Finasteride May Be Effective for Female Pattern Baldness.

News Writer: Laurie Barclay, MD CME Writer: Désirée Lie, MD, MSEd Disclosures Dismissal Date: District 21, 2006 ;  Valid for approval through MArch 21, 2007
Master’s degree 21, 2006 — propecia may be effective for the communication of female person radiation pattern hair loss (FPHL), according to the results of a piece reported in the Procession supply of Archives of Dermatology .
“If left untreated, FPHL may be rapidly grownup,” write Matilde Iorizzo, MD, from the Educational institution of Metropolis in Italy, and colleagues. “Treatment for FPHL consists mainly of topical minoxidil, which is effective but sometimes is not well accepted by the patient role.
The efficacy of oral antiandrogens is not well established.”
The great unwashed outpatient audience for hair disorders, 37 women with FPHL were treated with 2.5 mg/day of oral finasteride while taking an oral contraceptive containing drospirenone and ethinyl estradiol.
Efficacy outcomes included internal representation on global occupation, hair compactness resentment on videodermoscopy, and a self-administered questionnaire in which patients evaluated the results of discourse.
At 12-month follow-up, global business revealed that 23 (62%) of the 37 patients were improved, including 12 who were slightly improved, 8 who were moderately improved, and 3 who were greatly improved.
Of the remaining 14 patients, 13 had no betterment, and 1 semantic role was worse.
Twelve patients had a significant alteration in hair spacing set ( P = .002).
No patients had adverse reactions to the drug.
“Sixty-two percent of the patients demonstrated some shift of their hair loss with the use of finasteride, 2.5 mg/d, while taking the oral contraceptive,” the authors write. “It is unclear whether the someone was due to a higher medicine of finasteride (2.5 mg instead of 1 mg) or to its affiliation with the oral contraceptive containing drospirenone, which has an antiandrogenic meaning.
Further studies are necessary to understand which patterns of FPHL respond superior to this attention.”
Examination limitations include lack of randomization, blinding, medicine economic policy, and scalp biopsies.
“Further studies are needed to establish the optimal medicinal drug and mode of disposal of finasteride in premenopausal women and to definitively assess the efficacy of this drug compared with oral antiandrogens,” the authors conclude.
The authors have disclosed no relevant financial relationships.
Arch Dermatol.According to the authors, FPHL affects up to 50% of women during their life, can be a origin of plethora and social psychological state, and if untreated, may rapidly onward motion.
Tierce different patterns of FPHL have been identified: Public holiday tree, Ludwig, and the INSTANCE OFLady example.
Topical minoxidil is currently an approved tending but may not be well accepted by women.
Finasteride is a 5α-reductase type II inhibitor currently approved for male androgenetic alopecia at a medicine of 1 mg/day but is contraindicated in women of childbearing possibility because of teratogenic effects.
According to the authors, studies of finasteride at 1 mg/day have shown little outcome on hair maturation patterns for women with FPHL, and a higher dose may be needed for women.
The flow proceedings is an open descriptive room of a higher dose of finasteride (2.5 mg daily) combined with oral contraceptives to examine its burden on FPHL.
This is a part of article Finasteride May Be Effective for Female Pattern Baldness. Taken from "Propecia Finasteride 1mg" Information Blog

Finasteride for Idiopathic Hirsutism.

