Abstract
This is a critical review of the current literature data about sexual dysfunction as a potential side effect related to drugs commonly used for the treatment of Benign Prostatic Hyperplasia and Lower Urinary Tract Symptoms. In this narrative review, we analyzed data from the literature related to the development of sexual dysfunctions during the treatment of BPH or LUTS. Both α-blockers and 5-alpha reductase inhibitors (5-ARIs) can induce erectile dysfunction, ejaculatory disorders and a reduction in sexual desire. The sexual side effect profile of these drugs is different. Among the α-blockers, silodosin appears to have the highest incidence of ejaculatory disorders. Persistent sexual side effects after the discontinuation of finasteride have been recently reported; however, further studies are needed to clarify the true incidence and the significance of this finding. However, most of the published studies are affected by a weak methodology and other important limitations, with only a few RCTs available. Therefore, it is desirable that future studies will include validated tools to assess and diagnose the sexual dysfunction induced by these medications, especially for ejaculation and sexual desire disorders.
Highlights
Papers were deemed eligible if they included any form of the following words: “sexual dysfunction”, “drugs”, “carotid atherosclerosis”, “α-blocker”, “5-alpha reductase inhibitors”, “phosphodiesterase type 5 inhibitors”, Benign Prostatic Hyperplasia (BPH), Lower Urinary Tract Symptoms (LUTS)
For similar reasons, Erdemir et al [71] reported high rates of sexual dysfunction with 5-alpha reductase inhibitors (5-ARIs); they conclude that the rate of erectile dysfunction in clinical trials with 5-ARIs ranges from 5 to 9%
Similar conclusions were reached by Ponholzer et al [39]: “5α-reductase inhibitors are associated with erectile dysfunction (ED), loss of libido and decreased ejaculate volume by up to 10%”
Summary
Α-blockers and 5-alpha reductase inhibitors (5-ARIs) can induce erectile dysfunction and ejaculatory disorders [5,9,13,14,15,16,17,18,19], despite these drugs being used to treat Benign Prostatic Hyperplasia (BPH) and Lower Urinary Tract Symptoms (LUTS) or LUTS.
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