Beliefs and counseling practices among dermatologists regarding sexual and other adverse effects of finasteride.


Journal

International journal of impotence research
ISSN: 1476-5489
Titre abrégé: Int J Impot Res
Pays: England
ID NLM: 9007383

Informations de publication

Date de publication:
04 Aug 2023
Historique:
received: 23 07 2023
accepted: 27 07 2023
revised: 25 07 2023
medline: 5 8 2023
pubmed: 5 8 2023
entrez: 4 8 2023
Statut: aheadofprint

Résumé

Finasteride may cause low libido and erectile dysfunction and the product label of finasteride also includes post-marketing reactions of sexual dysfunction that continued after discontinuation of treatment, as well as male infertility and depression. The aim of this study was to evaluate the beliefs and counseling practices among dermatologists regarding adverse effects of finasteride. Anonymous paper surveys were personally distributed to 122 attendees at two annual major dermatology meetings. The participation rate was 82% with 47% women and 77% residents of the United States. 51% of respondents believed that finasteride could cause sexual side effects and 18% believed that it could cause persistent sexual side effects. Fewer than a quarter believed that finasteride could cause depression or lower sperm counts. When initiating finasteride, 69% of respondents counseled at least half of their patients about potential sexual side effects with 52% for persistent sexual side effects and 30% for depression. This study identifies the need for greater awareness of the potential adverse effects of finasteride and identifies opportunities for improvement in counseling practices that reflect finasteride's product labeling.

Identifiants

pubmed: 37542152
doi: 10.1038/s41443-023-00750-0
pii: 10.1038/s41443-023-00750-0
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2023. The Author(s), under exclusive licence to Springer Nature Limited.

