AB089. What should we know role of finasteride in erectile dysfunction?

BACKGROUND: 5-α reductase inhibitor (5 ARI), finasteride is primarily used to treat benign prostatic hyperplasia (BPH) and male androgenic alopecia (MAA). By the physiological role of testosterone and dihydrotestosterone (DHT), 5 ARI could induce a bit of male sexual dysfunction. We provide the update knowledge about the effect of finasteride to erectile dysfunction (ED). METHOD: We listed and discussed the principal studies on the finasteride and ED. The search strategy used each term of finasteride and ED in PubMed for the main studies. ED data reported from available trials for finasteride were summarized and reviewed. RESULTS: Evidence from the clinical studies suggested that finasteride was associated with increased adverse effects on ED in men with BPH. However, the association was not statistically significant in men with MAA. However, some studies reported side effects of finasteride comprise sexual dysfunction including erectile dysfunction, male infertility, ejaculation problem and loss of libido, even in the MAA patients. CONCLUSIONS: The mechanism of 5 ARI suggests that 5 ARI may independently increase the risk of ED. Well-designed randomized controlled trials are indicated to study further the mechanism and effects of finasteride on ED. However, physicians should discuss with their patients the possible long-term effects of finasteride on sexual function, even though we do not have evidence adverse events about the sexual dysfunction has completely been related with 5 ARI.