what causes androgenetic alepecia or pattern baldness?
it is triggered by the build - up of the androgen dihydrotestosterone (DHT) in the hair follicles in the scalp
What is the chemical derivative of DHT?
testosterone through the enzyme type II 5-alpha reductase (5-AR)
What is used to manage AGA in both men and women?
anti androgen therapies
What do anti-androgens do?
block the biological effects of androgens on responsive tissues. 1. blocking the hormone receptors 2. restricting androgen production 3. competing for binding sites on the cells's surface
who are finasteride prescribed to?
men and postmenopausal women
what does finasteride do?
selectively inhibits of type 2 5-alpha reductase, the enzyme responsible for the conversion of testosterone into DHT. because it can cause birth defects to a male fetus, finasteride is contraindicated in women
what are the side effects of finateride?
loss of libido
erectile dysfunction
maybe increases the risk of men developing high grade prostate cancer
what are the differences between dutasteride and finasteride?
dutasteride is not a selective inhibitor (it blocks both type I and type II of the 5-AR enzyme)
AND it is not approved by the FDA for hair loss treatment (finasteride is approved)
what is considered the king of anti-androgens?
spironolactone
what does spironolactone do?
it prevents DHT from binding with the androgen receptors on the hair follicles and obstructs the production of testosterone which is why it is rarely prescribed in men
what properties does cyproterone acetate contain?
containes antiandrogenic properties that work best in women with hirsutism and hair loss
how does cyproterone acetate work
it blocks the androgen receptors in the follicles from binding with DHT
what is used in conjunction with cyproterone acetate?
estrogen therapy
why is cyproterone acetate not used in men?
cause it obstructs the production of testosterone which leads the impotence and breast enlargement
what is the major adverse side effect of cyproterone acetate?