Why would men use finasteride in 2005?
In the late 1800s, reports of treatment for obstructive benign prostatic hyperplasia (BPH) by bilateral castration in humans were published. Subsequent observations that BPH regressed following castration in male dogs (beagles) generated additional interest in androgen manipulation to treat BPH in humans. Estrogens, aromatase inhibitors, and luteinizing hormone-releasing hormone analogs were tested, but were minimally efficacious or caused significant side effects such as sexual dysfunction or cardiovascular events. With the observation that testosterone is converted to dihydrotestosterone and that the dihydrotest-osterone is the more active hormone in prostatic epithelial cell proliferation and maintenance, the concept of 5α-reductase inhibition was developed and clinically tested. Finasteride is a type-2 5-reductase inhibitor and dutasteride is a blocker of type-1 and type-2 reductase. Both are now clinically available.
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References and Recommended Reading
- 1.McConnell JD, Bruskewitz R, Walsh P, et al.: The effect of finasteride on the risk of acute urinary retention and the need for surgical treatment among men with benign prostatic hyperplasia. Finasteride Long-term Efficacy and Safety Study Group. N Engl J Med 1998, 38:557–563. Retraces the issues and areas of controversy for α-reductase drugs. Each development has spawned a new area of concern to be balanced against the established efficacy.CrossRefGoogle Scholar
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