National Taiwan University Hospital, Taipei, Taiwan.
Inha University Hospital, Incheon, South Korea.
J Dermatol. 2018 Jul;45(7):799-804. doi: 10.1111/1346-8138.14329. Epub 2018 Apr 18.
Treatment with 5α-reductase inhibitors has been associated with sexual adverse events such as impotence (erectile dysfunction) and decreased libido. The primary objective of this study was to evaluate adverse events related to sexual function, based on their frequency, duration, persistence and associated treatment discontinuations, in men treated with dutasteride for androgenetic alopecia. Participants were randomized to receive double-blind dutasteride 0.5 mg or placebo once daily for 24 weeks, followed by open-label dutasteride 0.5 mg for an additional 24 weeks. Sexual adverse events were followed up until resolution or for up to 24 weeks after the last dose. Overall, 117 men, 23-50 years of age, were randomized. The incidence of sexual adverse events was approximately twofold higher in the dutasteride group (16%) than the placebo group (8%) during the double-blind period; the overall incidence of sexual adverse events was lower (5%) during the open-label period. All adverse events were mild to moderate in severity and considered treatment-related. The adverse events resolved while on study treatment or after the end of treatment and did not lead to treatment discontinuation. A limitation of this study was the small sample size. The sexual adverse events of impotence, decreased libido and ejaculation disorders reported in this study were expected and reversible.
5α-还原酶抑制剂的治疗与性不良反应相关，如阳痿（勃起功能障碍）和性欲降低。本研究的主要目的是评估接受度他雄胺治疗雄激素性脱发的男性的性功能相关不良事件，根据其频率、持续时间、持续性和相关治疗中断情况进行评估。参与者被随机分配接受每日一次双盲度他雄胺 0.5mg 或安慰剂治疗 24 周，随后再接受 24 周的开放性度他雄胺 0.5mg 治疗。性不良反应的随访时间直到其缓解或最后一次给药后最长 24 周。总体而言，117 名年龄在 23-50 岁的男性被随机分组。在双盲期，度他雄胺组（16%）的性不良反应发生率约为安慰剂组（8%）的两倍；在开放性期，性不良反应的总发生率较低（5%）。所有不良反应的严重程度均为轻度至中度，且被认为与治疗相关。在研究治疗期间或治疗结束后，不良反应得到解决，且未导致治疗中断。本研究的一个局限性是样本量较小。本研究报告的阳痿、性欲降低和射精障碍等性不良反应是预期且可逆转的。
