In Reply Our article¹ is indeed specific only to men taking this medication for benign prostatic hyperplasia. Unfortunately, our administrative data sources only have reliable prescribing information for people older than 65 years, thus we could not include the many younger men taking this medication at a lower dose for hair loss. Added to this limitation, we did not include the comparatively small number of women older than 65 years who may be using a 5α-reductase inhibitor for other indications (such as hirsutism or alopecia). Of the 799 997 prescriptions for a 5α-reductase inhibitor in 2015 in Ontario, only 0.04% (n = 302) were filled by women. Even if we did include them in our study,¹ we would not have been powered to detect outcomes (which were only occurring among <2% of men) in this subgroup, which, as pointed out, could be very different based on gender. While there is certainly some evidence suggesting it may be used in women in certain situations, the product monographs for finasteride 5 mg or 1 mg and dutasteride 0.5 mg still state that use in women is contraindicated.^2- 4 We obviously support studies with maximal generalizability whenever feasible; however, in this case we feel limiting the study population to men was justified.

在答复中，我们的第¹条确实仅针对服用这种药物治疗前列腺增生的男性。不幸的是，我们的行政数据源仅对65岁以上的人提供可靠的处方信息，因此我们不能包括以较低剂量服用这种药物以减少脱发的许多年轻男性。除此限制外，我们还没有纳入相对少数的65岁以上的女性，他们可能将5α-还原酶抑制剂用于其他适应症（如多毛症或脱发）。在2015年安大略省的799997例5α-还原酶抑制剂处方中，只有0.04％（n = 302）是女性填写的。即使我们确实将它们包括在我们的研究中，¹我们将无权检测此亚组的结局（仅发生在2％以下的男性中），正如所指出的那样，根据性别可能存在很大差异。尽管确实有证据表明某些情况下可以在女性中使用它，但非那雄胺5 mg或1 mg和度他雄胺0.5 mg的产品专着仍然指出，在女性中是禁忌的。^{2 - 4}显然，我们支持与最大普遍性在可行研究; 但是，在这种情况下，我们认为将研究人群限于男性是合理的。