Prolonged use of finasteride-induced gonadal sex steroids alterations, DNA damage and menstrual bleeding in women

Abstract

The aim of the present study was to examine the effect of prolonged use of finasteride on serum levels of dihydrotestosterone (DHT), estradiol (E2), progesterone, testosterone and androstenedione in women during the menstrual period. Further, to screen and compare the 5α-reductase activities through the expression of SRD5A1, SRD5A2 and AR gene and to determine the level of VEGF, VKOR and SAA gene expression and DNA damage. A total of 30 Saudi women aged between 25 and 35 years were enrolled in the study. The selected women were divided into two groups. The first group (n = 15) received 5 mg finasteride/day for prolonged period of one year and second group (n = 15) was taken as a healthy control. ELISA technique was used for measuring the serum levels of the targeted hormones, and Comet assay was used for checking the DNA integrity. Our findings revealed significant decrement of DHT, E2, progesterone and androstenedione levels and elevated levels of testosterone in group treated with daily oral doses of 5 mg finasteride/day compared with the control subjects. mRNA expression suggested that finasteride has concrete effects on the gene expression of the selected genes from the treated group in comparison with the control group. In addition, finasteride induced DNA damage, and heavy menstrual bleeding was noted in women treated with finasteride. In conclusion, the present findings revealed that finasteride has adverse health effects in women associated with gonadal sex steroids alterations, DNA damage and heavy menstrual bleeding with no consensus in the treatment of androgenetic alopecia in women.

Commentary Regarding the Effect of Long Term Use of Finasteride on Saudi Women

“…There are several issues of concern to the study performed by Albasher et al, (2020) . One concern is its small sample size.…”

“…The researchers are clear in their findings and warned women under androgenetic alopecia treatment not to use finasteride. Albasher et al, (2020) yielded that the prolonged use of medication was associated with adverse effects that are common in women under androgenetic alopecia treatment. These adverse effects are DNA damage, heavy menstrual bleeding, high cholesterol, and aromatase disorder.…”

“…Therefore, the pharmacokinetic study using the dosage of 5 mg/day is suggested. The following tests are recommended to be performed: blood tests cell blood count, aspartate aminotransferase, alanine transaminase (ALT), total bilirubin alkaline phosphatase, blood glucose, urea, creatinine, iron, dehydroepiandrosterone sulfate (DHEA-S), delta-4-androstenedione, 5α-DHT, 17β-prolonged, cortisol, prolactin luteinizing hormone (LH), and follicle-stimulating hormone (Albasher et al, 2020).…”

Association between P582S <i>HIF-1A</i> gene polymorphism and hematological parameters among women: A cross-sectional study

“…Among the proposed causes of menorrhagia are infection and hormonal changes [5,6]. Understanding the factors that affect the amount of blood loss and hematological homeostasis in menstruating women can help improve women's health during their reproductive age [7,8].…”