Persistent Sexual Dysfunction and 5 Alpha Reductase Inhibitors

摘要

In your editorial in the Journal of Sexual Medicine (Volume 8, 2011) titled "An old problem with a new cause-5 alpha reduc-tase inhibitors and persistent sexual dysfunction" [1], you suggest an interesting theory to explain the persistent alteration in the sexual desire of some patients treated with these drugs. This theory is based on alteration of neuro-steroids that influence calcium channels centrally as well as other receptors and brain plasticity [1] (defined as "a lifelong ability of the brain to reorganize neural pathways based on new experiences"). Indeed it is an attractive hypothesis, but in my opinion, it is necessary to also involve the architecture of the androgen receptor (AR), and especially the polymorphic CAG polyglutamine (cytosine, adenine and guanine) sequence repeat has been widely studied. The CAG polyglutamine repetition oscillates between 6 and 39 times, with a 19 normal average, conferring the receptor its functional properties [2-5].