Conclusions: This study showed that long-term 5α-RIs therapy but not tamsulosin in men with BPH is associated with continued worsening of ED, which does not resolve with continuing treatment, contrary to previous claims. Most importantly, it appears that 5α-RIs therapy but not tamsulosin results in a reduction of T levels and increased AMS score as well as AST and ALT in the liver. These findings raise a safety concern regarding 5α-RI therapy for the long-term. Clinicians are urged to discuss the impact of 5α-RIs therapy with their patients before commencing this therapy.
Traish AM, Haider KS, Doros G, Haider A, et al. Finasteride, not tamsulosin, increases the severity of erectile dysfunction and decreases testosterone levels in men with benign prostatic hyperplasia. Horm Mol Biol Clin Investig. 2015 Sep;23(3):85-96. doi: 10.1515/hmbci-2015-0015. [PubMed]