Total Prostate Volume as Risk Factor for Semen Pathologies in Aging Male

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.

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.

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.

The conversation is about managing allopregnanolone deficiency caused by 5-alpha-reductase inhibitors like finasteride or dutasteride. Specific treatments discussed for hair loss include Minoxidil, finasteride, and RU58841.

Epristeride is a selective 5 alpha reductase type 2 inhibitor that may reduce scalp DHT similarly to finasteride, with potentially fewer side effects. It is suggested that combining epristeride with finasteride or dutasteride could enhance hair loss treatment effectiveness.

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.