Women Also Use 5α-Reductase Inhibitors—Reply

Elevated bile acids can inhibit the enzyme AKR1C2, leading to increased DHT levels, which may accelerate hair loss in those predisposed to androgenetic alopecia. Treatments mentioned include topical minoxidil and finasteride.

The conversation concludes that finasteride, a 5α-Reductase inhibitor used for hair loss, does not impair cognition either short-term or long-term. It suggests "brain fog" is not caused by the medication.

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.

A 19-year-old with rapid hair loss since 16 is considering a hair transplant but refuses to take finasteride or any 5α-Reductase inhibitors. They are currently using minoxidil, tretinoin, and microneedling with a Derminator 2, and only want hair until age 27.

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.

A user who has tried multiple treatments for hair loss, including oral and topical finasteride and liposomal finasteride, but experienced severe side effects in each case; the user is considering trying RU58841 or aromatise inhibitors as alternatives.