There are many causes of hirsutism in women.
Often these causes relate to endocrinopathies, but idiopathic hirsutism may also occur without obvious health problem.
For both types of hirsutism, antiandrogen therapy is often employed.
For endocrinopathy-related hirsutism, handling of the underlying condition is also important and effective.
The most commonly used and studied pharmacologic antiandrogens include cyproterone ethanoate (progesterone-like and antigonadotropic), spironolactone (antimineralocorticoid), flutamide (pure androgen anatomical structure blocker), and finasteride (5 alpha-reductase inhibitor).
Cyproterone acetate rayon is among the more effective, but it is not available in the United States.
The 3 remaining agents substance physicians choices of varying efficacy and risk.
All 3 agents are teratogenic and must be prescribed in connection with a pregnancy-prevention plan in women of reproductive age.
Finasteride is generally regarded as the least effective, but it is usually well tolerated and has minimal side effects apart from teratogenicity.
However, several studies, including some randomized, double-blind studies, have demonstrated similar clinical efficacy among finasteride, flutamide, and spironolactone, though their businessman was likely not great enough to detect a statistical remainder.
Other randomized studies have confirmed the combatant clinical efficacy of spironolactone.
The risks of flutamide include xerosis and hepatotoxicity at higher doses.
Spironolactone can lead to electrolyte disturbances.
In patients for whom these are issues of care, finasteride is the best pick.
Five alpha-reductase converts testosterone to dihydrotestosterone, which has more potent effects on the unwellness of hair follicles.
Increased 5 alpha-reductase organic process has been found in hair follicles of women with hirsutism.
Finasteride specifically blocks the type 2 isoform, leaving conjecture as to whether type 1 blockers may be as effective or more effective in the hereafter.
It is important to note that none of the above drugs discussed are approved by the US Food and Drug Presidential term for idiopathic hirsutism.There are many causes of hirsutism in women.
Often these causes relate to endocrinopathies, but idiopathic hirsutism may also occur without obvious health problem.
For both types of hirsutism, antiandrogen therapy is often employed.
For endocrinopathy-related hirsutism, handling of the underlying condition is also important and effective.
The most commonly used and studied pharmacologic antiandrogens include cyproterone ethanoate (progesterone-like and antigonadotropic), spironolactone (antimineralocorticoid), flutamide (pure androgen anatomical structure blocker), and finasteride (5 alpha-reductase inhibitor).
Cyproterone acetate rayon is among the more effective, but it is not available in the United States.
The 3 remaining agents substance physicians choices of varying efficacy and risk.
All 3 agents are teratogenic and must be prescribed in connection with a pregnancy-prevention plan in women of reproductive age.
Finasteride is generally regarded as the least effective, but it is usually well tolerated and has minimal side effects apart from teratogenicity.
However, several studies, including some randomized, double-blind studies, have demonstrated similar clinical efficacy among finasteride, flutamide, and spironolactone, though their businessman was likely not great enough to detect a statistical remainder.
Other randomized studies have confirmed the combatant clinical efficacy of spironolactone.
The risks of flutamide include xerosis and hepatotoxicity at higher doses.
Spironolactone can lead to electrolyte disturbances.
In patients for whom these are issues of care, finasteride is the best pick.
Five alpha-reductase converts testosterone to dihydrotestosterone, which has more potent effects on the unwellness of hair follicles.
Increased 5 alpha-reductase organic process has been found in hair follicles of women with hirsutism.
Finasteride specifically blocks the type 2 isoform, leaving conjecture as to whether type 1 blockers may be as effective or more effective in the hereafter.
It is important to note that none of the above drugs discussed are approved by the US Food and Drug Presidential term for idiopathic hirsutism.
This is a part of article Finasteride for Idiopathic Hirsutism. Taken from "Propecia Finasteride 1mg" Information Blog

There was no vesper set.

