Faculty Opinions Recommendation of Androgenetic Alopecia as an Early Marker of Benign Prostatic Hyperplasia

    April 2012 in “ Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ”
    Gerhard Haidl
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    TLDR Early hair loss in men could be a sign of non-cancerous prostate enlargement, and treating hair loss early might help prevent prostate issues later.
    In 2012, Arias-Santiago et al. conducted an observational case-control study on 87 men, 45 of whom had early onset androgenetic alopecia (AGA) and 42 were control subjects. The study found that patients with AGA had significantly higher mean prostate volume, international prostate symptom score, and prostatic-specific antigen value, as well as significantly lower maximum urinary flow compared to control subjects. No significant difference was found in total testosterone, estradiol, luteinizing hormone (LH), follicle-stimulating hormone (FSH), and prolactin, but free testosterone levels were higher in the alopecia group. The study suggested that AGA could be an early marker of benign prostatic hyperplasia (BPH), both of which are androgen-dependent diseases. The authors proposed the idea of treating early onset alopecia with 5-alpha blockers like finasteride, which could potentially prevent later prostatic disease. However, they also noted the need for future studies to confirm these results and to consider potential effects of finasteride on fertility.
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