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Androgen metabolism in men receiving finasteride before prostatectomy
R W Norman1, K E Coakes, A S Wright
1Department of Urology, Dalhousie University, Halifax, Nova Scotia, Canada.
The Journal of Urology
|November 1, 1993
Summary
Finasteride treatment for benign prostatic hyperplasia significantly reduces intraprostatic dihydrotestosterone. Serum dihydrotestosterone levels effectively indicate these changes, with 5 mg doses showing greater inhibition than 1 mg.
Area of Science:
- Endocrinology
- Urology
- Pharmacology
Background:
- Benign prostatic hyperplasia (BPH) is a common condition in aging men.
- Finasteride, a 5 alpha-reductase inhibitor, impacts intraprostatic androgens.
- Understanding finasteride's effects on serum and intraprostatic androgens is crucial for BPH management.
Purpose of the Study:
- To correlate the effects of finasteride on intraprostatic androgens with changes in serum dihydrotestosterone, testosterone, and androstanediol glucuronide.
- To evaluate finasteride's efficacy in reducing intraprostatic dihydrotestosterone and increasing testosterone.
- To determine the best serum marker for intraprostatic dihydrotestosterone changes.
Main Methods:
- A double-blind, placebo-controlled study involving 27 men with symptomatic BPH.
- Participants received placebo or 1 or 5 mg/day finasteride for 6-8 weeks prior to prostate surgery.
- Measurements included serum and intraprostatic levels of dihydrotestosterone, testosterone, and androstanediol glucuronide.
Main Results:
- Finasteride significantly decreased serum dihydrotestosterone and androstanediol glucuronide levels.
- Both 1 mg and 5 mg finasteride doses reduced intraprostatic dihydrotestosterone, with 5 mg showing greater inhibition.
- Intraprostatic testosterone increased with finasteride treatment.
- Serum dihydrotestosterone showed a significant correlation with intraprostatic dihydrotestosterone.
Conclusions:
- 5 mg of finasteride provides greater inhibition of intraprostatic 5 alpha-reductase compared to 1 mg.
- Serum dihydrotestosterone is a more reliable marker of intraprostatic dihydrotestosterone changes than androstanediol glucuronide.
- Finasteride effectively modulates intraprostatic androgen levels in men with BPH.