The 5-α reductase inhibitors finasteride and dutasteride are widely used for the treatment of benign prostatic hyperplasia. While prostatic hyperplasia is an independent risk factor for erectile dysfunction, some studies have suggested that 5-α reductase inhibitors may also affect erectile functionality. This study aims to investigate the risk of erectile dysfunction associated with the use of 5-α reductase inhibitors.

This collection of cohort studies with nested case-control analyses included two populations of men free for risk factors of erectile dysfunction and other sexual dysfunction. The included participants had confirmed benign prostatic hyperplasia and were assigned to one of the following cohorts: α reductase inhibitors only, 5-α reductase inhibitors+α blockers or α blockers only. The primary outcome of the study was a diagnosis of erectile dysfunction.

The findings suggested that the risk of erectile dysfunction was not associated with the use of 5-α reductase inhibitors only (IR 0.92) or 5-α reductase inhibitors+α blocker (1.09). The risk of erectile dysfunction was proportional to the duration of benign prostatic hyperplasia, irrespective of the exposure.

The research concluded that in patients with benign prostatic hyperplasia, the exposure to 5-α reductase inhibitors was not associated with an increased risk of incident erectile dysfunction.