Related research: Special topics

5-alpha reductase deficiency

See also: Sources on guevedoces and the early history of finasteride

Cheng T, Wang H, Han B, et al. Identification of three novel SRD5A2 mutations in Chinese patients with 5α-reductase 2 deficiency. Asian J Androl. 2019. doi:10.4103/aja.aja_113_18PubMed

Imperato-McGinley J. 5alpha-reductase-2 deficiency and complete androgen insensitivity: lessons from nature. Adv Exp Med Biol. 2002. doi:10.1007/978-1-4615-0621-8_8PubMed

Imperato-McGinley J, Guerrero L, Gautier T, Peterson RE. Steroid 5alpha-reductase deficiency in man: an inherited form of male pseudohermaphroditism. Science. 1974. doi:10.1126/science.186.4170.1213PubMed

Kang HJ, Imperato-McGinley J, Zhu YS, Rosenwaks Z. The effect of 5α-reductase-2 deficiency on human fertility. Fertil Steril. 2014. doi:10.1016/j.fertnstert.2013.11.128PubMed

Kumar G, Barboza-Meca JJ. 5 Alpha Reductase Deficiency. StatPearls Publishing. 2020 Jan. NCBI Bookshelf

MedlinePlus. National Library of Medicine (US). 5-alpha reductase deficiency.

PubMed search for MeSH term ‘3-Oxo-5-alpha-Steroid 4-Dehydrogenase / deficiency

Robitaille J, Langlois VS. Consequences of steroid-5α-reductase deficiency and inhibition in vertebrates. Gen Comp Endocrinol. 2020. doi:10.1016/j.ygcen.2020.113400PubMed

Sasaki G, Ishii T, Hori N, Amano N, Homma K, Sato S, Hasegawa T. Effects of pre- and post-pubertal dihydrotestosterone treatment on penile length in 5α-reductase type 2 deficiency. Endocr J. 2019 Sep 28. doi:10.1507/endocrj.EJ19-0111 • PubMed

Androgen receptors

See also: Related research: Genetics

Bauman TM, Sehgal PD, Johnson KA, et al. Finasteride treatment alters tissue specific androgen receptor expression in prostate tissues. Prostate. 2014. doi:10.1002/pros.22810 • PubMed

Brinkmann AO, Faber PW, van Rooij HC, et al. The human androgen receptor: domain structure, genomic organization and regulation of expression. J Steroid Biochem. 1989. doi:10.1016/0022-4731(89)90098-8PubMed

Cauci S, Chiriacò G, Cecchin E, et al. Androgen Receptor (AR) Gene (CAG)n and (GGN)n Length Polymorphisms and Symptoms in Young Males With Long-Lasting Adverse Effects After Finasteride Use Against Androgenic Alopecia. Sex Med. 2017. doi:10.1016/j.esxm.2016.11.001PubMed

Cecchin E, De Mattia E, Mazzon G, Cauci S, Trombetta C, Toffoli G. A pharmacogenetic survey of androgen receptor (CAG)n and (GGN)n polymorphisms in patients experiencing long term side effects after finasteride discontinuation. Int J Biol Markers. 2014. doi:10.5301/jbm.5000095PubMed

Cherian MT, Wilson EM, Shapiro DJ. A competitive inhibitor that reduces recruitment of androgen receptor to androgen-responsive genes. J Biol Chem. 2012 Jul 6. doi:10.1074/jbc.M112.344671PubMedFull text

Davey RA, Grossmann M. Androgen Receptor Structure, Function and Biology: From Bench to Bedside. Clin Biochem Rev. 2016 Feb. PubMedPMC full text

Ellis JA, Stebbing M, Harrap SB. Polymorphism of the androgen receptor gene is associated with male pattern baldness. J Invest Dermatol. 2001 Mar. doi:10.1046/j.1523-1747.2001.01261.xPubMed

