Synthesis and Evaluation of 2'-Substituted 4-(4'-Carboxy- or 4'-Carboxymethylbenzylidene)-N-Acylpiperidines: Highly Potent and In Vivo Active Steroid 5α-Reductase Type 2 Inhibitors

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.

FCE 28260 (PNU 156765), an under-explored 5α-reductase inhibitor, showcases promising results in research by Giudici et al., outperforming well-known treatments like Finasteride in reducing the conversion of testosterone to DHT. Its superior efficacy, demonstrated through lower IC50 values in both natural and human recombinant enzyme studies, suggests it could offer more effective management of DHT-related conditions. Additionally, its lower molecular weight hints at better potential for topical application, potentially offering advantages in treating conditions such as androgenic alopecia. Despite its potential, it has not advanced in development, possibly due to financial limitations, leaving its therapeutic prospects and side effect profile largely unexplored.

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.

The conversation discusses the use of 5-alpha-reductase inhibitors like finasteride and dutasteride for hair loss in transgender women, particularly in relation to testosterone suppression. The original poster has been using dutasteride and is considering stopping it due to undetectable testosterone levels.

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.

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.