AB40. Sexual Side Effects of Medical Treatment of BPH

Finasteride and Dutasteride do not cause depression or "Post Finasteride Syndrome," with concerns often linked to the nocebo effect and preexisting mental health issues. The EU is unlikely to ban these drugs, but access may become more restricted due to ongoing debates.

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.

The release of a study on 5a-reductase inhibitors (finasteride and dutasteride) which showed an increased risk of depression, dementia, decreased libido, and reduced semen load as potential side effects; discussion around other forms of hair loss treatments such as topical minoxidil, RU58841, or opting to accept baldness; and advice to consider professional help for deeper issues related to hair loss.

The conversation discusses using very low dose topical finasteride to achieve specific serum DHT reduction percentages. It concludes that finasteride dosage increases linearly between 5-30% DHT reduction but requires exponential increases for reductions up to 70%.

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.

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.