cholestenone 5 alpha reductase


Summary: An oxidoreductase that catalyzes the conversion of 3-oxo-delta4 steroids into their corresponding 5alpha form. It plays an important role in the conversion of TESTOSTERONE into DIHYDROTESTOSTERONE and PROGESTERONE into DIHYDROPROGESTERONE.

Top Publications

  1. Kramer B, Hagerty K, Justman S, Somerfield M, Albertsen P, Blot W, et al. Use of 5alpha-reductase inhibitors for prostate cancer chemoprevention: American Society of Clinical Oncology/American Urological Association 2008 Clinical Practice Guideline. J Urol. 2009;181:1642-57 pubmed publisher
    ..No specific cut point or change in PSA has been prospectively validated in men taking a 5-ARI. ..
  2. Marks L, Andriole G, Fitzpatrick J, Schulman C, Roehrborn C. The interpretation of serum prostate specific antigen in men receiving 5alpha-reductase inhibitors: a review and clinical recommendations. J Urol. 2006;176:868-74 pubmed
    ..The prostate specific antigen increase from nadir appears to be a more accurate cancer indicator than a doubled value in some patients. ..
  3. Nam R, Toi A, Vesprini D, Ho M, Chu W, Harvie S, et al. V89L polymorphism of type-2, 5-alpha reductase enzyme gene predicts prostate cancer presence and progression. Urology. 2001;57:199-204 pubmed
    ..Men who have the V allele of the SRD5A2 gene have a twofold increase in the risk of prostate cancer development and an additional twofold increase in the risk of progression compared with men with the L/L genotype. ..
  4. Tomlinson J, Finney J, Hughes B, Hughes S, Stewart P. Reduced glucocorticoid production rate, decreased 5alpha-reductase activity, and adipose tissue insulin sensitization after weight loss. Diabetes. 2008;57:1536-43 pubmed publisher
    ..Reduced 5alphaR activity after weight loss may decrease hypothalamo-pituitary-adrenal axis activation and reduce glucocorticoid metabolite production. ..
  5. Latil A, Azzouzi R, Cancel G, Guillaume E, Cochan Priollet B, Berthon P, et al. Prostate carcinoma risk and allelic variants of genes involved in androgen biosynthesis and metabolism pathways. Cancer. 2001;92:1130-7 pubmed
    ..For these reasons, the development of a polygenic model, incorporating multiple loci from the individual genes may maximize the chance of identifying individuals with high-risk genotypes. ..
  6. Hsing A, Chen C, Chokkalingam A, Gao Y, Dightman D, Nguyen H, et al. Polymorphic markers in the SRD5A2 gene and prostate cancer risk: a population-based case-control study. Cancer Epidemiol Biomarkers Prev. 2001;10:1077-82 pubmed
  7. Clark R, Hermann D, Cunningham G, Wilson T, Morrill B, Hobbs S. Marked suppression of dihydrotestosterone in men with benign prostatic hyperplasia by dutasteride, a dual 5alpha-reductase inhibitor. J Clin Endocrinol Metab. 2004;89:2179-84 pubmed
    ..3% suppression observed with 5 mg finasteride. Mean testosterone levels increased but remained in the normal range for all treatment groups. Dutasteride appeared to be well tolerated with an adverse event profile similar to placebo. ..
  8. Livingstone D, McInnes K, Walker B, Andrew R. Increased A-ring reduction of glucocorticoids in obese Zucker rats: effects of insulin sensitization. Obes Res. 2005;13:1523-6 pubmed
    ..This increased hepatic clearance may underpin compensatory activation of the hypothalamic-pituitary-adrenal axis in obesity. ..
  9. Endo T, Kamiya N, Yano M, Oka R, Lee F, Utsumi T, et al. [CLINICOPATHOLOGICAL STUDY OF PROSTATE BIOPSY IN PATIENTS RECEIVING DUTASTERIDE FOR BENIGN PROSTATIC HYPERPLASIA]. Nihon Hinyokika Gakkai Zasshi. 2015;106:156-62 pubmed
    ..All PCa were detected in the early clinical stage. No delays in detection or treatment of PCa were seen in any cases. Careful observation of PSA levels is simple and useful for detecting PCa in patients under dutasteride administration. ..

More Information


  1. Kyriakou A, Dessens A, Bryce J, Iotova V, Juul A, Krawczyński M, et al. Current models of care for disorders of sex development - results from an International survey of specialist centres. Orphanet J Rare Dis. 2016;11:155 pubmed
    ..The quality of care provided by these centres locally requires further exploration. ..
