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<blockquote data-quote="madman" data-source="post: 231807" data-attributes="member: 13851"><p>[URL unfurl="true"]https://www.excelmale.com/forum/threads/the-clinical-applications-of-5aris.23264/[/URL]</p><p></p><p><strong><em><u>The most common side effects of 5-ARIs include impotence, decreased libido, ejaculatory disorders, and gynecomastia</u>.14 Less common side effects that have been reported include infertility, breast tenderness, depression, anxiety, dementia, and suicide. 15-18</em></strong></p><p></p><p></p><p>[URL unfurl="true"]https://www.excelmale.com/forum/threads/the-connection-of-5ar-inhibitors-like-finasteride-to-the-development-of-depression.24336/[/URL]</p><p></p><p><strong><em>*Changes in neuroactive steroids following 5-ARI use can lead to <u>dysfunction of the dopaminergic system, reduction of hippocampal neurogenesis, an increase in neuroinflammation, alterations of the HPA axis, and epigenetic modification</u>. <u>Moreover, the alterations of the neuroactive steroids, especially AP, are also linked to the alteration of central nervous system receptor functions including dopaminergic receptors, GABA-A receptors, estrogen receptors, and androgen receptors</u></em></strong></p><p></p><p></p><p>[URL unfurl="true"]https://www.excelmale.com/forum/threads/persistent-adverse-sexual-effects-of-finasteride.24844/#post-217481[/URL]</p><p></p><p><em><strong>*The term post-finasteride syndrome was coined by some men to describe the <u>persistent symptoms (sexual and non-sexual) that they developed in the setting of using or stopping finasteride</u>. <u>The most commonly reported symptoms include low libido, erectile dysfunction, loss of penile and scrotal sensitivity, decreased ejaculatory force and volume, reduction in penile size, anhedonia, depressive symptoms, anxiety, decreased concentration, reduced muscle mass, and fatigue</u>.3</strong></em></p><p><em><strong></strong></em></p><p><em><strong>*<em><strong>According to the public dashboard of the FDA’s Adverse Event Reporting System, as of June 2021, there were 10,295 serious adverse events for finasteride. It is well established that most adverse medication events are grossly underreported.8 <u>Importantly, three of the four most common reaction types are related to sexual dysfunction</u>: <u>erectile dysfunction, sexual dysfunction, and decreased libido</u></strong></em></strong></em></p><p></p><p></p><p>[URL unfurl="true"]https://www.excelmale.com/forum/threads/persistent-sexual-dysfunction-after-finasteride.25186/#post-223830[/URL]</p><p></p><p>*<em><strong>In a large series, we replicated Khera’s findings of persistent physical sequelae associated with changes in SF in men after DC FIN. <u>While more research is needed, this population is young, ED is most often severe, and testing shows a high prevalence of vascular, neurologic, and hormonal pathologies</u></strong></em></p><p></p><p></p><p>[URL unfurl="true"]https://www.excelmale.com/forum/threads/synthesis-and-actions-of-5a-r-metabolites-of-t-in-the-nervous-system.24606/#post-214249[/URL]</p><p></p><p>*<strong><em>Significant literature indicating that 5a-Rs and 3a/3bHSORs are widely expressed and distributed in various regions of the nervous system suggests a critical function of these enzymes in the effects exerted by testosterone and its metabolites. <u>Indeed, 5a-Rs catalyze a key rate-limiting step in the formation of 5a-reduced neuroactive steroids and, therefore, is critical in maintaining the physiological function of the nervous system</u>. <u>Indeed, T and its metabolites are implicated in processes of neurogenesis, myelination and remyelination, neuroprotection, and attenuation of neuroinflammation</u>. <u>Furthermore, these metabolites play an important role in the reduction of stress responses and modulation of behavior</u></em></strong></p><p></p><p></p><p></p><p></p><p>[URL unfurl="true"]https://www.excelmale.com/forum/threads/higher-estradiol-t-and-dht-correlated-to-higher-libido-in-older-hypogonadal-men-than-t-alone.24831/[/URL]</p><p></p><p><em><strong>*Circulating testosterone is converted in many peripheral tissues to its two active metabolites, 5α dihydrotestosterone (DHT) and 17β estradiol (E2)</strong></em></p><p></p><p><strong><em>*In many androgen-responsive tissues, a family of steroid 5α reductase enzymes converts testosterone to DHT, and the aromatase enzyme, a product of the CYP19A1 gene, converts it to E2</em></strong></p><p><strong><em></em></strong></p><p><strong><em>*Many tissue-specific biologic effects of testosterone are <u>mediated through DHT and E2</u></em></strong></p><p><strong><em></em></strong></p><p><strong><em>*The <u>rates of conversion of testosterone to DHT and E2 vary among people due to polymorphisms of genes that encode the steroid 5α reductases and the aromatase enzyme as well as other host-specific factors that affect the activity of these enzymes</u></em></strong></p><p><strong><em></em></strong></p><p><strong><em>*It is not known how the circulating concentrations of testosterone’s metabolites – DHT and E2 – modulate the effects of testosterone on various outcomes and how their circulating levels rank in their contribution to the observed effects of testosterone treatment on physiologic outcomes</em></strong></p></blockquote><p></p>
