Baldness male pattern

In men, administration of an androgen may result in breast enlargement (gynecomastia), testicular atrophy, inhibition of testicular function, impotence, enlargement of the penis, nausea, jaundice, headache, anxiety, male pattern baldness, acne, and depression. Fluid and electrolyte imbalances, which include sodium, water, chloride, potassium, calcium, and phosphate retention, may also be seen. 

In women receiving an androgen preparation for breast carcinoma, the most common adverse reactions are amenorrhea, other menstrual irregularities, and virilization (acquisition of male sexual characteristics by a woman). Virilization produces facial hair, a deepening of the voice, and enlargement of the clitoris. Male pattern baldness and acne may also be seen. 

Benign prostate hyperplasia, male pattern baldness Cancer Inflammation... 

Evidence that BPH could be hormone related came from studies of a population of pseudohermaphrodites in the Dominican Republic. These individuals are genetically male, but do not display normal male genitalia until the onset of puberty. They are therefore raised as females until puberty. Studies revealed that these pseudohermaphrodites are deficient in an isoform of the enzyme steroid 5a-reductase, which is responsible for catalyzing the conversion of testosterone to dihydrotestosterone (DHT). In addition to the overt sexual manifestations of this condition, affected individuals show no incident of male pattern baldness, mild or no acne, and underdevelopment of the prostate. These observations led researchers to postulate that a selective inhibitor of steroid 5a-reductase would be an effective treatment for BPH. 

Finasteride has been clinically proved to reduce the median volume of the prostate in patients and is currently prescribed for the treatment of BPH. The compound also has demonstrated efficacy in the treatment of male pattern baldness and is prescribed for this indication as well. Subsequent to the discovery of finasteride, it was found that there are two isoforms of steroid 5a-reductase in mammals, type 1 and type 2. The type 2 isoform is primarily active in reproductive tissue, while the type 1 isoform contributes to DHT formation in the skin, liver, and reproductive tissue. Finasteride inhibits both isozymes in rats, but selectively inhibits the type 2 isozyme only in humans. It is hypothesized that dual inhibition of both isoforms of steroid 5a-reductase might prove more effective in treating BPH. Hence the GlaxoSmithKline group identified and developed dutasteride (Figure 8.18C). Dutasteride inactivates both human isoforms of steroid 5a-reductase by a mechanism similar to that described for finasteride (Bramson et al., 1997 see also the Web site www.avodart.com). Both finasteride and dutasteride have demonstrated clinical efficacy and are currently used in the treatment of BPH. 

Such an inhibitor is finasteride, marketed as Proscar for treatment of BPH and Propecia for treatment of male-pattern baldness. 

Topical minoxidil is used for the treatment of male pattern baldness (alopecia androgenetica) of the vertex of the scalp. Use of the tablets, in any formulation, to promote hair growth is not an approved use. 

Females-. Virilism (e.g., acne, decreased breast size, enlarged clitoris, male pattern baldness), deepening voice... 

Edema, nausea, insomnia, oligospermia, priapism, male-pattern baldness, bladder irritability, hypercalcemia (in immobilized patients or those with breast cancer), hypercholesterolemia, inflammation and pain at IM injection site Transdermal Pruritus, erythema, skin irritation Rare... 

Topical minoxidil is effective in reversing the progressive miniaturization of scalp hairs associated with androgenic alopecia (male pattern baldness). It is a hereditary disorder due to excessive conversion of testosterone to dehydrocorticosterone in the scalp skin in genetically susceptible men. 

It makes Cozaar and Hyzaar for hypertension Vytorin, Zetia, and Zocor to lower cholesterol Pro-pecia for male-pattern baldness Singulair for asthma Fosamax for osteoporosis and Gardasil, a vaccine for cervical cancer but it is also well known for making Vioxx, a pain relief drug taken off the market for causing heart problems. 

Males with deficiency of the 5a-reductase isoenzyme do not develop acne, male pattern baldness, or enlarged prostates.274 The last fact was some of the impetus for development of the steroid 5a-reductase inhibitor finasteride, which is widely used to treat benign prostate enlargement 274/277/278 It is an enzyme-activated inhibitor in which the NADH reduces the C= C bond in the A ring, which is not in the same position as in the substrate. The resulting anion cannot become protonated but instead adds to the NAD+ as shown in Eq. 22-15. 

Hirsutism is common in patients taking androgens, and is often irreversible (62,63). In contrast, in women, loss of scalp hair can occur (64). Of 81 female-to-male transsexual subjects, mean age 37 years (range 21-61), treated with testosterone esters (n = 61 250 mg intramuscularly every 2 weeks) or testosterone undecanoate (n = 20 160-240 mg/day orally), 31 developed male-pattern baldness thinning of the hair was related to the duration of androgen administration and was present in about half of the transsexuals after 13 years (65). 

In women and children, the main effect will be one of virilization in its various forms, ranging from hirsutism and deepening of the voice to enlargement of the female clitoris and male pattern baldness the effect on the voice rapidly becomes irreversible because of changes in the larynx laryngeal polyps have also been observed (69). In women, menstrual abnormalities are likely. Shortterm treatment can produce increases in estradiol, dihydrotestosterone, testosterone (total and unbound), and the ratio of dihydrotestosterone to testosterone. 

The ability of finasteride to block the conversion of testosterone to dihydrotestosterone also makes it useful in both male-pattern baldness (15) and hirsutism related to hyperandrogenism (for example, in polycystic ovary syndrome) in women (16). 

In an unusual study, finasteride 1 mg/day was used for 1 year to treat male-pattern baldness in nine subjects each had an identical twin who received placebo (30). Finasteride significantly improved hair growth. There were no drug-related adverse events, either clinical or biochemical. 

Of 1553 men with male-pattern baldness who took finasteride 1 mg/day, all of whom had initially taken part in one of two 1-year placebo-controlled studies, 1215 continued into further controlled studies over another 4 years (31). There was durable improvement in scalp hair over 5 years and no new safety concerns were identified. 

Accelerated genetic predisposition expression of male pattern balding. 

Male pattern baldness. (Accelerated genetic predisposition)... 

In females Androgens can cause masculinization with acne, growth of facial hair, deepening of the voice, male pattern baldness, and excessive muscle development. Menstrual irregularities may also occur. Testosterone should not be used by pregnant women, because of the possible virilization of the female fetus. 

In. Minoxidil (CyH N O) is a compound that has been approved as a treatment for some types of male-pattern baldness. An incomplete Lewis structure for minoxidil is... 

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