Journal of Clinical Endocrinology & Metabolism, Vol 74, 505-508, Copyright © 1992 by Endocrine Society

ARTICLES

Finasteride, an inhibitor of 5 alpha-reductase, suppresses prostatic dihydrotestosterone in men with benign prostatic hyperplasia

JD McConnell, JD Wilson, FW George, J Geller, F Pappas and E Stoner
Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas 75235-8857.

The oral administration of finasteride, a 4-aza-steroid inhibitor of 5 alpha-reductase, decreases serum dihydrotestosterone levels, but has little effect on serum testosterone. The current study was designed to assess the effect of finasteride on dihydrotestosterone levels in the prostates of men with benign prostatic hyperplasia. In a double blind, placebo-controlled study, 69 men with symptomatic prostatic hyperplasia were treated with placebo or 1, 5, 10, 50, or 100 mg/day finasteride for 7 days before transurethral resection of the prostate. In the placebo group the mean concentration of prostatic dihydrotestosterone was 10.3 +/- 0.6 nmol/kg (+/- SE), and the mean concentration of testosterone was 0.7 +/- 0.1 nmol/kg. After 7 days of treatment with all doses of finasteride, prostatic dihydrotestosterone declined to 15% or less of control levels, and the testosterone concentration increased in a reciprocal fashion. Compared to the placebo group, there was no significant difference in the mean prostatic dihydrotestosterone level achieved in any of the finasteride-treated groups. However, prostatic dihydrotestosterone levels were lower in the groups receiving higher doses of the drug. In two additional patients, finasteride treatment for 2 days also caused a decrease in prostatic dihydrotestosterone levels. No significant adverse experiences occurred during the study. We conclude that finasteride causes profound decrease in prostatic dihydrotestosterone.

This article has been cited by other articles:

				L. S. Marks, N. A. Mazer, E. Mostaghel, D. L. Hess, F. J. Dorey, J. I. Epstein, R. W. Veltri, D. V. Makarov, A. W. Partin, D. G. Bostwick, et al. Effect of Testosterone Replacement Therapy on Prostate Tissue in Men With Late-Onset Hypogonadism: A Randomized Controlled Trial. JAMA, November 15, 2006; 296(19): 2351 - 2361. [Abstract] [Full Text] [PDF]

				S. T. Page, D. W. Lin, E. A. Mostaghel, D. L. Hess, L. D. True, J. K. Amory, P. S. Nelson, A. M. Matsumoto, and W. J. Bremner Persistent Intraprostatic Androgen Concentrations after Medical Castration in Healthy Men J. Clin. Endocrinol. Metab., October 1, 2006; 91(10): 3850 - 3856. [Abstract] [Full Text] [PDF]

				Y. Xu, S. L. Dalrymple, R. E. Becker, S. R. Denmeade, and J. T. Isaacs Pharmacologic Basis for the Enhanced Efficacy of Dutasteride against Prostatic Cancers. Clin. Cancer Res., July 1, 2006; 12(13): 4072 - 4079. [Abstract] [Full Text] [PDF]

				J. K. Parsons, H. B. Carter, E. A. Platz, E. J. Wright, P. Landis, and E. J. Metter Serum Testosterone and the Risk of Prostate Cancer: Potential Implications for Testosterone Therapy Cancer Epidemiol. Biomarkers Prev., September 1, 2005; 14(9): 2257 - 2260. [Abstract] [Full Text] [PDF]

				S. Seenundun and B. Robaire Cloning and Characterization of the 5{alpha}-Reductase Type 2 Promoter in the Rat Epididymis Biol Reprod, April 1, 2005; 72(4): 851 - 861. [Abstract] [Full Text] [PDF]

				A. Bozec, A. Ruffion, M. Decaussin, J. Andre, M. Devonec, M. Benahmed, and C. Mauduit Activation of Caspases-3, -6, and -9 during Finasteride Treatment of Benign Prostatic Hyperplasia J. Clin. Endocrinol. Metab., January 1, 2005; 90(1): 17 - 25. [Abstract] [Full Text] [PDF]

				K. L. Matthiesson, J. K. Amory, R. Berger, A. Ugoni, R. I. McLachlan, and W. J. Bremner Novel Male Hormonal Contraceptive Combinations: The Hormonal and Spermatogenic Effects of Testosterone and Levonorgestrel Combined with a 5{alpha}-Reductase Inhibitor or Gonadotropin-Releasing Hormone Antagonist J. Clin. Endocrinol. Metab., January 1, 2005; 90(1): 91 - 97. [Abstract] [Full Text] [PDF]

