Step 1: Testosterone is amplified inside target tissues by the enzyme $5\alpha$-reductase, which forms dihydrotestosterone, the strongest natural androgen acting on the prostate and scalp.
Step 2: Finasteride works by competitively blocking this very enzyme. With less dihydrotestosterone formed, the androgenic drive on the gland drops, the prostate regresses, urine flow improves in benign prostatic hyperplasia, and scalp hair is preserved in androgenetic alopecia.
Step 3: This identifies it as a $5\alpha$-reductase inhibitor, option a.
Step 4: The other labels belong elsewhere: phosphodiesterase inhibition is the mechanism of sildenafil, selective alpha 1a antagonism is that of tamsulosin, and direct androgen receptor blockade describes flutamide or bicalutamide.
\[\boxed{\text{5 alpha reductase inhibitor}}\]