Fiansteride

Finasteride is a medication that acts as a 5α-reductase inhibitor, specifically targeting the type II and type III isoenzymes of the enzyme. This enzyme is responsible for converting testosterone into the more potent androgen, dihydrotestosterone (DHT). By inhibiting 5α-reductase, finasteride effectively reduces DHT production in various tissues, including the scalp and prostate gland.

Mechanism of Action:

Finasteride works by blocking the conversion of testosterone to DHT, with its primary effects on the type II and III isoenzymes. This leads to a reduction in serum DHT levels by about 65-70%, and in the prostate, DHT levels decrease by up to 85-90%. However, finasteride does not entirely eliminate DHT production, as it has limited impact on the type I isoenzyme, unlike drugs like dutasteride, which inhibit all three isoenzymes and can reduce total body DHT levels by over 99%.

This decrease in DHT levels is beneficial in several conditions, as DHT is linked to prostate enlargement and hair loss. In the prostate, finasteride helps reduce the size of the gland, improving urinary flow and relieving symptoms of benign prostatic hyperplasia (BPH). In the scalp, the reduction of DHT slows hair loss and can stimulate mild regrowth.

Therapeutic Uses:;

Prostate Enlargement (Benign Prostatic Hyperplasia) Finasteride is commonly prescribed to treat BPH, where it helps reduce prostate size and improve urinary symptoms like reduced flow or difficulty urinating. While symptom relief may take several months, long-term use has been shown to decrease the need for surgery and reduce the risk of acute urinary retention. Stopping the drug typically leads to the return of prostate enlargement within six to eight months.

Hair Loss (Androgenetic Alopecia) Finasteride is FDA-approved for treating male pattern baldness (androgenetic alopecia). It slows hair loss and can improve hair regrowth by around 30% after six months of treatment. However, its effectiveness is maintained only as long as the medication is continued.

Excessive Hair Growth (Hirsutism) Finasteride has proven effective in reducing excessive facial and body hair in women, particularly in cases of hyperandrogenism. Studies show significant reductions in facial and body hair after two years of treatment.

Transgender Transition In hormone replacement therapy for transgender women, finasteride is sometimes used to block the effects of testosterone and reduce male-pattern hair growth, in combination with estrogen therapy.

Doping in Sports Although previously banned by the World Anti-Doping Agency (WADA) due to its potential to mask steroid use, finasteride was removed from the WADA list in 2009. It can be used by athletes to mitigate androgenic side effects from anabolic steroid use, especially when aesthetic outcomes are prioritized.

Effects and Side Effects:

Positive Effects:;;;

Treatment for prostate adenoma and benign prostatic hyperplasia
Hair loss prevention and regrowth in men with androgenetic alopecia
Treatment of excessive hair growth in women
Reduces DHT levels, improving prostate health and reducing risks of prostate cancer
Side Effects:

Reduced libido
Decreased ejaculate volume
Gynecomastia (development of breast tissue in men)
Allergic reactions (skin)