Successes and Failures of Evidence-Based Urology

DHT is important for sexual function and mood, but finasteride and dutasteride can reduce DHT, causing side effects like reduced libido and erectile dysfunction. These treatments are effective for hair loss, but their impact on DHT leads to debate.

Dutasteride takes 1-3 months to affect scalp DHT levels, not just a week. The prostate absorbs Dutasteride faster than the scalp due to different vascular networks and enzyme densities.

Finasteride is used for hair loss, with mixed reports of no side effects and claims of long-term negative effects known as Post Finasteride Syndrome (PFS). The conversation debates the existence and causes of PFS, with differing opinions on whether it is psychological or real.

Topical Finasteride doesn't directly reduce 5ar enzyme on scalp and has the same mechanism as oral, needing to go through the liver. Users debate the accuracy of this information and discuss various studies and experiences.

Switching from oral to topical dutasteride may reduce side effects like anxiety and depression while maintaining hair health. Combining it with minoxidil, Nizoral, and dermarolling could be effective for hair preservation.

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.