Ejaculatory Problems Linked to BPH Drugs

Alpha blockers and 5-alpha reductase inhibitors increase the risk of ejaculatory dysfunction.
Alpha blockers and 5-alpha reductase inhibitors increase the risk of ejaculatory dysfunction.

STOCKHOLM—Medications used to treat benign prostatic hyperplasia (BPH) may increase the risk of ejaculatory dysfunction (EjD), according to study findings presented at the European Association of Urology 29th annual congress.

Mauro Gacci, MD, of the University of Florence in Italy, and colleagues conducted a systematic review and meta-analysis of data from 30,000 patients enrolled in randomized controlled trials showing that alpha blockers increased the risk of EjD nearly 6-fold compared with placebo. The increase in EjD risk varied by alpha blocker. Silodosin and tamsulosin were associated with a 32.5 times and 8.6 times increased risk versus placebo, whereas doxazosin and terazosin did not differ significantly from placebo.

Results also showed that use of 5-alpha reductase inhibitors (5ARIs) was associated with a significant 2.7 times increased risk of EjD compared with placebo. Finasteride and dutasteride were associated with similar EjD risk. The risk of EjD did not differ significantly between alpha blockers and 5ARIs.

Combination therapy with both alpha blockers and 5ARIs was associated with a 3-fold increased risk compared with either drug class alone.

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