Anastrozole / Exemestane (Aromatase Inhibitors) vs Finasteride / Dutasteride
Both are used for sexual health. Here's how they compare on human evidence, mechanism, safety and availability — in plain English.
| Anastrozole / Exemestane (Aromatase Inhibitors) | Finasteride / Dutasteride | |
|---|---|---|
| Human evidence | ★★★★☆ | ★★★★★ |
| Legal status | Prescription, Off-Label | FDA Approved |
| How it works | Inhibit aromatase (CYP19A1), the enzyme converting testosterone to estradiol. Anastrozole is reversible; exemestane is a suicide (irreversible) inhibitor. | Inhibit 5α-reductase (SRD5A2), blocking testosterone→DHT conversion. DHT drives male-pattern hair loss and prostate growth. Finasteride hits type II; dutasteride hits I and II. |
| In plain English | High testosterone partly converts to estrogen, which can cause bloating and gyno. These drugs block that conversion. Easy to overdo — crashing estrogen wrecks mood, joints, and libido. | Testosterone gets converted into a stronger cousin (DHT) that kills scalp follicles. These drugs block that conversion to save hair — but for a minority, lowering DHT dents libido/mood ("post-finasteride" concerns). |
| Bottom line | Use only if estradiol is genuinely high; low estrogen is as bad as high. | Most effective hair-loss drug; weigh the sexual-side-effect risk honestly. |
| Availability | Prescription only | Available over the counter |
Which is better for sexual health?
Finasteride / Dutasteride has the stronger human-evidence rating (★★★★★ vs ★★★★☆), but the right choice still depends on your goal, tolerance and budget.
Full breakdowns: Anastrozole / Exemestane (Aromatase Inhibitors) · Finasteride / Dutasteride.
Common questions
Is Anastrozole / Exemestane (Aromatase Inhibitors) or Finasteride / Dutasteride better for sexual health?
Finasteride / Dutasteride has the stronger human-evidence rating (★★★★★ vs ★★★★☆), but the right choice still depends on your goal, tolerance and budget.
What's the difference between Anastrozole / Exemestane (Aromatase Inhibitors) and Finasteride / Dutasteride?
Anastrozole / Exemestane (Aromatase Inhibitors): Use only if estradiol is genuinely high; low estrogen is as bad as high. — Finasteride / Dutasteride: Most effective hair-loss drug; weigh the sexual-side-effect risk honestly.