Ghassemi M, Ghaffarpour GH, Ghods S. The effect of GGC and CAG repeat polymorphisms on the androgen receptor gene in response to finasteride therapy in men with androgenetic alopecia. J Res Med Sci. 2019. doi:10.4103/jrms.JRMS_27_19PubMed

Gibson DA, Saunders PTK, McEwan IJ. Androgens and androgen receptor: Above and beyond. Mol Cell Endocrinol. 2018. doi:10.1016/j.mce.2018.02.013PubMed

González-Cadavid N, Vernet D, Fuentes Navarro A, Rodríguez JA, Swerdloff RS, Rajfer J. Up-regulation of the levels of androgen receptor and its mRNA by androgens in smooth-muscle cells from rat penis. Mol Cell Endocrinol. 1993. doi:10.1016/0303-7207(93)90155-d • PubMed

Grigorova M, Punab M, Kahre T, et al. The number of CAG and GGN triplet repeats in the Androgen Receptor gene exert combinatorial effect on hormonal and sperm parameters in young men. Andrology. 2017. doi:10.1111/andr.12344PubMed

Hillmer AM, Hanneken S, Ritzmann S, et al. Genetic variation in the human androgen receptor gene is the major determinant of common early-onset androgenetic alopecia. Am J Hum Genet. 2005 Jul. doi:10.1086/431425PMC full text

Hunter I, Hay CW, Esswein B, Watt K, McEwan IJ. Tissue control of androgen action: The ups and downs of androgen receptor expression. Mol Cell Endocrinol. 2018. doi:10.1016/j.mce.2017.08.002PubMed

Keene S, Goren A. Therapeutic hotline. Genetic variations in the androgen receptor gene and finasteride response in women with androgenetic alopecia mediated by epigenetics. Dermatol Ther. 2011. doi:10.1111/j.1529-8019.2011.01407.xPubMed

Levy-Nissenbaum E, Bar-Natan M, Frydman M, Pras E. Confirmation of the association between male pattern baldness and the androgen receptor gene. Eur J Dermatol. 2005 Sep-Oct. PubMed

McEwan IJ, Brinkmann AO. Androgen Physiology: Receptor and Metabolic Disorders. In: Feingold KR, Anawalt B, Boyce A, et al., eds. Endotext. South Dartmouth (MA):, Inc.; 2016 Jun 12. Endotext site (free; registration required) • PubMed

Narayanan R, Coss CC, Dalton JT. Development of selective androgen receptor modulators (SARMs). Mol Cell Endocrinol. 2018. doi:10.1016/j.mce.2017.06.013PubMed

Takayama KI. The biological and clinical advances of androgen receptor function in age-related diseases and cancer [Review]. Endocr J. 2017. doi:10.1507/endocrj.EJ17-0328PubMed

Tirabassi G, Corona G, Biagioli A, et al. Influence of androgen receptor CAG polymorphism on sexual function recovery after testosterone therapy in late-onset hypogonadism. J Sex Med. 2015. doi:10.1111/jsm.12790PubMed

Tirabassi G, Corona G, Falzetti S, Delli Muti N, Maggi M, Balercia G. Influence of Androgen Receptor Gene CAG and GGC Polymorphisms on Male Sexual Function: A Cross-Sectional Study. Int J Endocrinol. 2016. doi:10.1155/2016/5083569PubMed

Tut TG, Ghadessy FJ, Trifiro MA, Pinsky L, Yong EL. Long polyglutamine tracts in the androgen receptor are associated with reduced trans-activation, impaired sperm production, and male infertility. J Clin Endocrinol Metab. 1997 Nov. doi:10.1210/jcem.82.11.4385PubMed

Xiao Q, Wang L, Supekar S, et al. Structure of human steroid 5α-reductase 2 with the anti-androgen drug finasteride. Nat Commun. 2020 Oct 27. doi:10.1038/s41467-020-19249-zPubMed

Yamazaki M, Sato A, Toyoshima KE, et al. Polymorphic CAG repeat numbers in the androgen receptor gene of female pattern hair loss patients. J Dermatol. 2011 Jul. doi:10.1111/j.1346-8138.2010.01060.xPubMed

