Hair Loss Drugs Found To Have Libido-Killing Side Effects

For men losing their hair, a new discovery by researchers at Boston University School of Medicine (BUSM) might prompt  them to opt out of treating their impending baldness.

5a-reductase inhibitors (or "5a-RIs"), commonly used to treat urinary problems in patients with benign prostatic hyperplasia (BPH) and found in the popular medication Propecia to treat hair loss, has been found to produce loss of libido, erectile dysfunction (ED), ejaculatory dysfunction, gynecomastia (breast enlargement in males), and potential depression in some patients.

Extreme caution

These findings suggest doctors should exercise extreme caution prior to prescribing 5a-RIs therapy to patients for hair growth or for BPH symptoms.

"The potential widespread use of 5a-RIs for treatment of BPH, prostate cancer and male pattern hair loss may produce undesirable adverse side effects on overall health and in particular, vascular health and sexual function in a subgroup of susceptible patients, " said lead author Abdulmaged M. Traish, MBA, PhD, a professor of biochemistry and professor of Urology at BUSM.

"Furthermore, treatment of hair loss, a benign condition with 5a-RIs may produce persistent side effects in a number of young patients," he added.

5a-RIs, finasteride (Propecia) and dutasteride, have been approved for treatment of lower urinary tract symptoms, due to BPH, with marked clinical efficacy.  Finasteride is also approved for treatment of hair loss (androgenetic alopecia).

Although the adverse side effects of these agents are thought to be minimal, the magnitude of adverse effects on sexual function, gynecomastia, depression, and quality of life remains ill-defined.

Prolonged adverse effects

In order to determine the potential extent of this problem, the researchers examined the data reported in various clinical studies concerning the side effects of finasteride and dutasteride.

After a review of the literature the researchers found that in a subset of men, prolonged adverse effects on sexual function such as erectile dysfunction and diminished libido were reported, raising the possibility of a connection.

According to the researchers, the adverse side effects of 5a-RIs on sexual function, gynecomastia and the impact on the overall health have received minimal attention.

However, in some patients, these side effects are persistent with regard to sexual function and with an emotional toll including decreased quality of life.

Counseling recommended

"Honest and open discussion with patients to educate them on these serious issues must be pursued prior to commencing therapy because, in some patients, these adverse effects are persistent and may be prolonged and patients do not recover well after discontinuation from drug use," said Traish.

The researchers believe additional clinical and preclinical studies are warranted to determine the reason for why some of these adverse effects persist in some individuals.

Colleagues of the BUSM researchers at the Lahey Clinic and from Denmark and Germany also collaborated on this study which currently appears on-line in Journal of Sexual Medicine.