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NO from Flaxseed Enhances Sexual Function
Published in Robert Fried, Richard M. Carlton, Flaxseed, 2023
Robert Fried, Richard M. Carlton
Conventional medical treatment for either BPH or pattern baldness, parenthetically; or both, consists mainly of prescription meds that inhibit the action of the enzyme, 5α-reductase (for instance, Dutasteride®). These are however not without some risk of adverse impact on libido and erectile function: in 2012, the Journal of Sexual Medicine reported that Finasteride (Propecia®) has been associated with sexual side effects that may persist despite discontinuation of the medication. In a clinical series, 20% of subjects with male pattern hair loss had persistent sexual dysfunction for more than six years, suggesting the possibility that the dysfunction may be permanent. (1)
Disorders of hair and nails
Published in Ronald Marks, Richard Motley, Common Skin Diseases, 2019
In recent years the drug finasteride has been used to treat androgenetic alopecia in men with good results. Its effect is limited to the specific testosterone receptor which is found only in the hair follicle and prostate gland (the drug was originally developed to treat prostatic hypertrophy). It is well tolerated and side effects are no higher than placebo, however recently a statistically non-significant increase in the incidence of male breast cancer has been reported in men taking the drug. The progress of pattern alopecia in men is halted by castration, but there are few patients who would undergo the operation for this purpose.
Polycystic ovary syndrome and hyperandrogenism in adolescents
Published in Joseph S. Sanfilippo, Eduardo Lara-Torre, Veronica Gomez-Lobo, Sanfilippo's Textbook of Pediatric and Adolescent GynecologySecond Edition, 2019
Andrea E. Bonny, Asma Javed Chattha
Antiandrogens can be used in combination with CHC or metformin to achieve further improvement in cutaneous symptoms. Spironolactone is most commonly used. It functions as an aldosterone antagonist in addition to directly inhibiting 5α-reductase activity, decreasing active androgen concentrations at hair follicles.113 Spironolactone doses are started at 25 mg and adjusted over time while monitoring for hyperkalemia. The highest recommended dose is 200 mg daily. Combination metformin and spironolactone has been found to be superior to either drug alone in improving menstrual irregularity, hirsutism, serum androgen levels, and insulin resistance.116 Finasteride is an antiandrogen that blocks hepatic 5α-reductase, reducing conversion of testosterone to dihydrotestosterone.117 Intermittent low-dose oral finasteride was found to be effective for treatment of hirsutism in adolescent girls with PCOS or idiopathic hirsutism.118 Importantly, both spironolactone and finasteride must be used in combination with effective contraception in sexually active adolescents due to teratogenic potential.
Enhanced skin penetration of Finasteride loaded DMSO-liposomes for the treatment of androgenic alopecia: comparison with conventional liposomes
Published in Drug Development and Industrial Pharmacy, 2023
Shweta Ramkar, Monika Kaurav, M. S. Sudheesh, Ravi Shankar Pandey
Androgenic alopecia (AGA) is caused due to the action of high dihydrotestosterone on androgen receptors present in hair follicles, and treatment during the early stages of alopecia can increase the chances of recovery or at least slow the progression [5]. Finasteride (FIN is used in the treatment of male pattern baldness (i.e. androgenetic alopecia) by inhibiting 5-α reductase in scalp follicles. However, long-term use of FIN via the oral route is restricted because of side effects, such as sexual disabilities and reduced libido, that occur due to systemic exposure to the drug [6]. It is not approved by FDA for use in women due to severe side effects like genetic abnormalities and teratogenicity [5]. It is previously reported that vesicular systems had the potential to deliver the bioactive into the skin layer when applied topically for the treatment of AGA. Recently, different types of vesicular systems viz. liposomes, transfersomes, ethosomes, cerosomes, and transethosomes were studied for the delivery of Coenzyme Q10 a strong antioxidant for the treatment of AGA [7]. Post-clinical observations by authors claimed that transethosomes were superior in delivering the Coenzyme Q10 deeper in the skin. In another study, FIN and baicalin were co-loaded into phospholipid vesicles. Vesicles delivered the FIN deeper into the skin layer and improvement in hair growth was observed in C57BL/6 mice after 21 d [7].
A review of the treatment of male pattern hair loss
Published in Expert Opinion on Pharmacotherapy, 2020
Katherine York, Nekma Meah, Bevin Bhoyrul, Rodney Sinclair
Side effects of finasteride include lowered libido, erectile dysfunction, reduced ejaculatory volume, temporary reduction in sperm count, testicular pain, depression and gynecomastia.[16] A 10-year follow- up study reported reduced libido as the most frequent side effect, whilst gynecomastia and depression were not reported at all[17]. A systematic review of nine trials, including 3570 patients, identified sexual dysfunction in 1.5% of men taking finasteride[12]. A more recent network meta-analysis demonstrated no significant difference between active treatment with dutasteride 0.5mg or finasteride 1mg and placebo, for the outcome global sexual disturbance[13]. The lay press has highly publicized persistent sexual side effects associated with finasteride [18–20] but controlled clinical trial data have found a low incidence of sexual side effects that abate on stopping treatment.[21]
Safety of testosterone therapy in men with prostate cancer
Published in Expert Opinion on Drug Safety, 2019
Abraham Morgentaler, Monica Caliber
The Androgen receptor (AR) is present in many tissues, including normal and malignant prostate tissue, and mediates the effect of androgens. Free testosterone enters the cell, is reduced by 5-alpha reductase to dihydrotestosterone (DHT), which has a higher affinity for the AR compared with testosterone. The weaker androgenic potency of testosterone compared to that of dihydrotestosterone resides in its weaker interaction with the androgen receptor [73]. The complex of androgen-AR then transposes to the cell nucleus where it binds to androgen response elements on DNA and stimulates production of androgen-dependent gene products. Interestingly, finasteride blocks reduction of testosterone to DHT, causing reduction in prostate volume. In the large Prostate Cancer Prevention Trial, finasteride reduced the number of diagnosed PCa compared to placebo but did not alter the number of high-grade PCa cases [74].