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Mens Health

Our Men’s Health section contains medications used to treat prostate cancer, hypersexuality in sex offenders, Benign Prostatic Hyperplasia (BPH), erectile dysfunction (ED) and hair loss. There are also dietary supplements for maintaining prostate health.

The different classes of Men’s Health medication are listed on the left of the page and when you click on one of these, the principal brand name products display in the left column and generic alternatives to the right.

Use the search feature to quickly find the product you are looking for, by entering either the active ingredient, e.g. sildenafil or the product name, e.g. Viagra

Our Anti-Androgens class of Mens Health medications are used to block the action of testosterone in certain conditions including treating androgen-dependent prostate cancer and to treat hypersexuality.

Use the search feature to quickly find the product you are looking for, by entering either the active ingredient, e.g. cyproterone or the product name, e.g. Siterone.

What is an anti-androgen?

Anti-androgens are drugs that counteract the biological effects of the male hormone testosterone or its active metabolite DHT. They bind to the same androgen receptor as testosterone in specific cells and act as androgen receptor antagonists because they block the biological action of testosterone and DHT working through this receptor. Anti-androgens are either steroidal or non-steroidal and act in a competitive manner for the receptors.

Steroidal anti-androgens

Cyproterone is a steroidal anti-androgen that binds to the androgen receptor competing with testosterone and blocking testosterone binding to its receptor. However, cyproterone does have some biological effects, acting as a weak progestogen and glucocorticoid, which are other hormones involved in production of sex hormones like testosterone. This means that cyproterone does not prevent the production of testosterone completely but reduces the amount of testosterone produced. Cyproterone is used to treat hypersexuality (increased sex drive) and aggression in male sex offenders. It is also used to treat advanced prostate cancer.

Non-steroidal anti-androgens

Bicalutamide is a non-steroidal anti-androgen that binds to the androgen receptor but has no androgen or any other hormonal activity. It does not activate any normal testosterone actions, which means that it does not promote prostate cell growth or testosterone production. Bicalutamide is used to treat advanced prostate cancer, in combination with another medication that induces medical castration by preventing testosterone production by the testes. This blocks the stimulation by testosterone of cancer cell growth and helps slow or prevent progression of the tumour.
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Our BPH class of Mens Health medications and dietary supplements are used to treat Benign Prostatic Hyperplasia to relieve symptoms of enlarged prostate and causing it to shrink.

Use the search feature to quickly find the product you are looking for, by entering either the active ingredient, e.g. dutasteride, or the product name, e.g. Avodart.

What is BHP?

Benign Prostatic Hyperplasia (BPH) is a condition where the prostate gland becomes enlarged due to overgrowth of connective tissue within the prostate gland and also cells that form the lining of the gland. These cells are responsive to testosterone and also convert testosterone into the potent metabolite dihydrotestosterone or DHT, which in turn is thought to stimulate the growth of prostate cells, causing enlargement of the gland. This causes the prostate glad to expand pushing into the urethra, which is the tube taking urine from the bladder and this causes obstruction of urine flow and can cause urinary retention in the bladder. Increased muscle tone of smooth muscle cells in the prostate gland also causes compression of the urethra. Symptoms of BPH include need for frequent or urgent urination, inability to empty the bladder, urinary hesitancy (difficulty starting to urinate) and difficulty passing urine.

Medications for BPH

The medications available for treating BPH are used to reduce the symptoms of BPH by acting directly on cells of the prostate gland to relieve pressure on the urethra, or by blocking an enzyme involved in stimulation of prostate growth. These include:
  • Alpha-blockers
  • Inhibitors of DHT production

Alpha-blockers

Alpha-blockers, like terazosin and tamsulosin are also known as alpha-adrenergic antagonists. They work by binding to the alpha adrenergic receptor in smooth muscle cells, which blocks the action of naturally occurring adrenergic chemicals like noradrenaline that causes smooth muscle cells to contract and tighten. This allows the muscle in the prostate to relax and relieve pressure on the urethra; this also relaxes the neck of the urethra, which helps urine to flow more easily.

Inhibitors of DHT production

The conversion of testosterone to DHT is carried out in several tissues, including the prostate gland. This conversion is dependent on the action of the enzyme 5α-reductase, which exists in two forms, 5α-reductase I and 5α-reductase II. Drugs that inhibit this enzyme are used to treat BPH and include finasteride, which inhibits type II 5α-reductase and dutasteride inhibits the action of both forms (type I and type II) of the enzyme. 5α-reductase inhibitors reduce the amount of DHT in the prostate, so that growth is no longer stimulated allowing the enlarged prostate to shrink.

Dietary supplements for BPH

A dietary supplement containing an extract of berries from the Saw Palmetto plant, has anti-androgen similar to the 5α-reductase inhibitors and is used to help relieve symptoms of BHP.
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Our Erectile Dysfunction class of Mens Health medication contains drugs used to induce and maintain an erection during the natural process of sexual stimulation, to treat erectile dysfunction or impotence.

Use the search feature to quickly find the product you are looking for, by entering either the active ingredient, e.g vardenafil, or the product name, e.g. Levitra.

What causes ED?

The natural process of sexual stimulation activates a series of biochemical reactions that relaxes blood vessels in the penis and allows blood flow into the corpus cavernosum, which is the spongy erectile tissue of the penis that fills with blood causing an erection. Loss of an erection is due to the activity of an enzyme called phosphodiesterase type 5 (PDE5) that breaks down the chemical responsible for relaxing blood vessels, cyclic guanosine monophosphate (cGMP), which results in contraction of the blood vessels, preventing blood flow. If the natural processes do not function properly due to physical or psychological problems, this can lead to erectile dysfunction or ED.