Zhuo FL, Xu W, Wang L, Wu Y, Xu ZL, Zhao JY. Androgen receptor gene polymorphisms and risk for androgenetic alopecia: a meta-analysis. Clin Exp Dermatol. 2012. doi:10.1111/j.1365-2230.2011.04186.xPubMed


Low LA, Mummery C, Berridge BR, Austin CP, Tagle DA. Organs-on-chips: into the next decade. Nat Rev Drug Discov. 2021 May. doi:10.1038/s41573-020-0079-3PubMed

DNA repair mediated by androgens or androgen receptor

Casimiro MC, Di Sante G, Ju X. Cyclin D1 Promotes Androgen-Dependent DNA Damage Repair in Prostate Cancer Cells. Cancer Res. 2016 Jan 15. doi:10.1158/0008-5472.CAN-15-0999 • PubMed • PMC full text

Chen SR, Hao XX, Zhang Y. Androgen receptor in Sertoli cells regulates DNA double-strand break repair and chromosomal synapsis of spermatocytes partially through intercellular EGF-EGFR signaling. Oncotarget. 2016 Apr 5. doi:10.18632/oncotarget.7916 • PubMed • PMC full text

Goodwin JF, Schiewer MJ, Dean JL, et al. A hormone-DNA repair circuit governs the response to genotoxic insult. Cancer Discov. 2013 Nov. doi:10.1158/2159-8290.CD-13-0108 • PubMed • PMC full text

McCarthy, N. Understanding why. Nat Rev Cancer. 2013. doi:10.1038/nrc3615 • PubMed

Epigenetics of adverse drug reactions

See also: Isotretinoin

Becker E, Bengs S, Aluri S, et al. Large-Scale Integrative Analysis of Epigenetic Modifications Induced by Isotretinoin, Doxycycline and Metronidazole in Murine Colonic Intestinal Epithelial Cells. Epigenomes. 2017. doi:10.3390/epigenomes1030024

Csoka AB, Szyf M. Epigenetic side-effects of common pharmaceuticals: a potential new field in medicine and pharmacology. Med Hypotheses. 2009 Nov. doi:10.1016/j.mehy.2008.10.039PubMed

Eckstein M, Rea M, Fondufe-Mittendorf YN. Transient and permanent changes in DNA methylation patterns in inorganic arsenic-mediated epithelial-to-mesenchymal transition. Toxicol Appl Pharmacol. 2017 Sep 15. doi:10.1016/j.taap.2017.03.017 • PubMed • PMC full text

Fisel P, Schaeffeler E, Schwab M. DNA Methylation of ADME Genes. Clin Pharmacol Ther. 2016. doi:10.1002/cpt.343PubMed

Jiang Y, Chen H, Han L, Xie X, Zheng Y, Lai W. Altered Gene Expression in Acne Vulgaris Patients Treated by Oral Isotretinoin: A Preliminary Study. Pharmgenomics Pers Med. 2020 Sep 15. doi:10.2147/PGPM.S250969. PubMedPMC full text

Kacevska M, Ivanov M, Ingelman-Sundberg M. Perspectives on epigenetics and its relevance to adverse drug reactions. Clin Pharmacol Ther. 2011. doi:10.1038/clpt.2011.21PubMed

Kanherkar RR, Getachew B, Ben-Sheetrit J, Varma S, Heinbockel T, Tizabi Y, Csoka AB. The Effect of Citalopram on Genome-Wide DNA Methylation of Human Cells. Int J Genomics. 2018 Jul 25. doi:10.1155/2018/8929057PubMedPMC full text

Nelson AM, Zhao W, Gilliland KL, Zaenglein AL, Liu W, Thiboutot DM. Early gene changes induced by isotretinoin in the skin provide clues to its mechanism of action. Dermatoendocrinol. 2009 Mar. doi:10.4161/derm.1.2.8107PubMedPMC full text

