Turosteride
Turosteride is a synthetic compound that belongs to the class of drugs known as 5-alpha reductase inhibitors. These drugs are primarily used in the management of conditions related to the overproduction of dihydrotestosterone (DHT), a potent androgen hormone. Turosteride, like other 5-alpha reductase inhibitors, works by inhibiting the enzyme 5-alpha reductase. This enzyme is responsible for the conversion of testosterone into dihydrotestosterone. By inhibiting this conversion, turosteride reduces the levels of DHT, which can be beneficial in conditions such as benign prostatic hyperplasia (BPH) and androgenetic alopecia (male pattern baldness).
Mechanism of Action
Turosteride exerts its therapeutic effects by specifically inhibiting the type 2 isoform of the 5-alpha reductase enzyme. This inhibition leads to a significant decrease in serum and tissue DHT levels. Since DHT plays a crucial role in the development and enlargement of the prostate gland, as well as in hair follicle miniaturization, turosteride's action helps in alleviating symptoms associated with BPH and in slowing the progression of hair loss in men with androgenetic alopecia.
Clinical Uses
While the primary indication for turosteride is not as well-defined as other 5-alpha reductase inhibitors like finasteride and dutasteride, its potential applications mirror those of its counterparts. These include:
- Benign Prostatic Hyperplasia (BPH): Turosteride may be used in the management of BPH, a condition characterized by the enlargement of the prostate gland which can lead to urinary difficulties.
 - Androgenetic Alopecia: Although not as commonly prescribed for this purpose as finasteride, turosteride could theoretically be used to treat male pattern baldness due to its mechanism of action.
 
Side Effects
The side effects associated with turosteride are similar to those observed with other 5-alpha reductase inhibitors. These can include:
- Sexual dysfunction (e.g., decreased libido, erectile dysfunction)
 - Gynecomastia (enlargement of breast tissue in men)
 - Psychological effects (e.g., depression)
 
Patients are advised to discuss the potential risks and benefits of turosteride with their healthcare provider.
Comparison with Other 5-alpha Reductase Inhibitors
Turosteride is one of several 5-alpha reductase inhibitors. Each of these drugs has a slightly different profile in terms of potency, specificity for the 5-alpha reductase isoforms, and side effects. Finasteride and dutasteride are more widely used and have been more extensively studied. Turosteride's place in therapy may be influenced by ongoing research and clinical experience.
Conclusion
Turosteride represents a potential option in the treatment of conditions like BPH and androgenetic alopecia, where the reduction of DHT levels is beneficial. However, its use, efficacy, and safety profile need to be further elucidated through clinical studies. Patients considering turosteride for the management of these conditions should consult with their healthcare provider to ensure it is the appropriate therapy for their specific situation.
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Contributors: Prab R. Tumpati, MD