Références

Lee S, Lee YB, Choe SJ, Lee WS. Adverse sexual effects of treatment with finasteride or dutasteride for male androgenetic alopecia: a systematic review and meta-analysis. Acta Derm Venereol. 2019;99:12–17.
pubmed: 30206635
Irwig MS, Kolukula S. Persistent sexual side effects of finasteride for male pattern hair loss. J Sex Med. 2011;8:1747–53.
doi: 10.1111/j.1743-6109.2011.02255.x pubmed: 21418145
Cecchin E, De Mattia E, Mazzon G, Cauci S, Trombetta C, Toffoli G. A pharmacogenetic survey of androgen receptor (CAG)n and (GGN)n polymorphisms in patients experiencing long term side effects after finasteride discontinuation. Int J Biol Markers. 2014;29:e310–6.
doi: 10.5301/jbm.5000095 pubmed: 24855036
Ganzer CA, Jacobs AR, Iqbal F. Persistent sexual, emotional, and cognitive impairment post-finasteride: a survey of men reporting symptoms. Am J Mens Health. 2015;9:222–8.
doi: 10.1177/1557988314538445 pubmed: 24928450
Unger JM, Till C, Thompson IM, Tangen CM, Goodman PJ, Wright JD. et al. Long-term consequences of finasteride vs placebo in the prostate cancer prevention trial. J Natl Cancer Inst. 2016;108:djw168. https://doi.org/10.1093/jnci/djw168 .
doi: 10.1093/jnci/djw168 pubmed: 27565902 pmcid: 5241895
Welk B, McArthur E, Ordon M, Anderson KK, Hayward J, Dixon S. Association of suicidality and depression with 5alpha-reductase inhibitors. JAMA Intern Med. 2017;177:683–91.
doi: 10.1001/jamainternmed.2017.0089 pubmed: 28319231 pmcid: 5818776
Irwig MS. Depressive symptoms and suicidal thoughts among former users of finasteride with persistent sexual side effects. J Clin Psychiatry. 2012;73:1220–3.
doi: 10.4088/JCP.12m07887 pubmed: 22939118
Uzunova V, Sheline Y, Davis JM, Rasmusson A, Uzunov DP, Costa E, et al. Increase in the cerebrospinal fluid content of neurosteroids in patients with unipolar major depression who are receiving fluoxetine or fluvoxamine. Proc Natl Acad Sci USA. 1998;95:3239–44.
doi: 10.1073/pnas.95.6.3239 pubmed: 9501247 pmcid: 19726
Romeo E, Ströhle A, Spalletta G, di Michele F, Hermann B, Holsboer F, et al. Effects of antidepressant treatment on neuroactive steroids in major depression. Am J Psychiatry. 1998;155:910–3.
doi: 10.1176/ajp.155.7.910 pubmed: 9659856
Frye CA, Walf AA. Hippocampal 3alpha,5alpha-THP may alter depressive behavior of pregnant and lactating rats. Pharmacol Biochem Behav. 2004;78:531–40.
doi: 10.1016/j.pbb.2004.03.024 pubmed: 15251262
Frye CA, Walf AA. Changes in progesterone metabolites in the hippocampus can modulate open field and forced swim test behavior of proestrous rats. Horm Behav. 2002;41:306–15.
doi: 10.1006/hbeh.2002.1763 pubmed: 11971664
Surendran P, Stewart ID, Au Yeung VPW, Pietzner M, Raffler J, Wörheide MA, et al. Rare and common genetic determinants of metabolic individuality and their effects on human health. Nat Med. 2022;28:2321–32.
doi: 10.1038/s41591-022-02046-0 pubmed: 36357675 pmcid: 9671801
Amory JK, Wang C, Swerdloff RS, Anawalt BD, Matsumoto AM, Bremner WJ, et al. The effect of 5alpha-reductase inhibition with dutasteride and finasteride on semen parameters and serum hormones in healthy men. J Clin Endocrinol Metab. 2007;92:1659–65.
doi: 10.1210/jc.2006-2203 pubmed: 17299062
Samplaski MK, Lo K, Grober E, Jarvi K. Finasteride use in the male infertility population: effects on semen and hormone parameters. Fertil Steril. 2013;100:1542–6.
doi: 10.1016/j.fertnstert.2013.07.2000 pubmed: 24012200
Tu HY, Zini A. Finasteride-induced secondary infertility associated with sperm DNA damage. Fertil Steril. 2011;95:e13–4.
doi: 10.1016/j.fertnstert.2010.12.061
Elzanaty S, Giwercman YL, Giwercman A. Significant impact of 5alpha-reductase type 2 polymorphisms on sperm concentration and motility. Int J Androl. 2006;29:414–20.
doi: 10.1111/j.1365-2605.2005.00625.x pubmed: 16487406
Birch MR, Dissing S, Skakkebæk NE, Rehfeld A. Finasteride interferes with prostaglandin-induced CatSper signalling in human sperm. Reproduction. 2021;161:561–72.
doi: 10.1530/REP-20-0287 pubmed: 33729179
Yim E, Nole KL, Tosti A. 5α-Reductase inhibitors in androgenetic alopecia. Curr Opin Endocrinol Diabetes Obes. 2014;21:493–8.
doi: 10.1097/MED.0000000000000112 pubmed: 25268732
Trüeb RM, Régnier A, Dutra Rezende H, Gavazzoni Dias MFR. Post-finasteride syndrome: an induced delusional disorder with the potential of a mass psychogenic illness? Skin Appendage Disord. 2019;5:320–6.
doi: 10.1159/000497362 pubmed: 31559258 pmcid: 6751456
Belknap SM, Aslam I, Kiguradze T, Temps WH, Yarnold PR, Cashy J, et al. Adverse event reporting in clinical trials of finasteride for androgenic alopecia: a meta-analysis. JAMA Dermatol. 2015;151:600–6.
doi: 10.1001/jamadermatol.2015.36 pubmed: 25830296
Ho RS. Ongoing concerns regarding finasteride for the treatment of male-pattern androgenetic alopecia. JAMA Dermatol. 2021;157:25–26.
doi: 10.1001/jamadermatol.2020.3384 pubmed: 33175098
Mondaini N, Gontero P, Giubilei G, Lombardi G, Cai T, Gavazzi A, et al. Finasteride 5 mg and sexual side effects: how many of these are related to a nocebo phenomenon? J Sex Med. 2007;4:1708–12.
doi: 10.1111/j.1743-6109.2007.00563.x pubmed: 17655657
Traish AM. Post-finasteride syndrome: a surmountable challenge for clinicians. Fertil Steril. 2020;113:21–50.
doi: 10.1016/j.fertnstert.2019.11.030 pubmed: 32033719

Auteurs

Michael S Irwig (MS)

Harvard Medical School, Boston, MA, USA. mirwig@bidmc.harvard.edu.
Division of Endocrinology, Beth Israel Deaconess Medical Center, Boston, MA, USA. mirwig@bidmc.harvard.edu.

Jessika Sanz (J)

Fenway Health, Boston, MA, USA.
New York Institute College of Osteopathic Medicine, Jonesboro, AR, USA.

Deborah Lin (D)

University of Miami Miller School of Medicine, Miami, FL, USA.

Nicholas Tan (N)

Fenway Health, Boston, MA, USA.
Department of Dermatology, Beth Israel Deaconess Medical Center, Boston, MA, USA.

Erica Dommasch (E)

Harvard Medical School, Boston, MA, USA.
Fenway Health, Boston, MA, USA.
Department of Dermatology, Beth Israel Deaconess Medical Center, Boston, MA, USA.

Classifications MeSH