Nelson AM, Zhao W, Gilliland KL, Zaenglein AL, Liu W, Thiboutot DM. Temporal changes in gene expression in the skin of patients treated with isotretinoin provide insight into its mechanism of action. Dermatoendocrinol. 2009 May. doi:10.4161/derm.1.3.8258 • PubMed • PMC full text


See also: Epigenetics of adverse drug reactions

Becker E, Bengs S, Aluri S, et al. Large-Scale Integrative Analysis of Epigenetic Modifications Induced by Isotretinoin, Doxycycline and Metronidazole in Murine Colonic Intestinal Epithelial Cells. Epigenomes. 2017. doi:10.3390/epigenomes1030024

Boudou P, Soliman H, Chivot M, et al. Effect of oral isotretinoin treatment on skin androgen receptor levels in male acneic patients. J Clin Endocrinol Metab. 1995 Apr. doi:10.1210/jcem.80.4.7714084PubMed

Jiang Y, Chen H, Han L, Xie X, Zheng Y, Lai W. Altered Gene Expression in Acne Vulgaris Patients Treated by Oral Isotretinoin: A Preliminary Study. Pharmgenomics Pers Med. 2020 Sep 15. doi:10.2147/PGPM.S250969. PubMedPMC full text

Melnik BC. Apoptosis May Explain the Pharmacological Mode of Action and Adverse Effects of Isotretinoin, Including Teratogenicity. Acta Derm Venereol. 2017 Feb 8. doi:10.2340/00015555-2535PubMed

Nelson AM, Zhao W, Gilliland KL, Zaenglein AL, Liu W, Thiboutot DM. Early gene changes induced by isotretinoin in the skin provide clues to its mechanism of action. Dermatoendocrinol. 2009 Mar. doi:10.4161/derm.1.2.8107PubMedPMC full text

Nelson AM, Zhao W, Gilliland KL, Zaenglein AL, Liu W, Thiboutot DM. Temporal changes in gene expression in the skin of patients treated with isotretinoin provide insight into its mechanism of action. Dermatoendocrinol. 2009 May. doi:10.4161/derm.1.3.8258PubMedPMC full text


Borgo F, Macandog AD, Diviccaro S, et al. Alterations of gut microbiota composition in post-finasteride patients: a pilot study. J Endocrinol Invest. 2021 Jun. doi:10.1007/s40618-020-01424-0. PubMedPMC full text

Diviccaro S, Giatti S, Borgo F, et al. Treatment of male rats with finasteride, an inhibitor of 5alpha-reductase enzyme, induces long-lasting effects on depressive-like behavior, hippocampal neurogenesis, neuroinflammation and gut microbiota composition. Psychoneuroendocrinology. 2019. doi:10.1016/j.psyneuen.2018.09.021 • PubMed

Liu J, Lai L, Lin J, et al. Ranitidine and finasteride inhibit the synthesis and release of trimethylamine N-oxide and mitigates its cardiovascular and renal damage through modulating gut microbiota. Int J Biol Sci. 2020 Jan 14. doi:10.7150/ijbs.40934PubMed


Almohanna HM, Perper M, Tosti A. Safety concerns when using novel medications to treat alopecia. Expert Opin Drug Saf. 2018 Nov. doi:10.1080/14740338.2018.1533549 • PubMed

Badri T, Nessel TA, Kumar D. Minoxidil. StatPearls; 2021. Available from: NCBI Bookshelf

da Cruz GK, Martins MIM, Antunes FTT, et al. Evaluation of the efficacy and toxicity of oral and topical pumpkin oil on the hair growth of mice. Acta Histochem. 2022 Apr 18. doi:10.1016/j.acthis.2022.151894PubMed

“Minoxidil increased the DNA damage in the blood and the liver tissues.”

Donovan DJ. Paresthesias from Topical Minoxidil: Are we missing it? Donovan Hair Clinic [dermatologist’s blog post].