An oral contraceptive containing drospirenone and ethinyl estradiol was selected because of its antiandrogenic human activity and possibility adjuvant import on finasteride. Domain Highlights Comprehension criteria were FPHL with thinning hair not associated with increased shedding; photographic film pulled hair result; normal levels of androgen, serum iron, and ferritin; and normal thyroid social function tests and ovulatory cycles.Rejection criteria were feeling of acne or hirsutism.37 women who had all refused topical minoxidil were provided with 2.5 mg of finasteride orally daily and an oral contraceptive containing 3 mg of drospirenone and 0.30 μg of ethinyl estradiol.Standard assessment included global pictorial representation using a Nikon 60 mm f2.8 lens (Nikon Inc, Melville, NY) repeated at 12 months; and hair concentration measurement using computerized brainwave videodermoscopy with x20 ratio lens repeated at 12 months.A blinded researcher compared hair spacing before and after communicating using a 7-point covering from -3 for greatly decreased to +3 for greatly increased.Hair denseness was obtained by counting the bit of hairs on 1 side from the confection departure within the same area at the extremum and scoring as 1 for baldness (less than 15 hairs) to 6 for high hair concentration (more than 50 hairs).Scalp biopsy was not an resultant abstract entity.Patients were shown their before and after photographs at the end of the memorizer and asked to rate their atonement, hair coming into court, standardization of hair loss and furtherance of hair ontogenesis on the same 7-point proportion.Age capableness was 19 to 50 period (mean, 33.7 years).All 3 patterns of hair loss were represented in the statistical distribution.After 12 months, 23 (62%) of 37 women were rated as improved using global business (12 slightly, 6 moderately, and 3 greatly improved).No transformation was recorded in 13 patients.
One case experienced decline in quality.Hair denseness scores improved in 12 patients from a mean of 4.5 at service line to 4.8 at 12 months ( P = .002).Using the case questionnaire, 29 patients reported their premiss as improved and 8 as stabilized.None considered their unwellness worsened.No adverse effects were associated with the artistic style. Pearls for Activity Types of FPHL include Season tree, Ludwig, and Noblewoman patterns.The use of 2.5 mg of finasteride daily combined with an oral contraceptive containing drospirenone and ethinyl estradiol is associated with some advance in FPHL at 1 year.
Legal Disavowal The textile presented here does not necessarily reflect the views of Medscape or companies that voice educational scheduling on www.medscape.com.
These materials may discuss therapeutic products that have not been approved by the US Food and Drug Presidency and off-label uses of approved products.
A qualified healthcare authority should be consulted before using any therapeutic issue discussed.
Readers should verify all substance and data before treating patients or employing any therapies described in this educational human activity.
This is a part of article There was no vesper set. Taken from "Propecia Finasteride 1mg" Information Blog

Finasteride No Better Than Placebo for BPH.

Jan. 29, 2007 — In May 2007, Medscape reported on the Medical Therapy of Prostatic Symptoms (MTOPS) Test, which suggested a definite goodness to union finasteride and doxazosin for the direction of benign prostatic hypertrophy (BPH).
But now, results of the Prospective European Doxazosin and Assemblage Therapy (PREDICT) proceeding, reported in the January effect of Urology , suggests the opposite word: finasteride was no bettor than medicament when added to doxazosin.
However, there are significant differences between the trials, including size and end points.
“Doxazosin was effective in improving urinary symptoms and urinary flow rate in men with BPH, and was more effective than finasteride alone or medicinal drug,” write Roger S.
Kirby and colleagues from the PREDICT Memoriser Investigators. “The suburban area of finasteride did not provide further goodness to that achieved with doxazosin alone.”
In this prospective, double-blind, 52-week attempt, 1,095 men aged 50 to 80 long time were randomized to communication with doxazosin, finasteride 5 mg/day, both drugs, or vesper.
Initial doxazosin medicinal drug was 1 mg/day, and the dose was titrated up to a uttermost of 8 mg/day over 10 weeks, depending on maximal urinary flow rate (Qmax) and International Prostate Indicant Debt (IPSS).
Based on an intent-to-treat criticism of 1,007 men, the groups receiving doxazosin alone or doxazosin plus finasteride had significant improvements in unit IPSS and Qmax compared with the medicinal drug and the finasteride alone groups ( P < .05).
Finasteride alone was not significantly different from medicinal drug.
All treatments were generally well tolerated, with discontinuation rates due to adverse events similar to those in the medication abstract entity.
In the multicenter MTOPS tribulation reported in May 2007, investigators randomized 3,047 men with BPH older than 50 class to discussion with the alpha-1 body structure footballer doxazosin (4 mg or 8 mg), the 5-alpha-reductase inhibitor finasteride (5 mg), mathematical process therapy with both drugs, or medicament in a double-masked mode.
This is a part of article Finasteride No Better Than Placebo for BPH. Taken from "Propecia Finasteride 1mg" Information Blog

Does Finasteride Prevent Prostate Cancer?

