Adverse Effects of 5-Alpha-Reductase Inhibitors: A Narrative Review

The conversation discusses whether to use finasteride for hair loss, considering its role in inhibiting DHT and 5AR, which can affect brain function and mood. Some users report anxiety and depression from finasteride, while others do not experience these side effects and emphasize the importance of DHT for brain and prostate health.

People notice more young individuals experiencing hair loss and discuss possible reasons, such as diet, hormones, and stress. Some treatments mentioned include finasteride, dutasteride, and minoxidil.

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.

The conversation discusses whether finasteride's reduction of DHT and increase in scalp testosterone contribute to hair follicle miniaturization. Some participants argue testosterone does not cause miniaturization, while others suggest that even with reduced DHT, other androgens like testosterone may still contribute to hair loss.

Effective treatments for male pattern baldness include finasteride, dutasteride, and oral minoxidil. Non-effective approaches include oils, shampoos, serums, laser therapies, massages, vitamins, and microneedling.

The conversation discusses topical androgen receptor blockers for hair loss, mentioning Clascoterone, Pyrilutamide, GT20029, and RU58841. Ketoconazole's effectiveness and application methods are also debated.