Said Mohammed A, Mehta Akanksha
Department of Urology, Emory University School of Medicine, Atlanta, GA, USA.
Curr Urol Rep. 2018 Jun 16;19(8):65. doi: 10.1007/s11934-018-0814-z.
Male pattern hair loss, mediated by dihydrotestosterone, is a common hair loss disorder, affecting over 50% of men over the age of 50. The 5-α reductase inhibitors, finasteride and dutasteride, are Food and Drug Administration-approved drugs for the treatment of this disorder. Several recent studies have reported adverse sexual and spermatogenic events among young men using 5-α reductase inhibitors, such as erectile dysfunction, decreased ejaculate volume, decreased libido, and infertility. In this review, we summarize and analyze the literature regarding the efficacy and safety of these medications, with an overall focus on men's health.
Finasteride for the treatment of male pattern hair loss was considered safe according to many previous clinical trials. However, these trials have been recently criticized for inadequate safety reporting. Comprehensive review of the current literature reveals that there is a disproportionately high number of men with 5-α reductase inhibitor-associated sexual dysfunction and infertility. Although uncommon, the use of 5-α reductase inhibitors is associated with serious and persistent sexual and reproductive side effects, such as erectile dysfunction, decreased ejaculate volume, decreased libido, and infertility.
由二氢睾酮介导的男性型脱发是一种常见的脱发疾病，影响超过50%的50岁以上男性。5-α还原酶抑制剂非那雄胺和度他雄胺是美国食品药品监督管理局批准用于治疗该疾病的药物。最近的几项研究报告了使用5-α还原酶抑制剂的年轻男性出现不良性和生精事件，如勃起功能障碍、射精量减少、性欲减退和不育。在本综述中，我们总结并分析了关于这些药物疗效和安全性的文献，总体关注男性健康。
根据许多先前的临床试验，非那雄胺治疗男性型脱发被认为是安全的。然而，这些试验最近因安全性报告不足而受到批评。对当前文献的全面综述显示，与5-α还原酶抑制剂相关的性功能障碍和不育的男性数量异常之高。虽然不常见，但使用5-α还原酶抑制剂与严重且持续的性和生殖副作用有关，如勃起功能障碍、射精量减少、性欲减退和不育。
