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The Miracle of 5α-Reductase Inhibitors: How to Change the Destiny of the Prostate and Hair?
In recent years, 5α-reductase inhibitors (5-ARIs) have shown amazing potential in treating symptoms such as prostatic hyperplasia and hair loss due to their unique pharmacological mechanisms.
Background on 5α-reductase inhibitors
5alpha-reductase inhibitors are a class of drugs with anti-androgenic effects that are primarily used to help manage health problems related to dihydrotestosterone (DHT). These drugs relieve symptoms by inhibiting the enzyme 5α-reductase, thereby preventing the conversion of testosterone into the stronger form of dihydrotestosterone.
These drugs differ in their effects on a variety of endogenous steroids, with significant effects on the health of both men and women.
Medical purposes
The clinical application scope of 5-ARIs mainly includes:
- Treatment of mild to moderate benign prostatic hyperplasia (BPH) and lower urinary tract symptoms
- Treatment of male and female pattern hair loss (also known as pattern hair loss)
- Helping women treat hirsutism
- In hormonal therapy for transgender women, these drugs can also help reduce body hair and hair loss.
Although 5-ARIs are effective in some aspects, there is much uncertainty about their potential to treat acne.
Available forms
Several common 5-ARIs on the market include:
- Finasteride can reduce DHT levels by about 70%
- Dutasteride reduces DHT levels by up to 95% and reduces DHT levels in the prostate by 97% to 99%.
- Epristeride is sold in China, but it can only reduce DHT by 25% to 54%.
- Alfatradiol is a topical drug specifically used to treat hair loss in the European market.
Side effects
Although 5-ARIs are generally well tolerated, adverse effects cannot be ignored. These include:
- Sexual dysfunction, especially impotence and loss of libido
- Breast changes, including breast pain and gynecomastia (gynecomastia)
- Emotional changes, depression and increased risk of self-harm
Several studies have found that men who use 5-ARIs may be at higher risk of depression and self-harm after long-term use.
Influence on emotional and sexual functions
Studies show that the side effects of 5-ARIs on sexual function account for approximately 3.4% to 15.8%. In some cases, these side effects persist even after the drug is discontinued and may lead to reduced quality of life and strained relationships.
According to a 2017 study, 5-ARIs were significantly associated with the risk of depression and self-harm during the initial 18 months of treatment, but after long-term use, the risk decreased.
Pharmacology and mechanism
The inhibition mechanism of 5α-reductase is complex, mainly involving the metabolic conversion of 5α-reductase and other steroid hormones. DHT, as a potent androgen, promotes prostatic hyperplasia and androgenic alopecia, so the use of 5-ARIs can alleviate these symptoms.