  2. Ntais C, Polycarpou A, Ioannidis J. SRD5A2 gene polymorphisms and the risk of prostate cancer: a meta-analysis. Cancer Epidemiol Biomarkers Prev. 2003;12:618-24 pubmed
  3. Zettergren A, Karlsson S, Hovey D, Jonsson L, Melke J, Anckarsäter H, et al. Further investigations of the relation between polymorphisms in sex steroid related genes and autistic-like traits. Psychoneuroendocrinology. 2016;68:1-5 pubmed publisher
  4. Strope S, Vetter J, ELLIOTT S, Andriole G, Olsen M. Use of Medical Therapy and Success of Laser Surgery and Transurethral Resection of the Prostate for Benign Prostatic Hyperplasia. Urology. 2015;86:1115-22 pubmed publisher
    ..41-4.43). Our results show a need for effective patient counseling about continued or new use of medical therapy after laser and TURP procedures. However, most patients experience durable improvement after surgical intervention for BPH. ..
  5. Vanden Bossche M, Sternon J. [Dutasteride (Avodart): a novel 5-alpha reductase inhibitor for treatment of benign prostate hypertrophy]. Rev Med Brux. 2005;26:103-6 pubmed
    ..By reducing prostatic volume, dutasteride improves moderate to severe symptoms and flow rate. It allows a reduction of disease progression by reducing the rate of acute urinary retention and need for surgery. ..
  6. Garcia C, Paez P, Soto E, Pasquini J. Differential gene expression during development in two oligodendroglial cell lines overexpressing transferrin: a cDNA array analysis. Dev Neurosci. 2007;29:413-26 pubmed
    ..Our findings provide new insights into the molecular basis of OLGc differentiation and on the role played by Tf in this process. ..
  7. Krysiak R, Okopień B, Szkróbka W, Herman Z. [Modern pharmacotherapy of benign prostatic hyperplasia]. Pol Merkur Lekarski. 2005;19:710-5 pubmed
    ..Wherever possible, our opinion is based on the detailed analysis of the results of available clinical trials. ..
  8. Liu J, Kurashiki K, Shimizu K, Kondo R. 5alpha-reductase inhibitory effect of triterpenoids isolated from Ganoderma lucidum. Biol Pharm Bull. 2006;29:392-5 pubmed
    ..6 microM and 41.9 microM respectively. A carboxyl group of side chain of ganoderic acid DM is essential to elicit the inhibitory activity because of much less activity of its methyl ester...
  9. Assinder S, Johnson C, King K, Nicholson H. Regulation of 5alpha-reductase isoforms by oxytocin in the rat ventral prostate. Endocrinology. 2004;145:5767-73 pubmed
    ..In conclusion, OT is involved in regulating conversion of testosterone to the biologically active dihydrotestosterone in the rat ventral prostate. It does so by differential regulation of 5alpha-reductase isoforms I and II. ..
  10. Hochberg Z, Chayen R, Reiss N, Falik Z, Makler A, Munichor M, et al. Clinical, biochemical, and genetic findings in a large pedigree of male and female patients with 5 alpha-reductase 2 deficiency. J Clin Endocrinol Metab. 1996;81:2821-7 pubmed
    ..A homozygous point mutation was identified in exon 1, leading to a thymidine for adenine substitution, predicting amino acid substitution of leucine for glutamine at position 55. ..
  11. Cohanzad S. Penile Improvement Protocol in Postoperative Management of Patients Undergoing Metoidioplasty. Aesthetic Plast Surg. 2016;40:947-953 pubmed
    ..For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors . ..
  12. Weisser H, Krieg M. In vitro inhibition of androstenedione 5alpha-reduction by finasteride in epithelium and stroma of human benign prostatic hyperplasia. J Steroid Biochem Mol Biol. 1998;67:49-55 pubmed
  13. Brown G, Sussman D. A current review of medical therapy for benign prostatic hyperplasia. J Am Osteopath Assoc. 2004;104:S11-6 pubmed
    ..The authors review the current state of diagnosis of BPH and medical therapy for this condition in the primary care setting. ..
  14. Dabanović V, Kostić M, Janković S. Cost effectiveness comparison of dutasteride and finasteride in patients with benign prostatic hyperplasia--The Markov model based on data from Montenegro. Vojnosanit Pregl. 2016;73:26-33 pubmed
  15. Vassiliadi D, Barber T, Hughes B, McCarthy M, Wass J, Franks S, et al. Increased 5 alpha-reductase activity and adrenocortical drive in women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2009;94:3558-66 pubmed publisher
    ..Increased adrenal corticosteroid production represents an important pathogenic pathway in PCOS. ..
