Use of 5α-reductase inhibitors (5ARIs) to treat benign prostatic hyperplasia (BPH) is associated with a significantly increased risk of sexual dysfunction, according to a new meta-analysis and systematic review published online in the Journal of Sexual Medicine.

In a meta-analysis and systematic review, Luhao Liu, MD, of Guangzhou Medical University in Guandong, China, and colleagues analyzed data from 17 randomized controlled trials with 17,494 patients. Of these, 9 evaluated the efficacy of 5ARIs in men with BPH and 8 looked at the use of 5ARIs in treating androgenetic alopecia (AGA).


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Use of 5ARIs for BPH was associated with a statistically significant 2.5, 1.5, and 1.7 times increased pooled relative risk for sexual dysfunction, erectile dysfunction, and decreased libido, respectively, compared with placebo, the investigators reported. The study found no statistically significant association between 5ARI use for AGA and sexual dysfunction.

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