Finasteride: A Double – edged Sword
In the field of modern medicine, finasteride is undoubtedly a dazzling star drug, especially achieving remarkable results in the treatment of benign prostatic hyperplasia (BPH) and androgenetic alopecia (AGA). For patients with BPH, finasteride can be regarded as a “savior”. BPH often causes urinary difficulties and frequent nocturia in middle – aged and elderly men, seriously affecting their quality of life. As a 5α – reductase inhibitor, finasteride can precisely block the conversion of testosterone to dihydrotestosterone (DHT). DHT is the “culprit” that stimulates the hyperplasia of the prostate. By reducing the level of DHT, finasteride gradually shrinks the prostate volume, relieves urinary tract obstruction, enabling patients to urinate smoothly and no longer be troubled by frequent night – time awakenings.
In the treatment of AGA, finasteride also shows its prowess. AGA is more common in men, manifested as a receding hairline and thinning hair on the top of the head, which deals a heavy blow to the patient’s appearance and self – confidence. Finasteride reduces the attack of DHT on hair follicles by inhibiting its production, allowing the atrophied hair follicles to gradually regain vitality and grow healthy hair again. Many hair – loss patients are pleasantly surprised to find that after using finasteride, hair loss decreases, and even new hair begins to grow, restoring their former handsome appearance.
However, finasteride, this “sharp blade”, also has a harmful side. Its adverse effects on male sexual function have gradually come to people’s attention. Numerous clinical studies and patient feedback show that some men experience varying degrees of sexual function abnormalities after taking finasteride. Decreased libido is one of the common symptoms. Men who were originally enthusiastic about sexual life become uninterested after taking the medicine, greatly reducing the harmony of their conjugal life. Some men also encounter erectile dysfunction, being unable to perform well at critical moments, with difficulty in penile erection or weak erections, making it impossible to complete sexual intercourse smoothly. Ejaculatory disorders also occur from time to time, including problems such as reduced ejaculation volume and ejaculatory pain. All these bring great psychological pressure and distress to patients. Being tortured by sexual function problems for a long time, patients’ self – confidence is severely frustrated, leading to negative emotions such as anxiety and depression, and their quality of life drops significantly.
Precisely because of this, how to enjoy the therapeutic benefits of finasteride while reducing its impact on male sexual function has become an urgent problem to be solved in the medical field. Combining with traditional Chinese medicine (TCM) treatment may be the key to unlocking hope. Next, let’s explore the mysteries in depth.
TCM to the Rescue: The Synergistic Effect of Combined Treatment
On the path of exploring how to reduce the impact of finasteride on male sexual function, combined TCM treatment shows unique advantages, among which the synergistic effect is particularly crucial. TCM and finasteride are like a pair of highly tacit partners. When treating BPH or AGA, they work hand in hand, exerting a magical effect of “1 + 1>2”, and can also subtly reduce the adverse effects of finasteride on sexual function.
From the perspective of traditional Chinese medicine theory, the human body is a delicate and complex whole, with internal organs, meridians, qi, and blood being interconnected and influencing each other. Finasteride focuses on inhibiting 5α – reductase, precisely blocking the conversion of testosterone to DHT, thus directly hitting the root cause of BPH and AGA. On the other hand, TCM starts from the overall perspective, adjusting the body’s yin – yang balance, qi – blood circulation, and internal organ functions, creating a good internal environment for the body and helping finasteride to exert its efficacy better.
In the study of the combination of Yishen Qushi Decoction and finasteride in the treatment of male androgenetic alopecia, this synergistic effect has been fully verified. The researchers carefully selected a group of male patients with androgenetic alopecia and randomly divided them into two groups. One group was treated with finasteride alone, and the other group was treated with a combination of finasteride and Yishen Qushi Decoction. After 6 months of treatment, the results were surprising. The treatment effective rate of the combined treatment group was significantly higher than that of the control group treated with finasteride alone, and the time for hair loss improvement was also significantly shorter. What’s more, there was no significant difference in the complication rate between the two groups, which means that the combination of Yishen Qushi Decoction and finasteride not only greatly improves the treatment effect but also does not increase the adverse effects on sexual function.
Yishen Qushi Decoction contains a variety of precious Chinese herbal medicines, each playing a unique role. Herbs such as wolfberries and rubus chingii can tonify the kidney and secure essence, replenishing vital energy for the body and fundamentally improving hair loss problems caused by kidney deficiency. It should be noted that in traditional Chinese medicine, the kidney is considered to store essence, and its brilliance is manifested in the hair. Only when the kidney essence is sufficient can the hair be black, shiny, tough, and strong. Herbs such as capillaris, scutellaria, and alisma orientalis are good at clearing heat and promoting diuresis, helping the body expel dampness and toxins, and improving the greasy environment of the scalp. The scalps of many patients with androgenetic alopecia often secrete excessive oil, and this damp – heat environment is like a “barren soil” that is not conducive to hair growth. Herbs such as biota orientalis and salvia miltiorrhiza have the effects of cooling blood, promoting blood circulation, removing blood stasis, and generating new tissue. They can promote the blood circulation of the scalp, deliver sufficient nutrients to the hair follicles, just like fertilizing the “barren soil”, enabling the hair follicles to regain vitality.