  16. Kumar V, Wahane V. Current status of 5alpha-reductase inhibitors in the treatment of benign hyperplasia of prostate. Indian J Med Sci. 2008;62:167-75 pubmed
    ..This review gives a brief account of rationale and efficacy of treatment by 5alpha-reductase inhibitors in the management of BPH. ..
  17. Santillo V, Lowe F. Treatment of benign prostatic hyperplasia in patients with cardiovascular disease. Drugs Aging. 2006;23:795-805 pubmed
    ..Of the newer alpha-adrenoceptor antagonists, tamsulosin has a lower rate of dizziness than alfuzosin. However, both of these agents are superior to doxazosin and terazosin in that no dose escalation or titration is needed for them. ..
  18. Schmidt L, Regan K, Anderson S, Sun Z, Ballman K, Tindall D. Effects of the 5 alpha-reductase inhibitor dutasteride on gene expression in prostate cancer xenografts. Prostate. 2009;69:1730-43 pubmed publisher
    ..These findings provide insights into the function of dutasteride within the tumor microenvironment, potentially allowing for development of agents that can be used in combination with this drug to further enhance its effectiveness. ..
  19. Moinpour C, Darke A, Donaldson G, Thompson I, Langley C, Ankerst D, et al. Longitudinal analysis of sexual function reported by men in the Prostate Cancer Prevention Trial. J Natl Cancer Inst. 2007;99:1025-35 pubmed
    ..22 points (95% CI = 7.52 to 8.92 points; P<.001) over the study period. The effect of finasteride on sexual functioning is minimal for most men and should not impact the decision to prescribe or take finasteride. ..
  20. Borst S, Conover C, Carter C, Gregory C, Marzetti E, Leeuwenburgh C, et al. Anabolic effects of testosterone are preserved during inhibition of 5alpha-reductase. Am J Physiol Endocrinol Metab. 2007;293:E507-14 pubmed
    ..Our study demonstrates that the effects of testosterone on muscle and bone can be separated from the prostate effects and provides a testable strategy for combating sarcopenia and osteopenia in older hypogonadal men. ..
  21. Eren E, Edgünlü T, Asut E, Karakaş Çelik S. Homozygous Ala65Pro Mutation with V89L Polymorphism in SRD5A2 Deficiency. J Clin Res Pediatr Endocrinol. 2016;8:218-23 pubmed publisher
    ..Identification of this mutation and polymorphism is a significant indicator of presence of 5αRD2 deficiency in Southeastern Turkey, a geographical region where consanguineous marriages are also highly common. ..
  22. Zhu H, Sacchetti M. Solubilization and solid-state characterization of a poorly soluble 5-alpha reductase inhibitor. Drug Dev Ind Pharm. 2004;30:573-80 pubmed
    ..Simulated vacuum-based crystal morphology (habit) calculated using the Bravais-Friedel-Donnay-Harker, Growth Morphology, and Hartman-Perdok modules in Cerius2 was a close match to the morphology observed by light microscopy. ..
  23. Wasson K, Watts S. Proscar (Finasteride) inhibits 5 alpha-reductase activity in the ovaries and testes of Lytechinus variegatus Lamarck (Echinodermata: Echinoidea). Comp Biochem Physiol C Pharmacol Toxicol Endocrinol. 1998;120:425-31 pubmed
    ..These data suggest that finasteride may be used to selectively and chemically ablate 5 alpha-reduced androgen synthesis in the gonads of L. variegatus. ..
  24. Chai T. Treatment of men with lower urinary tract symptoms and overactive bladder. JAMA. 2007;297:1191-2; author reply 1193 pubmed
  25. Osborne D, Frye C. Estrogen increases latencies to seizures and levels of 5alpha-pregnan-3alpha-ol-20-one in hippocampus of wild-type, but not 5alpha-reductase knockout, mice. Epilepsy Behav. 2009;16:411-4 pubmed publisher
    ..Thus, some of the anticonvulsive effects of E(2) may involve formation of 3alpha,5alpha-THP in the hippocampus. ..
  26. Festuccia C, Angelucci A, Gravina G, Muzi P, Vicentini C, Bologna M. Effects of 5 alpha reductase inhibitors on androgen-dependent human prostatic carcinoma cells. J Cancer Res Clin Oncol. 2005;131:243-54 pubmed
    ..These aspects could be considered in order to improve the therapeutical management of PCa and for future clinical trials. ..