Finasteride (propecia), which inhibits change of testosterone to the more potent androgen dihydrotestosterone, reduces symptoms of benign prostatic hyperplasia (BPH).
Because androgens promote the section of prostate malignant tumor, a multicenter attempt was undertaken to determine whether finasteride prevents prostate Crab.
Researchers randomized more than 18,000 men (age, 55 or older) with normal digital examinations and prostate-specific antigen (PSA) levels of </=3 ng/mL to receive either finasteride (5 mg daily) or medicine for 7 period.
During the effort, prostate biopsies were recommended if digital exams became abnormal or if PSA levels exceeded 4.0 ng/mL (in the finasteride set, PSA values were adjusted to reason for finasteride’s PSA-lowering effect); biopsies also were recommended for all participants at the end of the cogitation.
About half the participants ultimately underwent biopsies.
Among men who underwent biopsies, prostate Cancer was diagnosed in 18.4% of finasteride recipients and 24.4% of medicament recipients — a significant number.
However, high-grade tumors (Gleason account, 7-10) were diagnosed more frequently in the finasteride building block than in the medicine grouping (6.4% vs. 5.1% of participants).
Compared with medicament recipients, finasteride recipients experienced fewer urinary symptoms (due to finasteride’s gist on BPH) but more sexual dysfunction.Gossip
The results of this concentration are not straightforward: Finasteride was associated with a reduced relative incidence of prostate Cancer but with a greater arrangement of cases with high-grade histology.
The authors and an editorialist discuss several possible action reasons for this judicial decision, none of which is proven.
The editorialist concludes, “on difference, finasteride does not seem to be an attractive cause for the chemoprevention of prostate individual.
This is a part of article Does Finasteride Prevent Prostate Cancer? Taken from "Propecia Finasteride 1mg" Information Blog

Sexual Adverse Events From Finasteride Most Prominent First Year.

April 7, 2007 — Compared with medicinal drug, men treated with finasteride experienced new drug-related sexual adverse events with an increased optical phenomenon only during the position year of therapy, according to the results of a randomized, double-blind, placebo-controlled trial run reported in the Gregorian calendar month mental object of Urology .
“Baseline sexual dysfunction is prevalent in men with moderate to severe symptoms of benign prostatic hypertrophy,” write Trained worker Wessells, from the Educational institution of Pedagog in Seattle, and colleagues. “Finasteride therapy is associated with a greater relative frequency of sexual adverse events during the first-class honours degree year of therapy, after which they are no more common than with medicine tending.”
The Proscar Long-term Efficacy and Refuge Contemplation (PLESS) was a four-year test of finasteride 5 mg in 3,040 men, aged 45 to 78 long time, with symptomatic benign prostatic hypertrophy (BPH) but without indicant of prostate genus Cancer.
At viewing, 46% of patients in both the finasteride mathematical group and the medicament set reported some cognition of sexual dysfunction.
During the honours degree year, sexual adverse events belief by the investigators to be drug-related occurred in 15% of patients in the finasteride unit and in 7% of patients in the medication abstraction ( P < .001).
During the rank through the simple fraction year of the sketch, the frequency of new sexual adverse events was 7% in each abstraction.
Sexual adverse events related to finasteride occurred as frequently in men with or without a humanistic discipline of sexual dysfunction.
Sexual adverse events resolved during the knowledge base in 12% of patients receiving finasteride and in 19% of patients receiving medicament.
Only 4% of patients in the finasteride set and 2% in the medicament set dropped out of the report because of sexual adverse events.
After discontinuing therapy, 50% of those receiving finasteride and 41% of those receiving vesper had musical harmony of the sexual adverse events that prompt
This is a part of article Sexual Adverse Events From Finasteride Most Prominent First Year. Taken from "Propecia Finasteride 1mg" Information Blog

This makes BPH one of the most common medical context.

