The effects of chronic 5-alpha-reductase inhibitor (dutasteride) treatment on rat erectile function
Abstract
Introduction: Numerous clinical series have reported an association between 5-alpha-reductase inhibitors (5ARIs) and sexual dysfunction, but there are limited preclinical data available. Aim: To further investigate the mechanisms of erectile dysfunction (ED) related to 5ARI therapy using a rat model. Main Outcome Measures: Outcome measures include serum dihydrotestosterone (DHT), relaxant and contractile properties of cavernosal muscle, and nitric oxide synthase expression. Methods: Twenty adult male Sprague-Dawley rats were randomized into control (N = 10) and dutasteride (0.5 mg/rat/day, in drinking water, N = 10) groups. Serum samples were obtained at baseline, from which DHT was measured after 30 days of treatment via radioimmunoassay (Beckman Coulter, Fullerton, CA, USA). Before the terminal blood draw, erectile response was measured using cavernosal nerve stimulation. The relaxant and contractile properties of cavernosal muscle strips were evaluated in tissue baths, and immunohistochemical (IHC) staining for nitric oxide synthase (NOS) and collagen deposition was performed. Results: Mean serum DHT was suppressed by 86.5% (range 64.2–94.8%) after 30 days of 5ARI treatment and was statistically significant (P = 0.0024). In vivo erectile response in the dutasteride treated group decreased significantly compared with control (P < 0.001). While electrical field stimulation (EFS)-induced and acetylcholine-induced relaxation was decreased, EFS-induced and phenlyephrine-induced adrenergic contraction was significantly enhanced in the dutasteride group (P < 0.01). IHC studies demonstrated increased collagen deposition in the treatment arm as well as altered expression of neuronal NOS (nNOS) and inducible NOS (iNOS). Conclusions: The 5ARIs, as demonstrated in these rat cavernosal smooth muscle studies, have a detrimental effect on erectile function. Enhanced iNOS expression may protect penile smooth muscle from fibrosis. The effect of 5ARIs on human sexual function warrants further investigation.
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Testosterone and dihydrotestosterone likely have differential roles and expression in various tissues, including prostate, skin, penis, and testicles.
“T and DHT also likely have differential roles and expression in various tissues, including in the prostate, skin, penis, and testicles, among others.”
From Challenges in Testosterone Measurement, Data Interpretation, and Methodological Appraisal of Interventional Trials (2016) · cites this paper as [27]
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- Authors
- Pinsky, M. R., Gur, S., Tracey, A. J., Harbin, A., & Hellstrom, W. J. G.
- Affiliations
- Tulane University (US)
- Department of Urology, Tulane Health Sciences Center , New Orleans, LA , USA
- Corresponding author
- Hellstrom, Wayne J.G.
- Venue
- The Journal of Sexual Medicine
- Publisher
- Oxford University Press (OUP)
- Published
- 2011-11-01
- Volume
- 8
- Issue
- 11
- Pages
- 3066-3074
- ISSN
- 1743-6095 (ISSN-L)
- 1743-6109
- OpenAlex
- W1542310964
- Cited by
- 69
- References
- 21
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 2 · 2023: 5 · 2022: 4 · 2021: 6 · 2020: 6 · 2019: 5 · 2018: 3 · 2017: 3 · 2016: 6 · 2015: 5 · 2014: 4 · 2013: 5 · 2012: 9
- FWCI
- 3.94
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
- Locations
- The Journal of Sexual Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Sexual Medicine Society of North America
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Sexual function and dysfunction studies
- Health Sciences › Medicine › Urology › Urinary Bladder and Prostate Research
- Health Sciences › Medicine › Urology › Urological Disorders and Treatments
- Keywords
- dutasteride, 5-alpha reductase inhibitors, erectile dysfunction, dihydrotestosterone, corpus cavernosum smooth muscle, nitric oxide synthase, inducible nitric oxide synthase, neuronal nitric oxide synthase, collagen deposition, penile fibrosis, sexual dysfunction, rat model
- MeSH terms
- Dutasteride, Animals, Azasteroids, Isometric Contraction, Male, Muscle, Smooth, Vascular, Penile Erection, Penis, Rats, Sprague-Dawley, Rats, Nitric Oxide Synthase Type II, Nitric Oxide Synthase Type I, 5-alpha Reductase Inhibitors
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