Ersland E, Ebrahim N, Mwizerwa O, et al. Human Vascular Wall Microfluidic Model for Preclinical Evaluation of Drug-Induced Vascular Injury. Tissue Eng Part C Methods. 2022 Feb. doi:10.1089/ten.TEC.2021.0227PubMed

Minoxidil has “demonstrated preclinical drug-induced vascular injury but lack[s] clinical evidence… [M]inoxidil demonstrated minor endothelial cell barrier injury but damaged vascular smooth muscle cells…”

Hsu CL, Liu JS, Lin AC, Yang CH, Chung WH, Wu WG. Minoxidil may suppress androgen receptor-related functions. Oncotarget. 2014 Apr 30. doi:10.18632/oncotarget.1886PubMedPMC full text

Korbi M, Said El Mabrouk R, Abdelaali M, Youssef M, Belhadjali H, Zili J. Topical minoxidil-induced paresthesia. Dermatol Ther. 2022 Apr. doi:10.1111/dth.15328PubMed

Mazen A. Topical Minoxidil 5% Induced Male Sexual Dysfunction. Indian Journal of Medical Research and Pharmaceutical Sciences [not indexed in PubMed]. 2017 May. doi:10.5281/zenodo.580856

Mir-Bonafé JF, Mir-Bonafé M, Rozas-Muñoz E, Mir-Bonafé JM. Morning Periorbital Edema Related to Low-Dose Oral Minoxidil. Actas Dermosifiliogr. 2022 Apr 28. English, Spanish. doi:10.1016/ • PubMedPDF in English (automated translation)PDF in Spanish

Pekmezci E, Türkoğlu M. Minoxidil Acts as an Antiandrogen: A Study of 5α-reductase Type 2 Gene Expression in a Human Keratinocyte Cell Line. Acta Dermatovenerol Croat. 2017 Dec. PubMed

Tsoporis J, Keeley FW, Lee RM, Leenen FH. Arterial vasodilation and vascular connective tissue changes in spontaneously hypertensive rats. J Cardiovasc Pharmacol. 1998 Jun. doi:10.1097/00005344-199806000-00022PubMed

Penile imaging, anatomy, physiology and restoration

Abualruz AR, O’Malley R, Ponnatapura J, et al. MRI of common penile pathologies and penile prostheses. Abdom Radiol (NY). 2020 Sep. doi:10.1007/s00261-019-02080-6PubMed

Altun E. MR Imaging of the Penis and Urethra. Magn Reson Imaging Clin N Am. 2019 Feb. doi:10.1016/j.mric.2018.09.006PubMed

Cozzi D, Verrone GB, Agostini S, et al. Acute penile trauma: imaging features in the emergency setting. Radiol Med. 2019 Dec. doi:10.1007/s11547-019-01065-1PubMed

Diallo D, Zaitouna M, Alsaid B, et al. The visceromotor and somatic afferent nerves of the penis. J Sex Med. 2015 May. doi:10.1111/jsm.12851PubMed

Goldstein AMB, Padma-Nathan H. The Microarchitecture of the Intracavernosal Smooth Muscle and the Cavernosal Fibrous Skeleton. J Urol. 1990 Nov 1. doi:10.1016/S0022-5347(17)39677-5

Lefaucheur JP. Measurement of electrochemical conductance of penile skin using Sudoscan®: A new tool to assess neurogenic impotence. Neurophysiol Clin. 2017 Jun. doi:10.1016/j.neucli.2017.05.092PubMed

Lindquist CM, Nikolaidis P, Mittal PK, Miller FH. MRI of the penis. Abdom Radiol (NY). 2020 Jul. doi:10.1007/s00261-019-02301-yPubMed

Nakahara T, Narula J, Tijssen JGP, et al. 18F-Fluoride Positron Emission Tomographic Imaging of Penile Arteries and Erectile Dysfunction. J Am Coll Cardiol. 2019 Apr 2. doi:10.1016/j.jacc.2018.10.076PubMed

Parmar M, Masterson JM, Masterson TA 3rd. The role of imaging in the diagnosis and management of Peyronie’s disease. Curr Opin Urol. 2020 May. doi:10.1097/MOU.0000000000000754PubMed

