BH02 Reversibility of 5-alpha reductase inhibitor effects on semen parameters: a review of human evidence

Dutasteride is a stronger 5AR inhibitor than finasteride and can significantly lower DHT levels. Reduced doses of dutasteride may lower side effects.

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.

Dutasteride treatment may decrease sperm concentration, but levels remain above WHO recommendations and recover after discontinuation. The study has limitations, including small sample size and lack of pre-treatment sperm data, and does not assess other fertility factors.

Hair loss treatments, specifically 5AR inhibitors, can impact neurosteroids and sexual health. The effects of topical fin/dut on tissue-specific DHT levels are unclear.

Saw palmetto, a 5-alpha reductase inhibitor, caused unexpected side effects like breast changes and altered semen consistency, which resolved after stopping its use. Concerns about similar side effects with finasteride or dutasteride were expressed, and another user reported low libido and depression from saw palmetto.

Finasteride and dutasteride, used for hair loss, can cause sexual dysfunction, depression, and suicidal thoughts, with some effects persisting after stopping. The post stresses the importance of being aware of these risks.