				W. Gao, J. D. Kearbey, V. A. Nair, K. Chung, A. F. Parlow, D. D. Miller, and J. T. Dalton Comparison of the Pharmacological Effects of a Novel Selective Androgen Receptor Modulator, the 5{alpha}-Reductase Inhibitor Finasteride, and the Antiandrogen Hydroxyflutamide in Intact Rats: New Approach for Benign Prostate Hyperplasia Endocrinology, December 1, 2004; 145(12): 5420 - 5428. [Abstract] [Full Text] [PDF]

				T. Nishiyama, Y. Hashimoto, and K. Takahashi The Influence of Androgen Deprivation Therapy on Dihydrotestosterone Levels in the Prostatic Tissue of Patients with Prostate Cancer Clin. Cancer Res., November 1, 2004; 10(21): 7121 - 7126. [Abstract] [Full Text] [PDF]

				W. Rosner Proscar and Propecia--A Therapeutic Perspective J. Clin. Endocrinol. Metab., July 1, 2004; 89(7): 3096 - 3098. [Full Text] [PDF]

				R. V. Clark, D. J. Hermann, G. R. Cunningham, T. H. Wilson, B. B. Morrill, and S. Hobbs Marked Suppression of Dihydrotestosterone in Men with Benign Prostatic Hyperplasia by Dutasteride, a Dual 5{alpha}-Reductase Inhibitor J. Clin. Endocrinol. Metab., May 1, 2004; 89(5): 2179 - 2184. [Abstract] [Full Text] [PDF]

				P. Kunelius, O. Lukkarinen, M. L. Hannuksela, O. Itkonen, and J. S. Tapanainen The Effects of Transdermal Dihydrotestosterone in the Aging Male: A Prospective, Randomized, Double Blind Study J. Clin. Endocrinol. Metab., April 1, 2002; 87(4): 1467 - 1472. [Abstract] [Full Text] [PDF]

				M. S. Mahendroo, K. M. Cala, D. L. Hess, and D. W. Russell Unexpected Virilization in Male Mice Lacking Steroid 5{alpha}-Reductase Enzymes Endocrinology, November 1, 2001; 142(11): 4652 - 4662. [Abstract] [Full Text] [PDF]

				A. M. Comaru-Schally, W. Brannan, A. V. Schally, M. Colcolough, and M. Monga Efficacy and Safety of Luteinizing Hormone-Releasing Hormone Antagonist Cetrorelix in the Treatment of Symptomatic Benign Prostatic Hyperplasia J. Clin. Endocrinol. Metab., November 1, 1998; 83(11): 3826 - 3831. [Abstract] [Full Text]

				V. A. Tobin and B. J. Canny The Regulation of Gonadotropin-Releasing Hormone-Induced Calcium Signals in Male Rat Gonadotrophs by Testosterone Is Mediated by Dihydrotestosterone Endocrinology, March 1, 1998; 139(3): 1038 - 1045. [Abstract] [Full Text] [PDF]

				J. D. McConnell, R. Bruskewitz, P. Walsh, G. Andriole, M. Lieber, H. L. Holtgrewe, P. Albertsen, C. G. Roehrborn, J. C. Nickel, D. Z. Wang, 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 N. Engl. J. Med., February 26, 1998; 338(9): 557 - 563. [Abstract] [Full Text] [PDF]

				M. G. Biswas and D. W. Russell Expression Cloning and Characterization of Oxidative 17beta - and 3alpha -Hydroxysteroid Dehydrogenases from Rat and Human Prostate J. Biol. Chem., June 20, 1997; 272(25): 15959 - 15966. [Abstract] [Full Text] [PDF]

				J. I. Schwartz, W. K. Tanaka, D. Z. Wang, D. L. Ebel, L. A. Geissler, A. Dallob, B. Hafkin, and B. J. Gertz MK-386, an Inhibitor of 5{alpha}-Reductase Type 1, Reduces Dihydrotestosterone Concentrations in Serum and Sebum without Affecting Dihydrotestosterone Concentrations in Semen J. Clin. Endocrinol. Metab., May 1, 1997; 82(5): 1373 - 1377. [Abstract] [Full Text] [PDF]

				F. W. George Androgen Metabolism in the Prostate of the Finasteride-Treated, Adult Rat: A Possible Explanation for the Differential Action of Testosterone and 5{alpha}-Dihydrotestosterone during Development of the Male Urogenital Tract Endocrinology, March 1, 1997; 138(3): 871 - 877. [Abstract] [Full Text] [PDF]

				E. Diamanti-Kandarakis, G. Tolis, and A. J. Duleba Androgens and Therapeutic Aspects of Antiandrogens in Women Reproductive Sciences, July 1, 1995; 2(4): 577 - 592. [Abstract] [PDF]

				R. S. Rittmaster Finasteride N. Engl. J. Med., January 13, 1994; 330(2): 120 - 125. [Full Text]