Q: I have been taking dutasteride (Avodart) for almost 10 years. My PSA has stabilized between 3.25 and 3.75. This medication has affected my ability to maintain an erection long enough to engage in intercourse. It has also reduced my penis size somewhat.
What I am more concerned about than the sexual aspect, however, is the long-term effect on my overall health. Are there any consequences I should be watching for? My doctor does not seem to have any information on this.
Answer: Dutasteride and a related drug, finasteride (Proscar), are approved for the treatment of an enlarged prostate gland (benign prostate hypertrophy, or BPH). They work by blocking the enzyme that converts testosterone to dihydrotestosterone. DHT is largely responsible for prostate enlargement and male pattern baldness.
A review of adverse events reported to the Food and Drug Administration noted several side effects of these drugs. These included reduced libido, erectile dysfunction, orgasmic disorders, breast enlargement, fatigue, muscle weakness, fuzzy thinking and hearing loss (Urology, October 2018).
A study published in The BMJ (April 10, 2019) reported that men taking either dutasteride or finasteride were slightly more likely to develop Type 2 diabetes. Dutasteride increases insulin resistance.
Q: I take a statin for high cholesterol. Over the years, I have developed neuropathy. I suspect the statins caused this problem. Is there any research that links neuropathy to statin use? I’d be grateful for whatever you can send me.
Answer: Nerve damage leading to pain (neuropathy) is controversial as a statin side effect. A review of less-recognized adverse effects of these cholesterol-lowering drugs notes that peripheral neuropathy has been reported (American Journal of Cardiovascular Drugs, 2008). The authors cite the Australian Adverse Drug Reaction Bulletin: “Statin-associated peripheral neuropathy may persist for months or years after withdrawal of the statin....”
We are sending you our Guide to Cholesterol Control and Heart Health, with a discussion of the pros and cons of statins as well as other approaches for promoting cardiovascular health. Anyone who would like a copy, please send $3 in check or money order with a long (No. 10), stamped (70 cents), self-addressed envelope to: Graedons’ People’s Pharmacy, No. C-8, P.O. Box 52027, Durham, NC 27717-2027. It also can be downloaded for $2 from our website: www.peoplespharmacy.com.
King Features Syndicate