Pharmacological Treatment of Benign Prostatic Syndrome with Alpha1-Receptor Blockers: Basics and Clinical Results

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.

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 may affect prostate sensation and size, with some users reporting easier urination. Concerns exist about prostate shrinkage even at lower doses.

Finasteride is effective for treating male pattern baldness (MPB) with minimal side effects, and topical finasteride is similarly effective. Dutasteride is also effective but less understood, and Minoxidil is less effective than Finasteride.

Saw palmetto, a 5-alpha reductase inhibitor, caused unexpected side effects like breast changes and altered semen consistency, which resolved after stopping its use. Concerns about similar side effects with finasteride or dutasteride were expressed, and another user reported low libido and depression from saw palmetto.

Oral DHT blockers like finasteride are preferred for their ease of use, effectiveness, and long-term safety data, while topical treatments like RU58841 lack extensive safety data and can be more cumbersome to apply. Oral treatments are generally considered more effective and convenient despite potential side effects.