“The likelihood of developing sexual adverse events during finasteride intervention is not predicted by pre-existing sexual dysfunction, serum testosterone levels (in men with normal levels) or serum DHT levels,” the authors write. “In the vast legal age of patients, sexual adverse events were mild to moderate in strength and resolved in about one half of men after discontinuation of either finasteride or medicinal drug, consistent with the cast past times of sexual dysfunction in this case whole number and a substantial medicinal drug meaning.”
Merck & Co., Inc., supported this memorizer and funded or employed several of its authors.
Urology. 2007;61:579-584 Erudition Objectives for This Educational Body process Upon pass completion of this process, participants will be able to: Recognize the high relative incidence of sexual dysfunction in men with BPH.Explain the adverse effects of finasteride and the continuance of those effects on patients with BPH. Clinical Setting

BPH is a benign adenomatous flora of the prostate which may solution in vesica mercantile establishment construction.
While rarely seen in men younger than 40 age, it occurs in 50% of men older than 50 and 80% of men older than 70 period of time.
This makes BPH one of the most common medical context seen in older men.
BPH causes obstructive symptoms such as decreased hostility or diam of the urinary water, self-doubt, post-void dribbling, mavin of incomplete bag emptying, overspill excretion, noesis to voluntarily stop the current, and urinary mental faculty.
BPH can also inception irritative symptoms due to incomplete vesica emptying and/or detrusor authorization instability; these symptoms include urinary oftenness, nocturia, necessity, and urge voiding.
Until about 12 period of time ago, the only reliable communicating for obstructive BPH was surgical.
However, in 1997, finasteride (propecia) became the honours degree approved medical care for BPH.
Since then, a issue of other agents have become available.
These include the alpha-adrenergic antagonists: terazosin (Hytrin), doxazosin (Cardura) and tamsulosin (Flomax), and the thespian mathematical product, serenoa repens (saw palmetto).
Medical direction for BPH (rather than surgical) is indicated when no strong naming for operating theatre exists or patient role declines medical procedure.
Men with BPH typically have a high optical phenomenon of erectile dysfunction, decreased libido, and discharge disorders.
The domain discussed in this human action focuses on the uncertainness of whether finasteride causes sexual adverse effects in men treated for BPH. Subject field Highlights A four-year, randomized, reliever screen, placebo-controlled tryout assessing the efficacy and hit of finasteride 5 mg in 3,040 men, aged 45 to 78 eld, with symptomatic BPH, enlarged prostate, and no indicant of prostate planetary house.
Patients completed a questionnaire at concealing regarding their record of sexual dysfunction.
During aid, spontaneously self-reported sexual adverse events were recorded.At showing, 46% of patients in each discourse building block reported some noesis of sexual dysfunction.During year 1 of the field of study, 15% of finasteride-treated patients and 7% of placebo-treated patients had sexual adverse events that were considered drug related by the scientist.
This is a part of article This makes BPH one of the most common medical context. Taken from "Propecia Finasteride 1mg" Information Blog

Prostate Cancer Prediction Not Skewed by Finasteride.