Medications for ED

The medications available for treating ED are used to increase blood flow into the penis, working by different mechanisms. These are:
  • Phosphodiesterase type 5 (PDE5) inhibitors
  • Prostaglandins

Phosphodiesterase type 5 (PDE5) inhibitors

Phosphodiesterase type 5 (PDE5) inhibitors block the action of the enzyme PDE5 that prevents blood flow into the penis and this action allows blood to remain in the penis, which maintains an erection. This resolves ED by allowing the natural process of sexual stimulation to activate the mechanism for achieving and maintaining an erection. However, PDE5 inhibitors only work when sexually aroused and do not work otherwise; their effect lasts for around four hours. These medications include sildenafil, tadalafil, vardenafil.

Prostaglandins

Prostaglandin E1, also known as alprostadil, is a naturally occurring chemical that has many functions including relaxation of smooth muscle in various tissues, including the corpus cavernosum and blood vessel walls. Prostaglandin E1 is used to treat ED by direct injection into the penis resulting in widening of the cavernosal arteries in the penis and relaxation of trabecular smooth muscle in the penis. This increases blood flow into the penis causing an erection.

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Our Hair Loss class of Mens Health medication for men’s health are used to help prevent further hair loss in male pattern baldness and reverse the balding process in moderate hair loss.

Use the search feature to quickly find the product you are looking for, by entering either the active ingredient, e.g finasteride, or the product name, e.g. Propecia.

What causes hair loss?


Hair loss in men is an inherited condition called male pattern baldness or androgenic alopecia and this condition accounts for 99% of hair loss in men. This form of hair loss is due to an inherited increased sensitivity to dihydrotestosterone (DHT), which is an active form of testosterone and is converted from testosterone in the hair follicles by the action of the enzyme 5-alpha reductase. Increased conversion of testosterone to DHT is also responsible for hair loss.

DHT in the hair follicles of the scalp is involved in the regulation of hair growth. Normally old hairs fall out to be replaced by new hairs. However, increased action of DHT results in shortening of the anagen or growth phase of the hair cycle, causing the hair follicles to shrink and produce progressively smaller finer hairs, which eventually do not emerge from the follicle. The miniaturised hair follicles then enter a permanent state of catagen or rest phase, instead of resting before a new growth phase. They stop growing and although they are still alive, they cannot produce normal hairs and at this stage the process cannot be reversed.

DHT also stimulates the production of another chemical called transforming growth factor beta (TBG beta), which blocks growth of the skin cells that support hair follicles and eventually cause cell death.

Medications for reducing hair loss

Drugs that inhibit the production of DHT are used in the treatment of male pattern baldness. These include finasteride and dutasteride, which are both inhibitors of the enzyme 5-alpha reductase that converts testosterone to DHT. These drugs reduce the amount of DHT in the hair follicle and slow the progression of balding in men with mild to moderate hair loss, but do not restore hair that has been lost for a long time.
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About androgens

Androgens are steroid sex hormones produced mainly in the testes that control the development of the male sex organs, the testes, penis, seminal vesicles and prostate gland. They also regulate and maintain secondary male characteristics like the development of body and facial hair, increase in bone and muscle mass and deepening of the voice at puberty. Females also produce small amounts of androgens in the ovaries, but in some cases over production causes androgenisation with characteristics like unwanted body hair.

The main androgens are the male hormone testosterone and its active metabolite dihydrotestosterone (DHT), which is much more potent than testosterone. Both testosterone and DHT bind to the androgen receptor within responsive cells, including brain, bone, hair follicles, testes and prostate cells.

Increased production of or sensitivity to testosterone is thought to be involved in conditions like hypersexuality and aggression in male sex offenders. Also increased sensitivity to DHT and increased conversion of testosterone to DHT is thought to contribute to the hair loss process in male pattern baldness.

The prostate gland

The prostate gland is a small organ that lies just below the bladder and surrounds the top of the urethra, which is the tube that carries urine from the bladder. The prostate gland contributes to the seminal fluid made mainly by the seminal vesicles and the small amount made by the testes, which also contains sperm. Seminal fluid is transported by the urethra through the penis during ejaculation.
Growth and development of the prostate gland is controlled by testosterone, which binds to androgen receptors inside prostate cells. Conditions of the prostate gland include:
  • Prostatitis, which is inflammation of the prostate usually due to an infection.
  • Benign Prostatic Hyperplasia (BPH), which is an enlarged prostate but is not cancerous.
  • Prostate cancer, which is an androgen-dependent tumour and needs testosterone for the cancer cells to grow.

Erectile dysfunction

Erectile dysfunction (ED) is also known as impotence in men and is the inability to achieve or maintain a hard erect penis suitable for sexual activity, which is normally the natural response to sexual stimulation. ED is due to decreased blood flow into the penis and can be treated by specific medication taken at the time of planned sexual activity.

Treatments for men’s health problems

Medications available for treating specific men’s health problems include:
  • Anti-androgens that block the production of testosterone and its effects on cells containing androgen receptors, and are used to treat prostate cancer; also hypersexuality in male sex offenders.

  • Inhibitors of the enzyme 5α-reductase that converts testosterone to DHT, and is used to treat BPH and male pattern baldness.

  • Alpha blockers or alpha-adrenergic antagonists that relax muscle cells in the prostate gland and are used to treat symptoms of BPH.

  • Inhibitors of the enzyme phosphodiesterase type 5 (PDE5) that widen blood vessels allowing blood flow into penis, and are used to treat ED.

  • Prostaglandins that relax smooth muscle and are used to treat ED.

  • Dietary supplements containing a naturally occurring 5α-reductase inhibitor, used to support prostate health and to treat BPH and male pattern baldness.

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