[QUOTE="madman, post: 231807, member: 13851"] [URL unfurl="true"]https://www.excelmale.com/forum/threads/the-clinical-applications-of-5aris.23264/[/URL] [B][I][U]The most common side effects of 5-ARIs include impotence, decreased libido, ejaculatory disorders, and gynecomastia[/U].14 Less common side effects that have been reported include infertility, breast tenderness, depression, anxiety, dementia, and suicide. 15-18[/I][/B] [URL unfurl="true"]https://www.excelmale.com/forum/threads/the-connection-of-5ar-inhibitors-like-finasteride-to-the-development-of-depression.24336/[/URL] [B][I]*Changes in neuroactive steroids following 5-ARI use can lead to [U]dysfunction of the dopaminergic system, reduction of hippocampal neurogenesis, an increase in neuroinflammation, alterations of the HPA axis, and epigenetic modification[/U]. [U]Moreover, the alterations of the neuroactive steroids, especially AP, are also linked to the alteration of central nervous system receptor functions including dopaminergic receptors, GABA-A receptors, estrogen receptors, and androgen receptors[/U][/I][/B] [URL unfurl="true"]https://www.excelmale.com/forum/threads/persistent-adverse-sexual-effects-of-finasteride.24844/#post-217481[/URL] [I][B]*The term post-finasteride syndrome was coined by some men to describe the [U]persistent symptoms (sexual and non-sexual) that they developed in the setting of using or stopping finasteride[/U]. [U]The most commonly reported symptoms include low libido, erectile dysfunction, loss of penile and scrotal sensitivity, decreased ejaculatory force and volume, reduction in penile size, anhedonia, depressive symptoms, anxiety, decreased concentration, reduced muscle mass, and fatigue[/U].3 *[I][B]According to the public dashboard of the FDA’s Adverse Event Reporting System, as of June 2021, there were 10,295 serious adverse events for finasteride. It is well established that most adverse medication events are grossly underreported.8 [U]Importantly, three of the four most common reaction types are related to sexual dysfunction[/U]: [U]erectile dysfunction, sexual dysfunction, and decreased libido[/U][/B][/I][/B][/I] [URL unfurl="true"]https://www.excelmale.com/forum/threads/persistent-sexual-dysfunction-after-finasteride.25186/#post-223830[/URL] *[I][B]In a large series, we replicated Khera’s findings of persistent physical sequelae associated with changes in SF in men after DC FIN. [U]While more research is needed, this population is young, ED is most often severe, and testing shows a high prevalence of vascular, neurologic, and hormonal pathologies[/U][/B][/I] [URL unfurl="true"]https://www.excelmale.com/forum/threads/synthesis-and-actions-of-5a-r-metabolites-of-t-in-the-nervous-system.24606/#post-214249[/URL] *[B][I]Significant literature indicating that 5a-Rs and 3a/3bHSORs are widely expressed and distributed in various regions of the nervous system suggests a critical function of these enzymes in the effects exerted by testosterone and its metabolites. [U]Indeed, 5a-Rs catalyze a key rate-limiting step in the formation of 5a-reduced neuroactive steroids and, therefore, is critical in maintaining the physiological function of the nervous system[/U]. [U]Indeed, T and its metabolites are implicated in processes of neurogenesis, myelination and remyelination, neuroprotection, and attenuation of neuroinflammation[/U]. [U]Furthermore, these metabolites play an important role in the reduction of stress responses and modulation of behavior[/U][/I][/B] [URL unfurl="true"]https://www.excelmale.com/forum/threads/higher-estradiol-t-and-dht-correlated-to-higher-libido-in-older-hypogonadal-men-than-t-alone.24831/[/URL] [I][B]*Circulating testosterone is converted in many peripheral tissues to its two active metabolites, 5α dihydrotestosterone (DHT) and 17β estradiol (E2)[/B][/I] [B][I]*In many androgen-responsive tissues, a family of steroid 5α reductase enzymes converts testosterone to DHT, and the aromatase enzyme, a product of the CYP19A1 gene, converts it to E2 *Many tissue-specific biologic effects of testosterone are [U]mediated through DHT and E2[/U] *The [U]rates of conversion of testosterone to DHT and E2 vary among people due to polymorphisms of genes that encode the steroid 5α reductases and the aromatase enzyme as well as other host-specific factors that affect the activity of these enzymes[/U] *It is not known how the circulating concentrations of testosterone’s metabolites – DHT and E2 – modulate the effects of testosterone on various outcomes and how their circulating levels rank in their contribution to the observed effects of testosterone treatment on physiologic outcomes[/I][/B] [/QUOTE]
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