Review: Adding Alpha-1 Blockers to 5-Alpha-Reductase Inhibitors Improves Lower Urinary Tract Symptoms in Men

The conversation concludes that finasteride, a 5α-Reductase inhibitor used for hair loss, does not impair cognition either short-term or long-term. It suggests "brain fog" is not caused by the medication.

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.

A 19-year-old with rapid hair loss since 16 is considering a hair transplant but refuses to take finasteride or any 5α-Reductase inhibitors. They are currently using minoxidil, tretinoin, and microneedling with a Derminator 2, and only want hair until age 27.

A 15-year-old is concerned about hair loss, possibly at Norwood 2 or 3, and is using shampoos and conditioners recommended by a trichologist. Suggestions include considering topical minoxidil and consulting a doctor about topical anti-DHT treatments like finasteride or RU58841, but avoiding 5-alpha-reductase inhibitors at this age.

The release of a study on 5a-reductase inhibitors (finasteride and dutasteride) which showed an increased risk of depression, dementia, decreased libido, and reduced semen load as potential side effects; discussion around other forms of hair loss treatments such as topical minoxidil, RU58841, or opting to accept baldness; and advice to consider professional help for deeper issues related to hair loss.

Minoxidil 5% topical solution may cause eyesight problems, with some users experiencing blurred vision. The discussion also mentions finasteride's potential side effects, including erectile dysfunction, with varied personal experiences.