Focus on Finasteride: Efficacy, Mechanisms, and Recommendations for Clinical Use

March 2026 in “ Gazzetta Medica Italiana Archivio per le Scienze Mediche ”

Luca Boeri

finasteride dihydrotestosterone benign prostatic hyperplasia antiangiogenic effects antiproliferative effects α-blockers transurethral resection of the prostate Propecia DHT BPH TURP

Studysummary This analysis concluded that finasteride effectively reduces prostate size and urinary symptoms in benign prostatic hyperplasia, offering a favorable safety profile and versatility as a treatment option.

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research Lower Urinary Tract Symptoms in Men

July 2025 in “JAMA”

This review discusses various treatment options for lower urinary tract symptoms in men, including behavioral, pharmacologic, and surgical interventions, and reports no new clinical results; the authors emphasize first-line therapy with behavioral and pharmacologic approaches.

Comparison of Finasteride and Dutasteride on Risk of Prostate Cancer in Patients with Benign Prostatic Hyperplasia: A Pooled Analysis of 15 Real-World Databases

research Comparison of Finasteride and Dutasteride on Risk of Prostate Cancer in Patients with Benign Prostatic Hyperplasia: A Pooled Analysis of 15 Real-World Databases

2 citations , May 2024 in “The World Journal of Men s Health”

This cohort study using real-world data found no significant difference in the risk of developing prostate cancer between finasteride and dutasteride among patients with benign prostatic hyperplasia, despite previous suggestions that dutasteride might be more effective.

research Pharmacological Approaches in Managing Symptomatic Relief of Benign Prostatic Hyperplasia: A Comprehensive Review

1 citations , December 2023 in “Curēus”

This literature review identified that phosphodiesterase 5 inhibitors, such as Tadalafil, are highly effective in improving lower urinary tract symptoms associated with benign prostatic hyperplasia, while the efficacy of saw palmetto remains inconsistent.

research 5-Alpha Reductase Inhibitors Use in Prostatic Disease and Beyond

March 2023 in “Translational Andrology and Urology”

This review discusses the pharmacology of 5-alpha reductase inhibitors, their expanding clinical indications beyond benign prostatic hyperplasia, and notes unresolved claims about their potential role in SARS-CoV-2.

research Efficacy and Safety of Finasteride Monotherapy in Patients with Benign Prostatic Hyperplasia: A Critical Review of the Literature

14 citations , January 2020 in “Archivio Italiano di Urologia e Andrologia”

This review found that finasteride monotherapy for managing LUTS/BPH significantly reduced prostate volume and improved symptoms, with sexual dysfunctions reported as notable side effects compared to placebo, but emphasizes the need for more comprehensive studies.

research The Long-Term Effect of Doxazosin, Finasteride, and Combination Therapy on the Clinical Progression of Benign Prostatic Hyperplasia

1707 citations , December 2003 in “The New England Journal of Medicine”

Combination therapy of doxazosin and finasteride safely and effectively reduces benign prostatic hyperplasia progression risk.

The Effect of Finasteride on the Expression of Vascular Endothelial Growth Factor and Microvessel Density: A Possible Mechanism for Decreased Prostatic Bleeding in Treated Patients

research The Effect of Finasteride on the Expression of Vascular Endothelial Growth Factor and Microvessel Density: A Possible Mechanism for Decreased Prostatic Bleeding in Treated Patients

90 citations , January 2003 in “The Journal of Urology”

This study found that finasteride significantly reduced VEGF expression and microvessel density in prostatic suburethral tissue, suggesting a mechanism for decreased bleeding in patients with benign prostatic hyperplasia.

research Urinary Retention in Patients with BPH Treated with Finasteride or Placebo Over 4 Years

109 citations , April 2000 in “European Urology”

In this study, significantly fewer men treated with finasteride for moderate to severe BPH symptoms experienced acute urinary retention or required subsequent BPH-related surgery compared to placebo-treated patients.