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Original Abstract of the Article

Major Research Findings

Dutasteride, a dual 5α-reductase inhibitor, is an effective treatment for benign prostatic hyperplasia (BPH). Unlike finasteride, dutasteride inhibits both isoenzymes of 5α-reductase, resulting in almost complete suppression of serum dihydrotestosterone (DHT). 6

Dutasteride has been shown to be effective in relieving BPH symptoms, improving quality of life, increasing peak urinary flow rate, and reducing the incidence of acute urinary retention and the need for surgery in 2-year randomized placebo-controlled trials. 6

Similar to finasteride, dutasteride reduces serum prostate-specific antigen (PSA) levels by about 50% at 6 months and total prostate volume by 25% after 2 years. 6

Dutasteride may have chemopreventive effects against prostate cancer, and its role is being confirmed in the ongoing REDUCE trial. 22

Reasons for Side Effects

Dutasteride significantly lowers DHT levels in the blood because it inhibits both isoenzymes of 5α-reductase. DHT plays an important role in male sexual function, especially libido and erectile function, so taking dutasteride can lead to sexual dysfunction. 6

Common Side Effects

Sexual Dysfunction

Common side effects of dutasteride include decreased libido, erectile dysfunction, and ejaculation disorders. 6 These side effects often appear within a few months of taking dutasteride and can worsen with long-term use. 1 Decreased libido has been reported in about 10% of patients taking dutasteride. 16 Erectile dysfunction has been reported in about 15% of patients taking dutasteride. 16 The incidence of sexual dysfunction does not seem to increase with use of dutasteride for over 4 years. 6

Gynecomastia

Taking dutasteride may cause gynecomastia. 6 Gynecomastia often appears within a few months of taking dutasteride and can worsen with long-term use. 1

Depression

Dutasteride may increase the risk of depression. 1 The exact mechanism by which dutasteride causes depression is unknown, but it may be related to changes in the hormone balance in the brain. 20

Hair Loss

Although dutasteride is a medication used to treat hair loss, it can paradoxically cause hair loss when administered through mesotherapy, which involves injections into the scalp. 12 Mesotherapy aims to suppress hair loss more effectively by directly injecting dutasteride into the scalp, but it can also cause side effects such as hair loss. 12

High-grade Prostate Cancer

Taking dutasteride may increase the risk of high-grade prostate cancer. 1 The exact mechanism by which dutasteride causes prostate cancer is unknown, but it may promote the growth of prostate cancer cells. 1 Dutasteride may reduce the incidence of prostate cancer but also suggests an increased risk of high-grade prostate cancer. 1 Compared to finasteride, dutasteride inhibits both types 1 and 2 of 5α-reductase, so it is thought to have a stronger effect on reducing the incidence of prostate cancer. 1 However, dutasteride is also suggested to have a higher risk of high-grade prostate cancer than finasteride. 1

Side Effect Countermeasures

Sexual Dysfunction

If sexual dysfunction occurs, you may need to stop taking dutasteride or reduce your dosage. 1 You can also take sexual function enhancers under the guidance of your doctor. 25 Combining 5α-reductase inhibitors and phosphodiesterase type 5 inhibitors (PDE5I) is expected to suppress the androgenic sexual side effects of 5α-reductase inhibitors and simultaneously achieve synergistic effects on LUTS. 25

Gynecomastia

If gynecomastia occurs, you should stop taking dutasteride. 1 You may also receive hormone therapy under the guidance of your doctor. 1

Depression

If depression occurs, you need to take antidepressants under the guidance of your doctor. 1 Counseling can also be helpful. 1

Hair Loss

If hair loss occurs due to mesotherapy, you should stop the mesotherapy treatment. 12 You also need to receive appropriate treatment under the guidance of your doctor. 12

High-grade Prostate Cancer

Because taking dutasteride may increase the risk of high-grade prostate cancer, you should get regular PSA tests. 1 PSA tests help detect prostate cancer early. 1

Comparison Across Studies

Commonalities Among Studies

Most studies have reported that taking dutasteride can cause sexual dysfunction, such as decreased libido, erectile dysfunction, and ejaculation disorders. 2 Some studies also suggest that taking dutasteride can cause side effects such as gynecomastia and depression. 1

Differences Among Studies

Some studies suggest that taking dutasteride may increase the risk of high-grade prostate cancer, while other studies have not observed such a trend. 1 There are also several reports that taking dutasteride can cause hair loss, but this side effect is relatively rare. 12

Things to Note Regarding Application to Real Life

Dutasteride is an effective medication for treating BPH, but it can cause side effects such as sexual dysfunction, gynecomastia, and depression. 2 It is important to consult with your doctor before taking dutasteride and understand the risks of side effects. 2 You should also undergo regular checkups with your doctor while taking dutasteride. 2 Especially, if you experience symptoms such as sexual dysfunction or gynecomastia, consult your doctor immediately. 2

Limitations of Current Research

Research on the side effects of dutasteride is still insufficient. 2 In particular, there are many unknowns about the side effects of dutasteride with long-term use. 2 Also, many studies on the side effects of dutasteride are small, and it is important to be cautious about generalizing their results. 2

Future Research Directions

More detailed research is needed on the side effects of dutasteride with long-term use. 2 Furthermore, research on the side effects of dutasteride needs to be conducted on a larger scale. 2

Conclusion

Dutasteride is an effective medication for treating BPH, but it can cause side effects such as sexual dysfunction, gynecomastia, and depression. 2 It is important to consult with your doctor before taking dutasteride and understand the risks of side effects. 2 You should also undergo regular checkups with your doctor while taking dutasteride. 2


Keywords
Benefit Keywords
Risk Keywords
Literature analysis of 27 papers
Positive Content
18
Neutral Content
3
Negative Content
6
Article Type
2
2
2
16
26

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