Adverse effects of common prostate enlargement and hair growth drugs: A review

August 25, 2015

Twenty-five percent of men currently taking Finasteride or Dutasteride, popularly known as Proscar and Avodart, for the treatment of benign prostate enlargement (BPH), appear not to benefit from taking these medications. Those prescribed Propecia or Avodart for male pattern hair loss (known as alopecia) are also at risk for adverse events elicited by these drugs.

These findings are part of an international, collaborative review currently online in the journal Endocrine Reviews and Metabolic Disorders. Led by Abdulmaged Traish, PhD, professor of biochemistry and urology at Boston University School of Medicine (BUSM), the paper summarizes current available data and the impact of these drugs on sexual function as well as insulin resistance, depression and cognitive dysfunction.

Finasteride and Dutasteride are in the family of drugs known as 5α-reductase inhibitors (5α-RIs).They function by inhibiting the conversion of testosterone to 5α-dihydrotestosterone (5α-DHT) as well as several other critical steroid hormones. By reducing the concentration of 5α-DHT in the prostate, prostate volume decreases thus improving urinary flow.

Considerable controversy exists regarding the severity and persistence of the of 5α-RIs, but emerging clinical evidence strongly suggests that therapy is associated with sexual . The package insert for Finasteride reports a libido loss and/or reduction in 10 percent of patients and erectile dysfunction in 18 percent. In some patients, these effects can remain even after stopping therapy. According to the researchers the suggestion that sexual appear early in the first six months of therapy and then return to baseline is inaccurate. "The mechanism of dysfunction is likely multifactorial, related both to the direct decrease in 5α-DHT and direct influence on central and peripheral nerves," explains Traish.

In addition to sexual side effects, there has been some investigation into whether 5α-RIs can be used for prostate cancer chemo-prevention, but the researchers found the data to be inconclusive. They also believe the potential for cardiovascular side effects of therapy to warrant further investigation. "Inhibition of 5α-R activity may potentiate , type 2 diabetes, vascular disease and osteoporosis, but studies have not been definitive. The investigation into psychiatric side effects of 5α-RIs has been limited, but some case series describe increased depression and anxiety symptoms among patients on the medication," he adds.

The U.S. National Institutes of Health recently added post-finasteride syndrome (PFS) to its Genetic and Rare Diseases Information Center. Specific diagnostic criteria have not yet been described for the PFS spectrum. Further studies on PFS are needed to determine any relationship between dosing and severity of long-term side effects.

The authors contend that increased education and awareness of the adverse side effects of 5α-RIs is needed among clinicians and patients alike. "There needs to be a method of distinguishing who may benefit from therapy from those who will not," said Traish.

The authors also urge that further investigation into adverse side effects of 5α-RIs is needed.

Explore further: ED worsened, testosterone levels decreased by some treatments of prostate enlargement

Related Stories

ED worsened, testosterone levels decreased by some treatments of prostate enlargement

June 12, 2015
Men with benign prostate enlargement who used finasteride (also known as proscar and propecia) to treat their condition, experienced worsening erectile dysfunction (ED) that did not resolve with continued treatment. In addition, ...

Sexual dysfunction inadequately reported in hair loss drug trials

April 1, 2015
Published reports of clinical trials provide insufficient information to adequately establish the safety of finasteride for treatment of hair loss in men, according to a new Northwestern Medicine study to be published April ...

Finasteride, medication for male pattern hair loss, may also decrease drinking

June 13, 2013
Finasteride is a synthetic drug for the treatment of male pattern hair loss (MPHL) and an enlarged prostate. The side effects of finasteride for treatment of these two conditions can include increased rates of sexual dysfunction, ...

Hair loss drug shows long-term sexual side effects

July 23, 2012
(HealthDay) -- For men with finasteride-associated side effects, sexual dysfunction may persist for months or years, even after discontinuation of the drug, according to a study published online July 12 in The Journal of ...

Recommended for you

How ketogenic diets curb inflammation

September 25, 2017
Ketogenic diets – extreme low-carbohydrate, high-fat regimens that have long been known to benefit epilepsy and other neurological illnesses – may work by lowering inflammation in the brain, according to new research ...

Researchers develop treatment to reduce rate of cleft palate relapse complication

September 22, 2017
Young people with cleft palate may one day face fewer painful surgeries and spend less time undergoing uncomfortable orthodontic treatments thanks to a new therapy developed by researchers from the UCLA School of Dentistry. ...

Exosomes are the missing link to insulin resistance in diabetes

September 21, 2017
Chronic tissue inflammation resulting from obesity is an underlying cause of insulin resistance and type 2 diabetes. But the mechanism by which this occurs has remained cloaked, until now.

Thousands of new microbial communities identified in human body

September 20, 2017
A new study of the human microbiome—the trillions of microbial organisms that live on and within our bodies—has analyzed thousands of new measurements of microbial communities from the gut, skin, mouth, and vaginal microbiome, ...

Study finds immune system is critical to regeneration

September 20, 2017
The answer to regenerative medicine's most compelling question—why some organisms can regenerate major body parts such as hearts and limbs while others, such as humans, cannot—may lie with the body's innate immune system, ...

Immune cells produce wound healing factor, could lead to new IBD treatment

September 20, 2017
Specific immune cells have the ability to produce a healing factor that can promote wound repair in the intestine, a finding that could lead to new, potential therapeutic treatments for inflammatory bowel disease (IBD), according ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.