The Role of 5{alpha}-Reductase Inhibition in Men Receiving Testosterone Replacement Therapy [Editorial]

Posted by Dr. Michael White, Updated on December 21st, 2017

Ugis Gruntmanis, MD Author Affiliations: Department of Medicine, Division of Endocrinology, University of Texas, Southwestern Medical Center, Dallas; and Dallas Veterans Affairs Medical Center, Dallas, Texas.

Testosterone has a variety of well-known effects including bone accrual, building and maintaining muscle mass, and promoting erectile function and libido.1 Of the 5 mg of testosterone manufactured daily by the testes, about 6% to 8% is metabolized by 5-reductase to make 0.3 mg of dihydrotestosterone (DHT).2 Local conversion of testosterone to DHT by 5-reductase in the skin and prostate can create locally high concentrations of the potent androgen DHT. Dihydrotestosterone stimulates prostate growth and may promote scalp hair loss. 5-Reductase inhibition is the principal treatment for benign prostatic hypertrophy but the ramifications of treatment with drugs that inhibit this enzyme on the effects of androgen on the many tissues it influences is incompletely understood.

This uncertainty exists because research exploring the role of testosterone and DHT on different tissues has been confounded by complex hormonal interactions typical of replacement or inhibitor studies. When the 5-reductase inhibitors finasteride

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The Role of 5{alpha}-Reductase Inhibition in Men Receiving Testosterone Replacement Therapy [Editorial]

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