The Impact of 5α-Reductase Inhibitor Use for Male Pattern Hair Loss on Men’s Health
Said & Mehta, 2018
“The initial enthusiasm generated by the FDA approval of 5αRIs for male pattern hair loss, and their introduction into clinical practice, was followed by a post-market period characterized by increased patient complaints, with some side effects even being irreversible.”
Said and Mehta concluded that comprehensive literature review shows a disproportionately high number of men with 5-α reductase inhibitor-associated sexual dysfunction and infertility, and that though uncommon, broad sexual and reproductive symptoms that are both serious and persistent can occur.
They note that while methodological concerns have been raised regarding the possibilities of recall and selection bias in the questionnaire-based study of PFS patients, these results parallel scientific observations about the long-term pathophysiological changes induced by finasteride, even after treatment discontinuation. They state that it is critical to understand the role of DHT and androgen signaling in physiology to grasp the potential for adverse events.
They suggest physicians engage in productive conversation regarding the potential impact of these medications on their health and quality of life before 5alpha reductase inhibitor prescription.
