Abstract
Objective: Analyze adverse effects of 5–ARI’s regarding sexual health and fertility (erectile dysfunction and decreased libido); neurology and psychiatry (depressive symptoms, self-harm and suicidal ideation); endocrine, metabolic and cardiovascular (increased body fat, LDL and total cholesterol). Bibliographic review: This narrative review reports findings from various scientific articles published online, regarding the adverse effects of 5-ARI`s, often used to treat male-pattern baldness and benign prostate hyperplasia in adult males. Final considerations: Adverse effects were identified on several studies made in different populations. Thus, it is utterly important to raise public awareness of the implications associated with 5-ARI's treatment. Prescription of 5-ARI's therapy should be carefully assessed for each individual due to potential adverse effects that may occur upon its start, and drastically compromise quality of life in adult males.
References
ADAMOWICZ J, et al. May patients receiving 5-alpha-reductase inhibitors be in higher risk of COVID-19 complications? Medical Hypotheses, 2020; 140: e109751.
COSKUNER ER, et al. Sexual Problems of Men With Androgenic Alopecia Treated With 5-Alpha Reductase Inhibitors. Sexual Medicine Reviews, 2019; 7(2): 277-282.
DIVICCARO S, et al. Post-finasteride syndrome: an emerging clinical problem. Neurobiology Of Stress, 2020; 12: e100209.
FERTIG RM, et al. Sexual side efects of 5-α-reductase inhibitors fnasteride and dutasteride: A comprehensive review. Dermatology Online Journal, 2017; 11(23): 1-20.
GIATTI S, et al. Post-finasteride syndrome and post-SSRI sexual dysfunction: two sides of the same coin? Endocrine, 2018; 61(2): 180-193.
IRWIG MS. Finasteride and Suicide: a postmarketing case series. Dermatology, 2020; 236(6): 540-545.
KJÆRULFF TM, et al. Characteristics of finasteride users in comparison with nonusers: a nordic nationwide study based on individual level data from denmark, finland, and sweden. Pharmacoepidemiology And Drug Safety, 2020; 29(4): 453-460.
LEE S, et al. Adverse Sexual Effects of Treatment with Finasteride or Dutasteride for Male Androgenetic Alopecia: a systematic review and meta-analysis. Acta Dermato Venereologica, 2018; 99(1): 12-17.
LI Y, et al. The efficacy and safety of dutasteride and finasteride in patients with benign prostatic hyperplasia: a systematic review and meta-analysis. Translational Andrology and Urology, 2022; 11(3): 313-324.
MAKSYM RB, et al. Post-finasteride syndrome – does it really exist?. The Aging Male, 2019; 4(22): 250-259.
MOTOFEI IG, et al. Finasteride and androgenic alopecia; from therapeutic options to medical implications. Journal Of Dermatological Treatment, 2019; 31(4): 415-421.
NGUYEN DD, et al. Investigation of Suicidality and Psychological Adverse Events in Patients Treated With Finasteride. Jama Dermatology, 2021; 157(1): 35-42.
PALLOTTI F, et al. Androgenetic alopecia: effects of oral finasteride on hormone profile, reproduction and sexual function. Endocrine, 2020; 68: 688-694.
PEREIRA AFJR, COELHO TOA. Post-finasteride syndrome. Anais Brasileiros de Dermatologia, 2020; 95(3): 271-277.
SAENGMEARNUPARP T, et al. The connection of 5-alpha reductase inhibitors to the development of depression. Biomedicine & Pharmacotherapy, 2021; 143: e112100.
SAID MA, MEHTA A. The Impact of 5α-Reductase Inhibitor Use for Male Pattern Hair Loss on Men’s Health. Current Urology Reports, 2018; 19(65): 1-6.
TRAISH A, et al. Long-term dutasteride therapy in men with benign prostatic hyperplasia alters glucose and lipid profiles and increases severity of erectile dysfunction. Hormone Molecular Biology And Clinical Investigation, 2017; 30(3): 1-16.
TRAISH AM, et al. Finasteride, not tamsulosin, increases severity of erectile dysfunction and decreases testosterone levels in men with benign prostatic hyperplasia. Hormone Molecular Biology and Clinical Investigation, 2015; 23(3): 85-96.
TRAISH AM. Post-finasteride syndrome: a surmountable challenge for clinicians. Fertility And Sterility, 2020; 113(1): 21-50.
TRAISH AM. The Post-finasteride Syndrome: clinical manifestation of drug-induced epigenetics due to endocrine disruption. Current Sexual Health Reports, 2018; 10(3): 88-103.
TRÜEB M, et al. Post-Finasteride Syndrome: an induced delusional disorder with the potential of a mass psychogenic illness? Skin Appendage Disorders, 2019; 5(5): 320-326.
WALF AA, et al. Research Brief: self-reports of a constellation of persistent antiandrogenic, estrogenic, physical, and psychological effects of finasteride usage among men. American Journal Of Men'S Health, 2018; 12(4): 900-906.
WANG L, et al. Association of finasteride with prostate cancer. Medicine, 2020; 99(15): 1-8.
YEON B, et al. Depression risk associated with the use of 5α-reductase inhibitors versus α-blockers: a retrospective cohort study in south korea. Plos One, 2022; 17(3): e0265169.
ZAKHEM GA, et al. Sexual dysfunction in men taking systemic dermatologic medication: a systematic review. Journal Of The American Academy Of Dermatology, 2019; 81(1): 163-172.
