The oral enzyme inhibitor Finasteride, is used to decrease hair loss and treat prostate enlargement.
FINASTERIDE is a name of a medication that is commonly used in both dermatology and urology. It is an oral enzyme inhibitor that is used to decrease hair loss and to treat prostate enlargement. Finasteride is called a 5-alpha reductase inhibitor (5-ARI). It inhibits the enzyme that makes DHT out of free- testosterone.
DHT is not a bad hormone, it is only a problem for us if it is too high or too low. DHT is one of the hormones that you need in the right quantity for normal sexuality, normal brain function, normal muscle mass and strength et al, but it is not healthy to have too much which can cause male pattern hair loss, facial hair on women, hair loss at the temples in women, and prostate enlargement and trouble urinating in men.
Because men have a high incidence of hair loss, and prostate enlargement as they age, dermatologists, urologists and family docs start these men on Finasteride/Propecia/Proscar, but don’t think about the side effects or how the drug works. It is sometimes even started for genetic hair loss, which is not successfully treated with Finasteride.
What is the function of 5-alpha reductase inhibitor?
5-alpha reductase is vital to the development of male characteristics such as facial hair, deep voice, muscle growth, prostate enlargement male libido and prevention of ED.
What are finasteride and it’s brother medication, Dutasteride used to treat?
- Male Pattern hair loss (Androgenic alopecia) in men and postmenopausal women
- Benign Prostate enlargement (BPH)
- High DHT causing acne and facial hair in postmenopausal women (off label and only after spironolactone is found to not be enough in women only)
****Women who are of child-bearing age should not take this drug!
What are the names of the two drugs available that are 5-alpha reductase inhibitors?
Finasteride® and Dutasteride®
These medications decrease the amount of circulating DHT by 70-98%. Therefore, when it is used to decrease hair loss and shrink an enlarged prostate, all of the DHT is decreased which results in blocking all the positive actions of DHT such as libido, energy, muscle maintenance,
Penile length, erectile function, and male pattern body hair.
These male characteristics are blunted for the sake of a thick head of hair and to shrink the prostate. It takes a much higher testosterone blood level and free testosterone to maintain male characteristics when on these meds. In some men there is no amount of 5-alpha-reductase inhibitors is safe.
Side Effects of 5-alph-reductase inhibitors:
- Loss Sexual Dysfunction (Overall rate of sexual dysfunction 3.7%)
- Decreased ejaculatory volume-1.5-3.7%
- Ejaculation Disorders-0.2-0.8%
- ED/Impotence 5-8% of the users have this
- 34% decreased sperm count, and 14.5% reduced sperm volume after 26 weeks of use.
- Normalization of seminal quality usually returns after discontinuation of finasteride
- Depression and Suicide
- Breast tissue dysfunction-0.9-2.5% (men)
https://www.accessdata.fda.gov/drugsatfda_docs/label/2010/020180s037lbl.pdf, accessed January 25, 2021
POST FINASTERIDE SYNDROME:
SOMETIMES THE SIDE EFFECTS ARE PERMANENT AND CAN ONLY BE TREATED BY TESTOSTERONE REPLACEMENT OVER TIME….THIS IS A LIFE LONG PROCESS OF REGROWING TESTOSTERONE RECEPTOR SITES.
New Study Links Finasteride to Long-Term Sexual Dysfunction Finasteride users may experience severe sexual side effects for months or years after they discontinue use of the medication.
Kiguradze T, Temps WH, Yarnold PR, Cashy J, Brannigan RE, Nardone B, Micali G, West DP, Belknap SM. Persistent erectile dysfunction in men exposed to the 5α-reductase
Inhibitors, finasteride, or dutasteride. PeerJ. 2017 Mar 9;5:e3020. doi: 10.7717/peerj.3020. PMID: 28289563; PMCID: PMC5346286.
HOW LONG WILL THIS LAST?
***POST FINASTERIDE SYNDROME CAN LAST 3 MONTHS or PERMANENTLY. Replacing testosterone helps recover the DHT receptors and is the only treatment known.
ARE THE SEXUAL SIDE EFFECTS WORTH THICK HAIR? THE SIDE EFFECTS ARE ….
-DECREASED OR NO LIBIDO
-DECREASED SEMEN VOLUME
–LOSS OF AM ERECTIONS
-PEYRONIE’S DISEASE (SCAR TISSUE
–LOSS OF PLEASURABLE ORGASMS
–PENILE SHRINKAGE AND SCROTAL SHRINKAGE AND NUMBNESS
OTHER SIDE EFFECTS OF POST FINASTERIDE SYNDROME:
-NO OIL FROM SCALP—DRY BRITTLE HAIR
APATHY AND CHRONIC FATIGUE
-MUSCLE SHRINKAGE AND WEAKNESS
-DECREASED BODY TEMPERATURE
–PREDIABETES AND HIGH TRIGLYCERIDES= IR
–DECREASED PROBLEM SOLVING
What to expect after stopping? 6 weeks of hair loss but that is not a good reason to restart.
Alternative treatments for hair loss and BPD instead of Propecia, Proscar,
- Topical finasteride-only if it is not absorbed systemically
- Topical Minoxidil
- Oral zinc 30 mg/day
- Saw Palmetto 500-700 mg day
- Pumpkin seed extract
- Stinging nettle 200 mg/day
This Health cast was written and presented by Dr. Kathy Maupin, M.D., Bio-identical Hormone Replacement Expert and Author. www.BioBalanceHealth.com (314) 993-0963.
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