  27. Giganti F, Gambarota G, Moore C, Robertson N, McCartan N, Jameson C, et al. Prostate cancer detection using quantitative T2 and T2 -weighted imaging: The effects of 5-alpha-reductase inhibitors in men on active surveillance. J Magn Reson Imaging. 2017;: pubmed publisher
    ..Quantitative derivatives (T2 relaxation time) can be generated from T2 -WI. These outputs may be useful in helping to discriminate clinically significant prostate cancer from background signal...
  28. Raynaud J, Cousse H, Martin P. Inhibition of type 1 and type 2 5alpha-reductase activity by free fatty acids, active ingredients of Permixon. J Steroid Biochem Mol Biol. 2002;82:233-9 pubmed
    ..The dual inhibitory activity of LSESr on 5alpha-reductase type 1 and type 2 can be attributed to its high content in free fatty acids. ..
  29. Reznikov A, Tarasenko L. Hormonal protection of gender-related peculiarities of testosterone metabolism in the brain of prenatally stressed rats. Neuro Endocrinol Lett. 2007;28:671-4 pubmed
    ..Presumably testosterone exerts its protective effect on the male sexual behavior by prevention of neurochemical feminization of the brain preoptic area and, perhaps, due to some other mechanisms. ..
  30. Anastasiou I, Skoufias S, Katafigiotis I, Skarmoutsos I, Constantinides C. B-lymphocytic infiltration of the prostate to a patient with chronic lymphocytic leukemia. A case report. Arch Ital Urol Androl. 2017;89:83-84 pubmed publisher
    ..The prognosis of these patients is related to the generalized disease rather than to the prostatic involvement. ..
  31. Dahm P, Brasure M, MacDonald R, Olson C, Nelson V, Fink H, et al. Comparative Effectiveness of Newer Medications for Lower Urinary Tract Symptoms Attributed to Benign Prostatic Hyperplasia: A Systematic Review and Meta-analysis. Eur Urol. 2017;71:570-581 pubmed publisher
    ..In this paper, we reviewed the evidence of newer drugs to treat men with urinary problems attributable to an enlarged prostate. We found none of the new drugs to be better but there was more concern about side effects. ..
  32. Hernandez J, Basler J, Thompson I. The potential role of cyclooxygenase-2 inhibitors and 5alpha-reductase inhibitors in the prevention of urologic conditions. Urol Clin North Am. 2004;31:213-8 pubmed
    ..Urologists are frequently providers for and confidants of this patient population and must be able to counsel these men and women about the benefits and risks of such prevention strategies. ..
  33. Zhou X, Zhang X, Weng Y, Fang C, Kaminsky L, Ding X. High abundance of testosterone and salivary androgen-binding protein in the lateral nasal gland of male mice. J Steroid Biochem Mol Biol. 2009;117:81-6 pubmed publisher
  34. Aggarwal S, Thareja S, Bhardwaj T, Kumar M. 3D-QSAR studies on unsaturated 4-azasteroids as human 5alpha-reductase inhibitors: a self organizing molecular field analysis approach. Eur J Med Chem. 2010;45:476-81 pubmed publisher
    ..282), showed satisfied predictive ability. Analysis of SOMFA models through electrostatic and shape grids provide useful information for the design and optimization of new steroidal human 5alpha-reductase inhibitors. ..
  35. Shamsara J. Homology Modeling of 5-alpha-Reductase 2 Using Available Experimental Data. Interdiscip Sci. 2018;: pubmed publisher
    ..Despite the low sequence identity between the target and template sequences, a useful 3D model of 5-alpha-reductase 2 was generated by the inclusion of experimental data. ..
  36. Husmann D. Micropenis: an animal model and its human correlates. Adv Exp Med Biol. 2002;511:41-54; discussion 54-6 pubmed
  37. Nguyen S, Ko Ko N, Sattar A, Gucuk Ipek E, Ali S. Pulmonary Embolism Secondary to Testosterone-Enhancing Herbal Supplement Use. Cureus. 2017;9:e1545 pubmed publisher
    ..In this case report, we present a patient with new-onset, bilateral pulmonary embolism possibly associated with the daily use of fenugreek-containing testosterone supplements...
  38. Seiffert K, Seltmann H, Fritsch M, Zouboulis C. Inhibition of 5alpha-reductase activity in SZ95 sebocytes and HaCaT keratinocytes in vitro. Horm Metab Res. 2007;39:141-8 pubmed
    ..Our experimental findings and the existing clinical results indicate that the inhibition of 5alpha-reductase activity alone may be insufficient to reduce overall sebocyte activity and improve acne lesions. ..
