TLDR The conclusion is that individualized treatment and proper medication use are crucial in men's health, with specific recommendations for ED, BPH, and prostate cancer management.
The document "Clinical Pearls in Men's Health" from 2010 highlights several cases to emphasize the importance of proper medication use and individualized treatment in men's health issues. It discusses the correct administration of sildenafil for erectile dysfunction (ED), the interaction between tamsulosin for benign prostatic hyperplasia (BPH) and cataract surgery, the link between mood disorders and ED, and the limited effectiveness of finasteride for hair regrowth in men with mild BPH symptoms. Additionally, it addresses concerns about finasteride and prostate cancer, noting that despite the Prostate Cancer Prevention Trial's findings, finasteride is still used for BPH treatment, with a recommendation to monitor and adjust PSA levels. A study involving 6,729 men showed a 22.8% reduction in prostate cancer incidence with dutasteride. Watchful waiting is advised for mild BPH symptoms, and weight loss is recommended for ED treatment in obese men. The document also advises against yearly PSA screening for prostate cancer in men over 75 years old, as it does not reduce mortality. The best treatments for the cases presented are exercise stress testing and weight loss for ED, and discontinuing PSA screening for prostate cancer in older men.
2 citations
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February 2006 in “Mayo Clinic Proceedings” Finasteride is beneficial for BPH but requires careful monitoring due to cancer risks.
98 citations
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August 2004 in “BJU international” Medications have become the main treatment for enlarged prostate symptoms, replacing surgery and watchful waiting.
1707 citations
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December 2003 in “The New England Journal of Medicine” Combination therapy of doxazosin and finasteride safely and effectively reduces benign prostatic hyperplasia progression risk.
1040 citations
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October 1992 in “The New England Journal of Medicine” Finasteride effectively treats BPH but may increase sexual dysfunction risk.
15 citations
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December 2006 in “Clinical interventions in aging” 5 alpha-reductase inhibitors like finasteride may lower prostate cancer risk and improve cancer screening.
November 2020 in “Elsevier eBooks” Antiandrogens and androgen inhibitors like spironolactone, finasteride, and dutasteride can treat hair loss and skin conditions, but they have risks and side effects, including potential harm to pregnant women and risks of cancer and heart issues. Herbal remedies also have antiandrogenic effects but lack safety validation.
43 citations
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August 2016 in “Scientific Reports” Cinnamomi cortex may help treat prostate enlargement by reducing related proteins.
2 citations
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December 2021 in “International Journal of Andrology” Most legal cases about 5α-reductase inhibitors, drugs for hair loss and prostate issues, complain about side effects and delayed cancer diagnosis, with most lawsuits settled out of court.
15 citations
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July 2016 in “Urologic Clinics of North America” Finasteride and dutasteride are effective for long-term treatment of enlarged prostates but have sexual side effects and a risk of high-grade prostate cancer.
45 citations
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January 2008 in “Drugs” Dutasteride effectively treats enlarged prostate, reduces prostate cancer risk, and promotes hair regrowth with few side effects.
