Postmarketing surveillance from men using finasteride, a 5-alpha reductase inhibitor (5ARI), for male pattern hair loss (MPHL) includes reports of various forms of sexual dysfunction, such as decreased libido, erectile and ejaculatory dysfunction, and gynecomastia. Purported mechanisms for these effects include the decreased production of neurosteroids, which may regulate sexual desire and function, and impaired testosterone metabolism, leading to relative estrogen excess. Large randomized controlled trials of men on 5ARIs for benign prostatic hypertrophy have shown increased sexual dysfunction compared to placebo; however, similar association with MPHL was not statistically significant. This article is protected by copyright. All rights reserved.
The British journal of dermatology. 2018 Apr 06 [Epub ahead of print]
J S Mervis, L J Borda, M Miteva
Department of Dermatology & Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, U.S.A.