Schulster M, Bernie AM, Ramasamy R. The role of estradiol in male reproductive function. Asian J Androl. 2016 May-Jun. doi:10.4103/1008-682X.173932PubMedPMC full text

Shen ZJ, Zhou XL, Lu YL, Chen ZD. Effect of androgen deprivation on penile ultrastructure. Asian J Androl. 2003 Mar. PubMed

Shenoy-Bhangle A, Perez-Johnston R, Singh A. Penile imaging. Radiol Clin North Am. 2012 Nov. doi:10.1016/j.rcl.2012.08.009PubMed

Terrier JE, Tal R, Nelson CJ, Mulhall JP. Penile Sensory Changes After Plaque Incision and Grafting Surgery for Peyronie’s Disease. J Sex Med. 2018 Oct. doi:10.1016/j.jsxm.2018.07.020PubMed

Thornbury KD, Hollywood MA, Sergeant GP. Ion Channels and Intracellular Calcium Signalling in Corpus Cavernosum. Adv Exp Med Biol. 2019. doi:10.1007/978-981-13-5895-1_7PubMed

Tu LH, Spektor M, Ferrante M, Mathur M. MRI of the Penis: Indications, Anatomy, and Pathology. Curr Probl Diagn Radiol. 2020 Jan-Feb. doi:10.1067/j.cpradiol.2018.12.004PubMed

Waldinger MD, van Coevorden RS, Schweitzer DH, Georgiadis J. Penile anesthesia in Post SSRI Sexual Dysfunction (PSSD) responds to low-power laser irradiation: a case study and hypothesis about the role of transient receptor potential (TRP) ion channels. Eur J Pharmacol. 2015 Apr 15. doi:10.1016/j.ejphar.2014.11.031PubMed

Wang Y, Wang Y, Cong R, et al. Restoration of erectile function by suppression of corporal apoptosis and oxidative stress with losartan in aged rats with erectile dysfunction. Andrology. 2020 May. doi:10.1111/andr.12757PubMed

Wiggins A, Farrell MR, Tsambarlis P, Levine LA. The Penile Sensitivity Ratio: A Novel Application of Biothesiometry to Assess Changes in Penile Sensitivity. J Sex Med. 2019 Mar. doi:10.1016/j.jsxm.2019.01.002PubMed


Al Dweik R, Stacey D, Kohen D, Yaya S. Factors affecting patient reporting of adverse drug reactions: a systematic review. Br J Clin Pharmacol. 2017. doi:10.1111/bcp.13159PubMed

Gordijn R, Teichert M, Nicolai MPJ, Elzevier HW, Guchelaar HJ. Adverse drug reactions on sexual functioning: a systematic review. Drug Discov Today. 2019 Mar. doi:10.1016/j.drudis.2019.01.012PubMed

Hazell L, Shakir SA. Under-reporting of adverse drug reactions: a systematic review. Drug Saf. 2006. doi:10.2165/00002018-200629050-00003PubMed

Inch J, Watson MC, Anakwe-Umeh S. Patient versus healthcare professional spontaneous adverse drug reaction reporting: a systematic review. Drug Saf. 2012. doi:10.1007/bf03261977PubMed

Ioannidis JP, Lau J. Completeness of safety reporting in randomized trials: an evaluation of 7 medical areas. JAMA. 2001. doi:10.1001/jama.285.4.437PubMed

Lopez-Gonzalez E, Herdeiro MT, Figueiras A. Determinants of under-reporting of adverse drug reactions: a systematic review. Drug Saf. 2009. doi:10.2165/00002018-200932010-00002PubMed

Moore TJ. Finasteride and the Uncertainties of Establishing Harms. JAMA Dermatol. 2015 Jun. doi:10.1001/jamadermatol.2015.37PubMed

Nizzi MC. Should We Trust Patient-Reported Outcomes? AJOB Neurosci. 2021 Apr-Sep. doi:10.1080/21507740.2021.1904040PubMed

[Audio interview] Re: Adverse Event Reporting in Clinical Trials of Finasteride for Alopecia: Interview with SM Belknap and TJ Moore published by JAMA Dermatol. 2015 Apr 1. Journal site

Study in progress as of 2020: European Network of Centres for Pharmacoepidemiology and Pharmacovigilance. Suicide and suicidality after exposure to finasteride.

