Change in sexual function in men with lower urinary tract symptoms/benign prostatic hyperplasia associated with long-term treatment with doxazosin, finasteride and combined therapy

J Urol. 2014 Jun;191(6):1828-34. doi: 10.1016/j.juro.2013.12.014. Epub 2013 Dec 14.


Purpose: We examined the effects of doxazosin, finasteride and combined therapy in men with lower urinary tract symptoms associated with benign prostatic hyperplasia on sexual function, as assessed by the Brief Male Sexual Function Inventory during 4 years.

Materials and methods: The MTOPS (Medical Therapy of Prostatic Symptoms) study was a multicenter, randomized, double-blind, placebo controlled clinical trial with a primary outcome of time to benign prostatic hyperplasia progression. Change in sexual function was a secondary outcome. We analyzed the records of 2,783 men enrolled in the study who completed the inventory at baseline and at least once during followup.

Results: In men enrolled in MTOPS sexual function decreased with time. Men assigned to finasteride and combined therapy experienced overall statistically significant but slight worsening of ejaculatory function compared with men on placebo. Men assigned to combined therapy also experienced significant worsening in erectile function and sexual problem assessment. There was no significant difference in changes in any inventory domain in men assigned to doxazosin alone compared to placebo.

Conclusions: This study significantly extends understanding of the effects of long-term treatment with these drugs on sexual function in men with lower urinary tract symptoms associated with benign prostatic hyperplasia. Treatment with finasteride or combined therapy was associated with worsening sexual function while treatment with doxazosin alone was associated with minimal negative impact, if any. Physicians should discuss with their patients the possible long-term effects of these drugs for lower urinary tract symptoms associated with benign prostatic hyperplasia on sexual function.

Keywords: doxazosin; finasteride; lower urinary tract symptoms; physiological; prostate; sexual dysfunction.

Publication types

  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • 5-alpha Reductase Inhibitors / administration & dosage
  • Adrenergic alpha-1 Receptor Antagonists / administration & dosage
  • Disease Progression
  • Dose-Response Relationship, Drug
  • Double-Blind Method
  • Doxazosin / administration & dosage*
  • Drug Therapy, Combination
  • Finasteride / administration & dosage*
  • Humans
  • Lower Urinary Tract Symptoms / drug therapy*
  • Lower Urinary Tract Symptoms / etiology
  • Lower Urinary Tract Symptoms / physiopathology
  • Male
  • Middle Aged
  • Prostatic Hyperplasia / complications*
  • Prostatic Hyperplasia / drug therapy
  • Prostatic Hyperplasia / physiopathology
  • Sexuality / drug effects*
  • Surveys and Questionnaires
  • Treatment Outcome
  • Urination / drug effects*


  • 5-alpha Reductase Inhibitors
  • Adrenergic alpha-1 Receptor Antagonists
  • Finasteride
  • Doxazosin