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5α-reductase inhibitors are used to treat patients with benign prostatic hyperplasia (BPH) or male pattern baldness (alopecia). However, because 5α-reductase inhibitors lower available 5α-dihydrotestosterone, this class of drugs might cause sexual side effects such as erectile dysfunction (ED).
U.K. researchers performed a case-control analysis to estimate risk for ED in 72,000 men (age, ≥40) with BPH and 12,000 men (age range, 18–59) with alopecia who did not have baseline sexual dysfunction or conditions that might affect sexual function. In the BPH cohort, men received prescriptions for 5α-reductase inhibitors (finasteride or dutasteride) only, α-blockers (e.g., tamsulosin) only, or both drugs; in the alopecia cohort, men received prescri…