Sexual Adverse Effects Uncommon With Finasteride

Laurie Barclay, MD

July 19, 2004

July 19, 2004 — Sexual adverse effects from the use of 1 mg of finasteride for the treatment of alopecia are not common, according to the results of a multicenter study published in the July issue of the Archives of Dermatology.

"Because a systemic treatment for androgenetic alopecia (AGA) is now available, a careful balance between benefits and potential unfavorable consequences is necessary," write Antonella Tosti, MD, from the University of Bologna in Italy, and colleagues. "The main adverse effects related to finasteride therapy for AGA involve the sphere of sexual function (loss of libido, erectile dysfunction, and decreased ejaculate volume)."

At seven institutional dermatology departments in Bologna, Rome, Genoa, Cagliari, Milan, Florence, and Bari, 186 patients with AGA completed an abridged five-item version of the International Index of Erectile Function (IIEF-5) questionnaire regarding the domain of erectile function at baseline and four to six months after beginning treatment with 1 mg of finasteride.

Mean age was 28.3 years (range, 19-43 years). Subjects were followed as outpatients. On each of the five domains of the IIEF-5, there were no significant changes after four to six months of treatment.

"The sexual function of all patients remained stable during treatment with 1 mg of finasteride," the authors write. "Our results support the clinical impression that sexual side effects are actually much less common than reported in clinical trials."

The discrepancy between this result and those obtained in clinical trials may be explained by the fact that subjects enrolled in the clinical trials were informed about possible changes in their sexual function and were specifically asked about such changes at every visit, resulting in a higher percentage of reported adverse events than would otherwise occur.

The authors report no relevant financial interest in this article.

Arch Dermatol. 2004;140:857-858

Reviewed by Gary D. Vogin, MD

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