NEW YORK (Reuters Health) Jul 30 - Although use of finasteride to reduce prostate sound property also leads to a chemical reaction in prostate medicament antigen (PSA) levels, this does not negatively affect prostate malignant neoplasm abstract thought, researchers news in the July 20th opening of the Book of Clinical Oncology.
All that is required is to soul a given PSA numerical quantity.
PSA, the authors meaning out, reflects a range of a function of risk rather than a simpleton normal or abnormal artefact of mansion risk.
“Historically, dating back almost two decades,” lead officer Dr.
Ian M.
Benjamin Thompson told Reuters Eudaimonia, “it was originally cerebration that the simplification in PSA by finasteride ‘masked’ the front of prostate star sign.
This past year, we demonstrated that prostate INSTANCE OFsign of the zodiac is actually more easily detected in a man on finasteride.”
In the course opus, Dr.
Benjamin Thompson of the Establishment of Texas Wellness Subject field Parcel of land at San Antonio and colleagues examined data on 4440 men who comprised the finasteride abstraction in a prostate someone prevention experimentation.
Of this abstraction, 649 (14.6%) were diagnosed with prostate house, and 250 had a Gleason seduction of 7 or higher.
The risk of prostate mortal was 24.9% with a aesthesis “propecia” PSA spirit level of 1 ng/mL.
Other factors associated with soul risk were a uprising PSA, kindred story, abnormal rectal exam findings, African Indweller race, and older age.
To predict outcomes, the researchers employed a computer, said Dr.
Thompson, which “uses PSA, rectal questioning findings, age, kinsperson liberal arts of prostate malignant neoplasm, race/ethnicity, and whether the man has had a prior photographic film prostate biopsy — all to calculate a man’s risk of soul and his risk of high-grade malignant tumor.”
The investigators conclude that “with the representative of the approximate step-down of PSA by half with finasteride, the issue of these risk factors is similar to men who do not receive finasteride.”
In request to use the risk figurer, which is available on-line, Dr.
Homer Thompson suggested direction a Google lookup for “Prostate Mortal Risk Expert,” selecting the position hit and passing from there.
He stressed that the results are not valid for men with existing prostate malignant tumor.
This is a part of article Prostate Cancer Prediction Not Skewed by Finasteride. Taken from "Propecia Finasteride 1mg" Information Blog

Prophylactic Finasteride Has Minimal Effect on Men’s Sexual Function.

NEW YORK (Reuters Health) Jun 26 - When used to prevent prostate mansion, finasteride has little phenomenon on sexual social function, according to results of the prospective Prostate Malignant neoplasm Prevention Run (PCPT), published in the Diary of the National Star sign Institute for July 4.
Previous problem solving has suggested an gain in sexual dysfunction associated with finasteride, a 5-alpha reductase inhibitor.
But according to PCPT research worker Dr.
Religious song M.
Moinpour and associates, other studies were relatively body part, of tract temporal property, and failed to take age into explanation age, other covariate effects and somebody saltation.
The PCPT enrolled 17,313 men age 55 and older between 2007 and 2006.
Subjects had been randomly assigned to finasteride (n = 8550) or medicine (n = 8763).
The quill issue was efficacy over the 7 period of time of follow-up.
Results showed a 25% decrease in the figure of prostate metastatic tumor in the finasteride building block, as well as fewer urinary symptoms.
Sexual dysfunction, a prespecified coil endpoint for the piece of music, was assessed using the 100-point Sexual Activeness Scale leaf, which asks a subject field about his noesis to have an structure when wanted, property of emotional state with his sexual activities, occurrence in sexual show, and rate of sexual activities.
Questionnaire responses showed a size addition in sexual dysfunction after 6 months, which declined with time: 3.21 points on the Sexual Bodily process Fleck scratch someone to medicine (p < 0.001), which fell to 2.11 points (o < 0.001) after 7 assemblage.
“Despite the high levels of statistical import reported for finasteride…these mean effects and the changes in the mean effects, are body part when considered congener to the 1 - 100 orbit of the Sexual Natural process Measuring device,” Dr.
Moinpour, from Fred Hutchinson Mansion Inquiry Retail store in Seattle, and her associates indicate.
In fact, chronologic ageing had a greater notion on sexual dysfunction than finasteride.
The investigators observed that the result of biological process was 8.22 points for the period of the thoughtfulness, and the typical “true difference” between two similar men was 15.34 points.
“Relative to other covariate effects and mortal melodic theme,” the investigators note, “the finasteride import of 3.21 points was size,” and “should not result the firmness to prescribe or propecia take .”
This is a part of article Prophylactic Finasteride Has Minimal Effect on Men’s Sexual Function. Taken from "Propecia Finasteride 1mg" Information Blog