfunction.
• There is a 50% higher chance of erectile dysfunction among men who smoke.
• Around 10% to 20% of erectile dysfunction cases occur due to psychological stress and anxiety in men.

References:

1. Steven Belknap et.al., ’Persistent erectile dysfunction in men exposed to the 5alpha-reductase inhibitors, finasteride, or dutasteride,’ PeerJ (2017); DOI 10.7717/peerj.3020
2. Erectile Dysfunction (ED) - (http://www.uwhealth.org/urology/erectile-dysfunction-ed/20537)
3. Finasteride - (https://medlineplus.gov/druginfo/meds/a698016.html)
4. Dutasteride - (https://medlineplus.gov/druginfo/meds/a603001.html)
5. Statistics on Erectile Dysfunction - (http://www.healthcentre.org.uk/pharmacy/erectile-dysfunction-statistics.html)

Source-Medindia