When Yishen Qushi Decoction is used in combination with finasteride, finasteride inhibits the attack of DHT on hair follicles from the source, while Yishen Qushi Decoction regulates the body’s internal environment from the overall perspective. The two cooperate with each other to jointly promote hair growth and reduce the potential threat of finasteride to sexual function. This is like a football game. Finasteride is the striker, responsible for scoring goals and directly confronting the enemy. Yishen Qushi Decoction is the midfielder organizer and defender, responsible for coordinating the overall situation, creating good offensive conditions for the striker, and at the same time defending the rear to prevent accidents.
Multi – target Approach: The Unique Advantage of TCM
TCM treatment of male sexual dysfunction has unique advantages. Its characteristic of multi – target action enables it to be like an experienced commander, comprehensively coordinating various systems of the body and more effectively improving male sexual function. Different from finasteride, which acts solely on 5α – reductase, TCM can comprehensively regulate multiple aspects such as kidney function, the endocrine system, and microcirculation, conditioning the body from multiple angles and achieving all – round improvement.
In traditional Chinese medicine theory, the kidney is regarded as the root of congenital constitution, mainly storing essence, and is closely related to reproductive function. The strength of kidney function directly affects male sexual function and reproductive ability. The endocrine system is responsible for regulating various hormone levels in the human body, and hormone imbalance often leads to sexual dysfunction. The microcirculation is like the “capillary network” of the body. Whether it is unobstructed or not is related to whether various tissues and organs can receive sufficient blood supply and nutritional support, and it also plays a key role in the normal exertion of sexual function.
The study of oral TCM combined with 1mg finasteride in the treatment of male androgenetic alopecia provides strong evidence for the multi – target action of TCM. In this study, 70 young male patients with androgenetic alopecia were randomly divided into two groups. One group was treated with a combination of oral TCM and finasteride, and the other group was treated with oral TCM alone. After 6 months of treatment, the results showed that although there was no significant difference in the hair – stopping rate between the combined treatment group and the control group, the effective rate of the combined treatment group was significantly higher than that of the control group. The combined treatment group could also control the hair loss situation more quickly, relieve scalp symptoms, improve patient compliance, and reduce the dropout rate.
The secret lies in the multi – target regulation of TCM. The TCM used in the combined treatment group may contain a variety of herbs with different effects. For example, some herbs may have the effect of tonifying the kidney and replenishing essence, which can enhance kidney function, replenish vital energy for the body, and improve hair loss and sexual function problems caused by kidney deficiency. Herbs like dodder seeds and wolfberries are rich in various nutrients, which can nourish the kidney, improve kidney function, and thus improve male sexual function. Some herbs can regulate the endocrine system, balance the body’s hormone levels, reduce the stimulation of androgens on hair follicles, and also help improve sexual function. Some herbs can promote blood circulation and remove blood stasis, improve microcirculation, promote the blood circulation of the scalp and sexual organs, provide sufficient nutrients and oxygen to hair follicles and sexual organs, promote hair growth, and enhance sexual function. For example, salvia miltiorrhiza has the effect of promoting blood circulation and removing blood stasis. It can dilate blood vessels, increase blood flow, and improve microcirculation, enabling sexual organs to receive more sufficient blood supply, thereby enhancing sexual function.
Through multi – target action, TCM plays a role in coordination from multiple levels, not only improving the treatment effect of androgenetic alopecia but also improving male sexual function to a certain extent, demonstrating the unique charm and comprehensive advantages of TCM treatment.
Reducing Side Effects: The Protective Barrier of TCM
When finasteride is used to treat BPH and AGA, it often brings some side effects that have an adverse impact on male sexual function. However, TCM, with its unique pharmacological effects, can reduce these side effects and build a solid protective barrier for male sexual function.
The antioxidant, anti – inflammatory, and anti – stress effects of TCM play a key role in reducing the side effects of finasteride. From a biological perspective, finasteride may trigger an oxidative stress response, leading to an increase in free radicals in the body. These free radicals are like a group of “troublemakers” that attack cells and tissues, damage the structure and function of cell membranes, affect normal cell metabolism and signal transduction, and thus have a negative impact on male sexual function. Inflammatory reactions may also follow, and the release of inflammatory factors will interfere with the normal physiological functions of the body, affecting nerve conduction and vasodilation, resulting in sexual dysfunction.
