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Background: Finasteride is a widely used drug in dermatology for the treatment of androgenetic alopecia. There are many reports of associated sexual side effects. This article reviews the use of once-daily 1 mg fi nasteride in androgenetic alopecia and its associated sexual adverse effects. Methods: A literature search was performed to collect data on the use of fi nasteride in male pattern baldness. Relevant literature published till March 2014 was obtained from MEDLINE, EMBASE, CINAHL, Cochrane registers and LILACS. The keywords “fi nasteride”, “male pattern baldness” and “androgenetic alopecia” were used for literature search. Similarly, a search was done for fi nasteride in female pattern hair loss with keywords “female pattern baldness”, “fi nasteride” and “female pattern alopecia”. All systematic reviews, meta-analyses, national guidelines, randomized controlled trials, prospective open label studies and retrospective case series in the English literature were reviewed. Results: Two hundred sixty two studies were evaluated, twelve of which fulfi lled the inclusion criteria. Conclusions and Recommendations: Current evidence on the safety of fi nasteride indicates that it is safe but there is growing concern about its sexual side effects. In view of this, proper information should be provided to patients prior to starting treatment (Level of recommendation 1+, Grade of recommendation B). The reported sexual side effects are few and reverse with stoppage of the drug (Grade of recommendation B) but further studies are required.
RESUMO
OBJECTIVES: Adverse effects on sexual functions induced by antidepressant medications including selective serotonin reuptake inhibitors(SSRIs) have been reported. The reported incidences of sexual dysfunctions varies with the way of questioning, with relatively low on self reporting and high on direct questioning and symptom questionnaires. The purpose of this study was to evaluate the frequency and nature of sexual dysfunctions during SSRIs treatment in outpatients with depressive disorder and anxiety disorder. METHODS: Seventy seven patients on SSRI therapy(fluoxetine, sertraline, and paroxetine) were enrolled in this study. The six aspects of sexual function were investigated:sexual desire, sexual excitement, sexual pain, orgasm, erection and ejaculation. BDI, S-A, T-A and questionnaires on sexual side effects and on other side effects of SSRIs were measured. The frequency and the severity of sexual dysfunctions were measured. Sexual side effects and other side effects of SSRIs were analyzed in association with the duration and the dose of SSRI treatment and the severity of depression and anxiety. RESULTS: The frequency of sexual dysfunction during SSRI use in our study was 38.96%. Women reported more sexual dysfunction(sexual desire, sexual excitement, orgasm). Also, women's sexual dysfunction was more intense. The most common sexual dysfunction was delayed orgasm(or anorgasmia) in women and ejaculatory difficulty in men. In patients with depressive disorder, the frequency of sexual dysfunctions was higher than in patients with anxiety disorder, which was not statistically significant. CONCLUSIONS: These findings suggest that SSRIs-associated female sexual dysfunction occurs substantially higher and is more severe than expected. It is important to pay attention to female sexual dysfunction during treatment with SSRIs. The sexual problems must be questioned directly for prompt detection of them and promotion of treatment compliance with SSRIs.