Valeiro C, Matos C, Scholl J, van Hunsel F. Drug-Induced Sexual Dysfunction: An Analysis of Reports to a National Pharmacovigilance Database. Drug Saf. 2022 Apr 7. doi:10.1007/s40264-022-01174-3PubMed

Post-SSRI sexual dysfunction

Healy D, Bahrick A, Bak M, et al. Diagnostic Criteria for Enduring Sexual Dysfunction after Treatment with Antidepressants, Finasteride and Isotretinoin. Int J Risk Saf Med. 2021 Oct 26. doi:10.3233/JRS-210023

Hellmann-Regen J, Uhlemann R, Regen F, et al. Direct inhibition of retinoic acid catabolism by fluoxetine. J Neural Transm (Vienna). 2015 Sep. doi:10.1007/s00702-015-1407-3PubMed

See Medical Literature at UK PSSD Association.

Saw palmetto (Serenoa repens)

Regulatory reports

Assessment report on Serenoa repens (W. Bartram) Small, fructus. Committee on Herbal Medicinal Products (HMPC), European Medicines Agency. November 24, 2015.

Saw Palmetto. National Center for Complementary and Integrative Health (NCCIH), United States Department of Health and Human Services.

Research articles

Abe M, Ito Y, Suzuki A, Onoue S, Noguchi H, Yamada S. Isolation and pharmacological characterization of fatty acids from saw palmetto extract. Anal Sci. 2009 Apr;25(4):553-7. doi:10.2116/analsci.25.553PubMed

Agbabiaka TB, Pittler MH, Wider B, Ernst E. Serenoa repens (saw palmetto): a systematic review of adverse events. Drug Saf. 2009. doi:10.2165/00002018-200932080-00003PubMed

Avins AL, Bent S, Staccone S, et al. A detailed safety assessment of a saw palmetto extract. Complement Ther Med. 2008 Jun. doi:10.1016/j.ctim.2007.10.005PubMedPMC full text

Avins AL, Lee JY, Meyers CM, Barry MJ; CAMUS Study Group. Safety and toxicity of saw palmetto in the CAMUS trial. J Urol. 2013 Apr. doi:10.1016/j.juro.2012.10.002PubMedPMC full text

Gallo E, Maggini V, Lombardi N, et al. Serenoa repens induced erectile dysfunction: Underdiagnosis and phytovigilance. Br J Clin Pharmacol. 2021 Nov 7. doi:10.1111/bcp.15129 • PubMed

Gammoudi R, Ameur K, Ouni B, et al. Fixed drug eruption to Serenoa repens: First case report and consideration of the use of herbal medicine. Dermatol Ther. 2020 Nov. doi:10.1111/dth.14247PubMed

Pais P, Villar A, Rull S. Determination of the potency of a novel saw palmetto supercritical CO2 extract (SPSE) for 5α-reductase isoform II inhibition using a cell-free in vitro test system. Res Rep Urol. 2016 Apr 21. doi:10.2147/RRU.S96576PubMedPMC full text

Paulis G, Paulis A, Perletti G. Serenoa repens and its effects on male sexual function. A systematic review and meta-analysis of clinical trials. Arch Ital Urol Androl. 2021 Dec. doi:10.4081/aiua.2021.4.475PubMed

Sinclair RD, Mallari RS, Tate B. Sensitization to saw palmetto and minoxidil in separate topical extemporaneous treatments for androgenetic alopecia. Australas J Dermatol. 2002 Nov. doi:10.1046/j.1440-0960.2002.00620.xPubMed

