Synthesis and Biological Evaluation of 3-Tetrazolo Steroidal Analogs: Novel Class of 5α-Reductase Inhibitors

Topical androgen receptor antagonists may not be necessary if 5-AR inhibitors like finasteride or dutasteride effectively reduce DHT levels. Combining a 5-AR inhibitor with a topical androgen antagonist could potentially enhance treatment, but oral use of androgen antagonists is too risky due to severe side effects.

The conversation discusses the need for a localized 5-alpha reductase inhibitor that only affects the scalp without systemic side effects, similar to pyrilutamide's approach. Current treatments like topical liposomal finasteride and dutasteride are mentioned, but concerns about their systemic effects and lack of research are highlighted.

Androsterone may help with sexual and affective dysfunction from finasteride by replacing disrupted neurosteroids without increasing androgenic side effects. Controlled testing is needed to confirm its effectiveness and safety.

A 30-year-old man experienced significant hair regrowth and improved libido after using finasteride and dutasteride for androgenetic alopecia, with no adverse effects. He plans to reduce dutasteride dosage when trying to conceive and has been using topical minoxidil since 2015.

Natural vitamins like pumpkin seed oil, saw palmetto, and ecklonia cava are discussed for their potential to lower DHT levels. They may work similarly to finasteride but are significantly weaker.

Finasteride and dutasteride are discussed for hair loss, with concerns about their effects on neurosteroids and potential side effects like depression. Alternatives like topical estrogen and lifestyle changes are considered, with varying opinions on mental health and hair regrowth.