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Mesotherapy: Dutasteride, Minoxidil, Vitamins
Published in Rubina Alves, Ramon Grimalt, Techniques in the Evaluation and Management of Hair Diseases, 2021
David Saceda, Claudia Bernárdez
Some antiandrogens have been proven to be effective in stopping this mechanism and also to revert hair thinning. Peripheral antiandrogens are the most used drugs, especially the inhibitors of 5-alpha-reductase. Oral finasteride, which inhibits type II enzyme, is an FDA approved drug to treat AGA. Oral dutasteride inhibits both types, I and II enzymes, and its use in AGA is out-of-label. The use of both drugs has been related to side effects such as sexual impotence, ejaculation disorders, and decrease of libido. Although evidence-based medicine has not demonstrated a clear correlation between the use of these drugs and those side effects, they are the main concern for many patients and the main cause to refuse them.
Hair transplantation
Published in John Dudley Langdon, Mohan Francis Patel, Robert Andrew Ord, Peter Brennan, Operative Oral and Maxillofacial Surgery, 2017
N Ravindranathan, E Antonio Mangubat
The majority of hair transplant surgeons recommend the use of minoxidil and finasteride after the initial consultation for hair loss. These two medications have a synergistic effect. However, when finasteride is given, patients must be warned that there may be side effects during treatment, such as loss of libido, ejaculation disorders and erectile dysfunction. These effects are reversible and affect 2% of men. It usually takes 3–4 months to see demonstrable effects with minoxidil treatment.
Malignant Neoplasms of the Rectum
Published in Philip H. Gordon, Santhat Nivatvongs, Lee E. Smith, Scott Thorn Barrows, Carla Gunn, Gregory Blew, David Ehlert, Craig Kiefer, Kim Martens, Neoplasms of the Colon, Rectum, and Anus, 2007
Marijnen et al. (449) reported on the heath related quality of life and sexual functioning of 990 patients who underwent TME and were randomly assigned to short-term preoperative radiotherapy (5 × 5 Gy). Patients without a recurrence the first two years were analyzed (n = 990). Daily activities were significantly fewer for preoperative radiotherapy patients three months postoperatively. Irradiated patients recovered slower from defecation problems than TME-only patients. Preoperative radiotherapy had a negative effect on sexual functioning in males and females. Irradiated males had more ejaculation disorders and erectile functioning deteriorated over time. Preoperative radiotherapy had similar effects in patients who underwent a low anterior resection versus an abdominoperineal resection. Patients with an abdominoperineal resection scored better on the physical and psychologic dimension than low anterior resection patients, but worse on voiding.
Persistent sexual dysfunction after SSRI withdrawal: a scoping review and presentation of 86 cases from the Netherlands
Published in Expert Opinion on Drug Safety, 2022
Katherine Chinchilla Alfaro, Florence van Hunsel, Corine Ekhart
Sexual dysfunction (SD) is defined as disorders in sexual desire and/or in the psychophysiological changes associated with the sexual response cycle [1]. The etiology of sexual dysfunction is multifactorial, encompassing biological, psychological, relational, and sociocultural factors. Chronic illnesses, such as vascular disease, diabetes mellitus, neurological disease, and malignancy, can impact sexual function. Aging itself is associated with decreased sexual function. However, similar symptoms can also be caused by different groups of drugs, e.g. anticholinergics, cardiovascular and antihypertensive medications, hormonal preparations, or psychotropics [2,3]. Sexual dysfunction can take many forms, not only erectile dysfunction or low libido but also pain, discomfort and orgasm or ejaculation disorders [4]. Sexual dysfunction is common in both sexes. Studies show that the prevalence is between 10% and 52% in men, versus 25% and 63% in women. The wide spread of these values is due to differences in criteria, methods, and definitions between the studies [2,3,5]. Sexual dysfunction is still a ‘taboo,’ which usually makes people who suffer from it feel ashamed to talk about it with caregivers and family members [4].
Metabolic syndrome is associated worsened erectile function in patients undergoing TURP due to benign prostatic hyperplasia
Published in The Aging Male, 2020
Mustafa Erkoc, Huseyin Besiroglu, Alper Otunctemur, Emre Can Polat, Muammer Bozkurt
Pavone et al. [12] conducted a study on 264 patients who underwent surgery for BPH treatment. The study was conducted in two separate hospitals in Italy between 2008 and 2012 retrospectively. The IIEF-5 form was administered in patients for pre-op and post-op erectile dysfunction evaluation, as well as a questionnaire for retrograde ejaculation. Patients were separated into three groups as an excellent erectile function, mild-medium ED, and complete ED. In the study, contrary to ejaculation disorders, TURP treatment did not have any significant influence on the advancement of erectile dysfunction. The study conducted by Reşorlu et al. [13] in Turkey included 80 patients who were administered transvezical prostatectomy. Patients were evaluated with IIEF-5 form, pre-op, and post-op. Severe hypertension, history of diabetes, and coronary artery disease are observed in patients with post-op erectile dysfunction disease. The similarity of this study and the present study is the small fraction of the participants, especially patients with risk factors, decline in sexual functions is obtained and in some patients, with improved life quality, improvement of sexual functions is observed. However, evaluating the study as a whole, no significant difference in erectile function is observed. The ratio of retrograde ejaculation is calculated 90% [13]. The study to evaluate the effects of TURP treatment on sexual functions conducted by Muntener et al. [14] included 644 patients and also shows supporting results.
Safety concerns when using novel medications to treat alopecia
Published in Expert Opinion on Drug Safety, 2018
Hind M. Almohanna, Marina Perper, Antonella Tosti
A significant placebo effect has been noticed in subjects who were educated of possible sexual adverse events before starting finasteride [117]. In a blinded, controlled study, 107 patients with benign prostatic hyperplasia were randomized to receive finasteride 5 mg daily for 1 year, with one group being informed (n = 55) about the sexual side effects of the treatment and the other group not receiving such education (n = 52). Those subjects that were aware of the possible sexual adverse events of the drug described a significantly higher percentage of sexual dysfunction (43.6%) in comparison to those who were not informed (15.3%). The incidence of erectile dysfunction, decreased libido, and ejaculation disorders was 9.6%, 7.7%, and 5.7% respectively for subjects who were not educated about the sexual side effects. On the other hand, the reported incidence of erectile dysfunction, decreased libido, and ejaculation disorders was 30.9%, 23.6%, and 16.3% respectively for subjects that were informed about the sexual adverse effects [117].