Yeu E, Grostern R. Saw palmetto and intraoperative floppy-iris syndrome. J Cataract Refract Surg. 2007 May. doi:10.1016/j.jcrs.2006.12.032 • PubMed

Sexual development, effects on

Bowman CJ, Barlow NJ, Turner KJ, Wallace DG, Foster PM. Effects of in utero exposure to finasteride on androgen-dependent reproductive development in the male rat. Toxicol Sci. 2003. doi:10.1093/toxsci/kfg128 • PubMed

Christiansen S, Scholze M, Dalgaard M, et al. Synergistic disruption of external male sex organ development by a mixture of four antiandrogens. Environ Health Perspect. 2009 Dec. doi:10.1289/ehp.0900689PubMedPMC full text

Corbin CJ, Legacki EL, Ball BA, Scoggin KE, Stanley SD, Conley AJ. Equine 5α-reductase activity and expression in epididymis. J Endocrinol. 2016 Oct. doi:10.1530/JOE-16-0175PubMed

George FW, Johnson L, Wilson JD. The effect of a 5 alpha-reductase inhibitor on androgen physiology in the immature male rat. Endocrinology. 1989 Nov. doi:10.1210/endo-125-5-2434PubMed

Henderson NA, Robaire B. Effects of PNU157706, a dual 5alpha-reductase inhibitor, on rat epididymal sperm maturation and fertility. Biol Reprod. 2005 Feb;72(2):436-43. doi:10.1095/biolreprod.104.033548 | PubMed

Hib J, Ponzio R. The abnormal development of male sex organs in the rat using a pure antiandrogen and a 5 alpha-reductase inhibitor during gestation. Acta Physiol Pharmacol Ther Latinoam. 1995. PubMed

Imperato-McGinley J, Sanchez RS, Spencer JR, Yee B, Vaughan ED. Comparison of the effects of the 5 alpha-reductase inhibitor finasteride and the antiandrogen flutamide on prostate and genital differentiation: dose-response studies. Endocrinology. 1992 Sep. doi:10.1210/endo.131.3.1324152PubMed

Kolasa-Wołosiuk A, Tarnowski M, Baranowska-Bosiacka I, Chlubek D, Wiszniewska B. Antioxidant enzyme expression of mRNA and protein in the epididymis of finasteride-treated male rat offspring during postnatal development. Arch Med Sci. 2019 May. doi:10.5114/aoms.2017.68528 • PubMed • PMC full text

Kurzrock EA, Jegatheesan P, Cunha GR, Baskin LS. Urethral development in the fetal rabbit and induction of hypospadias: a model for human development. J Urol. 2000 Nov. PubMed

Maldarine JS, Sanches BDA, Santos VA, et al. Low-dose in utero exposure to finasteride promotes developmental changes in both male and female gerbil prostates. Environ Toxicol. 2020 Jan. doi:10.1002/tox.22838 • PubMed

Maldarine JS, Sanches BDA, Santos VA, et al. Postnatal exposure to finasteride causes different effects on the prostate of male and female gerbils. Cell Biol Int. 2020 Jun. doi:10.1002/cbin.11328 • PubMed

Prahalada S, Tarantal AF, Harris GS, et al. Effects of finasteride, a type 2 5-alpha reductase inhibitor, on fetal development in the rhesus monkey (Macaca mulatta). Teratology. 1997 Feb. doi:10.1002/(SICI)1096-9926(199702)55:2<119::AID-TERA1>3.0.CO;2-ZPubMed

Ribeiro CM, Pereira OC. 5alpha-reductase 2 inhibition impairs brain defeminization of male rats: reproductive aspects. Pharmacol Biochem Behav. 2005. doi:10.1016/j.pbb.2005.08.015 • PubMed

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Suzuki H, Suzuki K, Yamada G. Systematic analyses of murine masculinization processes based on genital sex differentiation parameters. Dev Growth Differ. 2015 Dec. doi:10.1111/dgd.12247PubMed

Vascular endothelial growth factor (VEGF)

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