Sexual Dysfunction With 5-Alpha-Reductase Inhibitor Therapy for Androgenetic Alopecia
abstract
This abstract is available on the publisher's site.
Access this abstract now Full Text Available for ClinicalKey Subscribers5α-reductase inhibitors (5-ARIs) are a therapeutic mainstay for androgenetic alopecia (AGA). Uncertainty exists surrounding sexual dysfunction (SD) associated with 5-ARIs. Meta analyses examining associations between 5-ARIs and SD demonstrate conflicting results (Mendeley supplemental table I). Prior analyses involved predominately pooled data from trials. Currently, there is a paucity of population-level data investigating 5-ARI and SD. Here we evaluate potential associations of 5-ARIs with SD in a global population.
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Sexual dysfunction with 5-alpha-reductase inhibitor therapy for androgenetic alopecia: a global propensity score matched retrospective cohort study
J Am Acad Dermatol 2024 Mar 27;[EPub Ahead of Print], KC Lauck, A Limmer, P Harris, D KivelevitchFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.
The specter of sexual dysfunction continues to cloud the prescribing of 5-alpha reductase inhibitors (5-ARIs) for androgenetic alopecia in men. I know many colleagues who have eagerly turned to low-dose oral minoxidil just to avoid having those counseling discussions around 5-ARIs! However, 5-ARIs provide targeted and effective reversal of hair miniaturization in patients with androgenetic alopecia, which warrants a continued presence in the therapeutic armamentarium. Additionally, these medications are now relatively inexpensive and can be used in combination with other treatments.
It is important to keep in mind that sexual dysfunction is a complex disorder and that many health-related factors can contribute to the condition. In this study, a large data set involving approximately 23,000 patients was evaluated. An initial association between sexual dysfunction and 5-ARIs disappeared when the authors factored in other comorbidities, including obesity, nicotine dependence, diabetes mellitus, hypertension, and mood and anxiety disorders. A good practice would be to review a checklist of these potential contributors to sexual dysfunction and then use shared decision–making before proceeding with a prescription.