  39. Gorin R, Crabbe J, Tanchuck M, Long S, Finn D. Effects of finasteride on chronic and acute ethanol withdrawal severity in the WSP and WSR selected lines. Alcohol Clin Exp Res. 2005;29:939-48 pubmed
    ..The differential effect of finasteride on acute versus chronic EtOH withdrawal severity may result from an indirect effect of finasteride on EtOH pharmacokinetics in the chronic paradigm. ..
  40. Luu The V, Pelletier G, Labrie F. Quantitative appreciation of steroidogenic gene expression in mouse tissues: new roles for type 2 5alpha-reductase, 20alpha-hydroxysteroid dehydrogenase and estrogen sulfotransferase. J Steroid Biochem Mol Biol. 2005;93:269-76 pubmed
  41. Allera A, Herbst M, Griffin J, Wilson J, Schweikert H, McPhaul M. Mutations of the androgen receptor coding sequence are infrequent in patients with isolated hypospadias. J Clin Endocrinol Metab. 1995;80:2697-9 pubmed
  42. Kim C, Chang H, Kim B, Park C. Long-term results of medical treatment in benign prostatic hyperplasia. Urology. 2006;68:1015-9 pubmed
  43. Carneiro M, Morsch D, Camargos A, Reis F, Spritzer P. Androgen receptor and 5alpha-reductase are expressed in pelvic endometriosis. BJOG. 2008;115:113-7 pubmed
    ..These findings suggest that active androgens may be formed within the endometriotic tissue and that both local and systemic androgens have the potential to act on endometriotic cells. ..
  44. Lebdai S, Azzouzi A, Delongchamps N, Benchikh A, Campeggi A, Cornu J, et al. [Medicoeconomic aspects of benign prostatic hyperplasia medical treatment]. Prog Urol. 2016;26:129-36 pubmed publisher
    ..The Markov models are imperfect tools, and resources invested in care depend on both the economic model and the value that individuals and society give to efficiency and cost. ..
  45. Helfand B, Blackwell R, McVary K. Consequences of switching 5alpha-reductase inhibitors on prostate specific antigen velocity. J Urol. 2010;184:218-23 pubmed publisher
    ..These prostate specific antigen velocity changes could place patients at risk for unnecessary prostate biopsy. Additional prospective studies are warranted. ..
  46. Panter B, Jose J, Hartmann R. 5alpha-reductase in human embryonic kidney cell line HEK293: evidence for type II enzyme expression and activity. Mol Cell Biochem. 2005;270:201-8 pubmed
    ..Western blot analysis of different fractions of a HEK293 homogenate performed with this antiserum detected a band at 45 kDa in the nuclear and microsomal fraction corresponding to 5alpha-reductase type II protein. ..
  47. Palusinski R, Barud W. Proscar and propecia--a therapeutic perspective. J Clin Endocrinol Metab. 2004;89:6359 pubmed
  48. Trost L, Saitz T, Hellstrom W. Side Effects of 5-Alpha Reductase Inhibitors: A Comprehensive Review. Sex Med Rev. 2013;1:24-41 pubmed publisher
    ..Trost L, Saitz TR, and Hellstrom WJG. Side effects of 5-alpha reductase inhibitors: A comprehensive review. Sex Med Rev 2013;1:24-41. ..
  49. Wilt T, N Dow J. Benign prostatic hyperplasia. Part 2--management. BMJ. 2008;336:206-10 pubmed publisher
  50. Paśko P, Rodacki T, Domagała Rodacka R, Owczarek D. Interactions between medications employed in treating benign prostatic hyperplasia and food - A short review. Biomed Pharmacother. 2016;83:1141-1145 pubmed publisher
    ..As in general grapefruit juice and alcohol tend to significantly affect the efficacy and safety of the applied drug therapy, it is highly advisable to be knowledgeable on the subject in order to educate patients. ..
  51. Azzouzi A, Cochand Priollet B, Mangin P, Fournier G, Berthon P, Latil A, et al. Impact of constitutional genetic variation in androgen/oestrogen-regulating genes on age-related changes in human prostate. Eur J Endocrinol. 2002;147:479-84 pubmed
  52. Brady B, Anderson R. Advances in male contraception. Expert Opin Investig Drugs. 2002;11:333-44 pubmed
    ..This review will focus on efforts to develop a safe, acceptable, efficacious hormonal contraceptive for men. ..
  53. Siler U, Barella L, Spitzer V, Schnorr J, Lein M, Goralczyk R, et al. Lycopene and vitamin E interfere with autocrine/paracrine loops in the Dunning prostate cancer model. FASEB J. 2004;18:1019-21 pubmed