Sexual Problems of Men With Androgenic Alopecia Treated With 5-Alpha Reductase Inhibitors
Coskuner et al., 2019
“The real problem is that it is unknown and unpredictable as to which men using these drugs may be subject to these side effects and when these effects may appear. Studies have been insufficient to give a clear answer to this question.”
In a literature review, Coskuner et al. viewed epigenetic changes as likely in the development and persistence of PFS.
They note the important effects of androgens and progestins on libido, orgasm, and erectile function in the brain and peripheral nervous system, and therefore state that finasteride may also be held responsible for persistent side effects. They urge studies to determine the true incidence of permanent sexual side effects, determine who susceptible to them, and clarify the underlying mechanism.
They assert it is necessary that doctors warn patients about potential permanent sexual side effects when prescribing for androgenic alopecia.
The review concludes that more genetic and clinical studies are necessary to understand the pathophysiological pathways leading to the onset and continuation of side effects in men who have used finasteride.