Many components in TCM are “experts” in combating these “troublemakers”. For example, astragalus polysaccharides, flavonoids, and other components rich in astragalus membranaceus have strong antioxidant capabilities, which can scavenge excessive free radicals in the body, just like putting on a “protective suit” for cells to protect them from the damage of free radicals. Components such as baicalin and wogonin in scutellaria baicalensis have significant anti – inflammatory effects, which can inhibit the production and release of inflammatory factors and reduce the damage of inflammatory reactions to the body.
In the study of the combination of modified Huangqi Chifeng Decoction and finasteride in the treatment of androgenetic alopecia, the effect of TCM in reducing the side effects of finasteride has been fully verified. The researchers randomly divided 120 patients with androgenetic alopecia into two groups. The control group was treated with finasteride alone, and the observation group was treated with a combination of finasteride and modified Huangqi Chifeng Decoction. After 3 treatment courses, the results were gratifying. The total effective rate of the observation group was as high as 90.00%, significantly higher than 68.33% of the control group.
In terms of improving serum androgen levels, after treatment, the levels of serum free testosterone (FT), dihydrotestosterone (DHT), and testosterone (T) in both groups decreased, but the decrease in the observation group was more significant. The level of serum estradiol (E2) in the observation group increased compared with that before treatment and was higher than that in the control group. This indicates that the modified Huangqi Chifeng Decoction can better regulate the body’s androgen levels and reduce the adverse effects of finasteride on androgen metabolism.
More notably, TCM also shows unique advantages in improving patients’ negative emotions and quality of life. After treatment, the Dermatology Life Quality Index (DLQI) of both groups increased, and the Hamilton Depression Scale (HAMD) score decreased. However, the DLQI of the observation group was higher, and the HAMD score was lower. This shows that the combination of modified Huangqi Chifeng Decoction and finasteride can significantly improve patients’ negative emotions and quality of life.
Patients with androgenetic alopecia often feel inferior and anxious due to hair loss, and these negative emotions will further exacerbate sexual dysfunction. Astragalus membranaceus in the modified Huangqi Chifeng Decoction has the effects of invigorating qi, ascending yang, securing the exterior, stopping sweating, promoting diuresis, and reducing edema. It can enhance the body’s healthy qi, improve the body’s resistance and stress – resistance. Radix paeoniae rubra has the effects of clearing heat, cooling blood, promoting blood circulation, and removing blood stasis, which can improve blood circulation and relieve anxiety. Ledebouriella seseloides can relieve exterior – wind, dampness – pain, and spasm, helping to regulate the body’s nervous system and reduce mental stress. These herbs cooperate with each other to improve the patient’s psychological state from multiple aspects, improve the quality of life, and thus indirectly reduce the impact on male sexual function.
Prospects: The Future Direction of Research
In the future, we will continue to study the application of topical finasteride, which not only avoids the disadvantages of oral administration but also can target the treatment of hair loss.
The research on combining TCM treatment to reduce the impact of finasteride on male sexual function has brought new hope to many troubled patients. Through mechanisms such as synergistic effects, multi – target effects, and reducing side effects, combined treatment can effectively alleviate the adverse effects of finasteride on sexual function while improving disease symptoms, showing unique advantages and great potential.
It is undeniable that the research in this field is still in the initial exploration stage. In terms of sample size, the sample sizes of many studies are relatively small, which may lead to certain limitations in the research results and prevent a comprehensive and accurate reflection of the true efficacy and safety of combined treatment. The short research cycle is also a common problem. The long – term efficacy and potential long – term side effects of drugs are difficult to determine through short – term observation. The research on the mechanism of action of TCM is not in – depth enough. Although the positive effects of TCM in combined treatment have been observed, which specific components and through what precise pathways they act still need to be further explored and clarified.
Looking to the future, in – depth research on the specific mechanisms of combining TCM treatment to reduce the impact of finasteride on male sexual function is of great significance. In terms of expanding the sample size and extending the research cycle, we need to carry out large – scale, multi – center, and long – term clinical trials. By including more patients of different ages, conditions, and constitutions and conducting long – term follow – up observations, we can obtain more representative and reliable data and more comprehensively evaluate the efficacy and safety of combined treatment.
With the help of advanced modern scientific technologies such as gene sequencing, proteomics, and metabolomics, in – depth analysis of the mechanism of action of the combination of TCM and finasteride at the molecular level, clarifying the key targets and signaling pathways of TCM, will provide a more solid theoretical basis for combined treatment. Strengthening the research on different TCM prescriptions and finasteride dose combinations, screening out the optimal treatment plan, improving the treatment effect, and reducing the occurrence of adverse reactions are also important directions for future research.
The research on combining TCM treatment to reduce the impact of finasteride on male sexual function has broad prospects. It is believed that with the unremitting efforts of researchers, new breakthroughs will be continuously made in this field, bringing safer and more effective treatment options to patients with BPH and AGA, enabling them to get rid of the troubles of diseases and also enjoy a healthy and harmonious sex life.—For minoxidil – finasteride combinations, you can check https://www.johnsonfoam.us