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Finasteride sexual side effects men

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Finasteride, a 5-alpha reductase inhibitor, widely used in the medical management of male pattern hairloss, has been reported to cause sexual side effects. This article critically examines the evidence available and makes recommendations as to how a physician should counsel a patient while prescribing the drug.

Some of the commonly faced questions by a physician while treating a patient of pattern hairloss are about the possible sexual side effects caused by finasteride. Reports in the press, internet sites, and misinformation by practitioners "Finasteride sexual side effects men" alternative medicine, all have contributed to this image of the drug, and has lead to apprehension in the minds of patients. Often even dermatologists seem to hesitate to prescribe the drug on a long term basis.

This article examines this subject in the light of evidence available. Pattern hair loss in males is androgenic in etiology. Antiandrogens such as finasteride are therefore useful in the management of the condition. Androgens, especially testosterone increases the libido. Any drug which interferes with the action of androgens is therefore assumed, by the lay person, to induce impotence.

However, the precise role of androgen in penile erection needs to be fully elucidated. In addition to androgens, visual, olfactory, tactile, auditory, and imaginative Finasteride sexual side effects men influence the libido.

The penile erection is mainly under the control of parasympathetic nervous system. Ejaculation and detumescence require an intact sympathetic system. The androgens testosterone and dihydrotestosterone DHT have somewhat different actions. It exists in two isoenzyme forms.

Introduction

While type I is predominant in liver, type II is predominant in prostate, seminal vesicles, epididymes, hair follicles, and liver.

Type I 5AR, is present in the sebaceous gland, while type II 5AR is found on the outer root sheath of the hair follicles and dermal papillae. At all these sites, the testosterone is converted to DHT. Finasteride is a specific and competitive inhibitor of Type II 5—AR, and has therefore a selective action on hair follicles. This explains why relatively small dose of finasteride may Finasteride sexual side effects men adequate therapeutically.

The bioavailability of finasteride is not related to food intake. Finasteride is extensively metabolized in liver by Cytochrome P 3A4 enzyme subfamily and excreted both in urine and feces.

The "Finasteride sexual side effects men" half-life is approximately hours in men between years of age and 8 hours in men more than 70 years of age. A number of studies have looked at the problem of side effects caused by finasteride.

These effects occurred early in the therapy and returned to normal on stopping or over a time on continuous use of the drug. The only causal relation between finasteride and sexual adverse effects is decreased ejaculatory volume because of predominant action of DHT on prostate. A comprehensive review of a total of 73 papers on medical therapies for BPH was conducted, with a focus on the effects of different pharmacological agents on sexual function.

The role of nocebo effect in the causation of ED due to finasteride has been investigated.