4 ms·

Can someone give us more context? Why is Finasteride of particular interest?

• whatwhaaaaat 1y ago
  Hair loss drug. Commonly prescribed.
  • LoganDark 1y ago
    I assume it's a drug to treat hair loss, not a drug to cause hair loss?
    • nemomarx 1y ago
      Yeah - it's a selective testosterone blocker, kind of, and tries to target the part that causes male pattern baldness without lowering overall T Levels. I assume it still blocks enough hormones to cause mood shifts or other effects?
      • chimeracoder 1y ago
        > Yeah - it's a selective testosterone blocker, kind of, and tries to target the part that causes male pattern baldness without lowering overall T Levels. > I assume it still blocks enough hormones to cause mood shifts or other effects? Endocrinology is a lot more complicated than you're giving it credit for. DHT blockers don't necessarily lower testosterone levels; they can actually increase it (although even then, the mechanism isn't as direct as you might think). It's neither established nor a given that any side effects of finasteride have anything to do with effects on testosterone or hormone levels at all. A lot of people make that assumption, and there's reason to suspect there's truth to that hypothesis, but it's completely possible it's an unknown side effect of the drug, and there hasn't been enough study into the mechanism to understand it (in part because the side effects are relatively rare and weakly established).
      • wizzwizz4 1y ago
        Blocking the conversion of testosterone to DHT (the effect of this medication) causes an indirect and minor increase in both testosterone and œstrogen levels, although DHT is more potent than testosterone for the receptors in many tissues.
      • anon373839 1y ago
        It’s not a testosterone blocker at all. It blocks 5-alpha reductase, an enzyme that converts testosterone to DHT. It can actually increase serum testosterone by more than 10%. As for DHT, that hormone doesn’t appear to have much significance for adult males. It’s critically important in puberty, though!
    • deleted 1y ago
      [deleted]
• michael_michael 1y ago
  A.k.a. Propecia.
  • koolba 1y ago
    I think it’s also for treating enlarged prostates.
• _--__--__ 1y ago
  It's one of the most commonly used DTC prescription drugs and is used for a purely cosmetic purpose, so debates about it are common online and full of low-quality motivated reasoning.
  • anonymousiam 1y ago
    Finasteride is also used (in higher dosage) to reduce the size of the prostate gland.
  • timr 1y ago
    > ...is used for a purely cosmetic purpose I know you probably didn't mean it this way, but Finasteride started as a treatment for prostate enlargement, and is still used for that.
  • tehnub 1y ago
    Self-perception can have a profound effect on one's physical and mental wellbeing, so even drugs which are for cosmetic purposes can be important for health.
    • lithocarpus 1y ago
      True, and, I'd posit that there are often better and safer alternatives that would be similarly or more beneficial with less potential for harmful side effects. I have several anecdotes from my own life. When I was ~18 the doctor proposed to give me jaw surgery to fix my overbite by extending my lower jaw. I asked him what the reasons for this were and he said it was mainly cosmetic. I thought this was not a good enough reason for surgery - which while often safe does also often have harmful side effects - I now know way too many people who had surgery complications that often took a long time for them to become aware of. I think I feel better about myself now for having made that choice than I imagine I would if I had a better jaw line. It's true that some people are going to have a story where they see the cosmetic medical intervention as having been beneficial for their mental wellbeing. I'd still suggest that in many such cases there might have been other ways to get a better outcome. It's for each of us to decide. Still, burden of proof of the safety of a drug should be on the company profiting from it.
• nick__m 1y ago
  It decreases dihydroxytestosterone to treat hair loss.
  • viking123 1y ago
    This is the hormone that makes you bald (if you got bad cards in the genetic lottery) and also makes your prostate the size of an apple. Also causes acne as a bonus, again a bit dependent on genetics. Amazing.
• m0llusk 1y ago
  Exactly what finasteride does is not well understood. It effects the endocrine system, but not in consistent ways, and with some possibly serious side effects. It is being aggressively marketed as a way to stop hair loss, but may do various other things instead.
• scythe 1y ago
  The paper mentions that finasteride passes through the blood-brain barrier and affects the conversion of progesterone to allopregnanolone, where low levels of allopregnanolone are associated with depression. Together with the correlational evidence for depression and suicidality, this presents a reasonable picture for concern. Since there is a known central activity, it also raises the question -- in fact the article explicitly mentions it -- of whether a brain-sparing analogue of finasteride might not show the same side effects. The apparent connection to "masculinity" or "feminization" may be a red herring. Excessive concern about "sex" effects in biological systems kind of reminds me of the alchemical theory of the four elements. It's not a great way to analyze the complicated effects of medicines.