US Food and Drug Administration Warning Regarding Finasteride and Suicidal Ideation: What Should Urologists Know?

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.

Dutasteride and finasteride may temporarily affect semen quality but are unlikely to cause permanent infertility. The Kim et al. study is criticized for poor methodology, and many prefer hair retention over potential fertility concerns, using treatments like dutasteride, finasteride, and minoxidil.

Finasteride and dutasteride have potential risks, including post-finasteride syndrome, but are commonly used for hair loss. RU58841, minoxidil, and needling are suggested as alternatives, though all treatments carry risks.

Most hair loss treatments are ineffective; only finasteride, dutasteride, and minoxidil show effectiveness.

A 28-year-old male experiencing hair thinning is considering minoxidil and finasteride. Minoxidil helps regrow hair, while finasteride prevents further loss; both are usually lifelong treatments.

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.