Benign Prostatic Hyperplasia: A Disorder of Androgen Metabolism in the Male

Horton, Richard

doi:10.1111/j.1532-5415.1984.tb02044.x

“…The amount of testosterone in the blood decreases with age, leading to a relative increase in the proportion of estrogen, a shift that may promote prostate cell growth (Bjørnerem et al, 2004; Coffey and Walsh, 1990). Interestingly, levels of DHT do not change in older men despite falling testosterone levels, likely due to reduced metabolism (Horton, 1984). These data seem contradictory for, while levels of prostate growth-promoting hormones decrease (testosterone) or stay the same (DHT) with age, actual prostate growth continues in ageing men, sometimes unchecked.…”

Section: Causes Of Lutsmentioning

confidence: 99%

Links between lower urinary tract symptoms, intermittent hypoxia and diabetes: Causes or cures?

Abler

¹

,

Vezina

²

2018

Respiratory Physiology & Neurobiology

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Bothersome lower urinary tract symptoms (LUTS) manifest as urinary frequency, urgency, incontinence and incomplete bladder emptying. Existing treatments ameliorate but do not eliminate most symptoms, leading to financial and personal burdens attributable to sustained medical therapies that may last a lifetime. The purpose of this review is to highlight evidence of causal associations between LUTS and several common comorbidities, including intermittent hypoxia (IH) concomitant with obstructive sleep apnea (OSA), obesity, metabolic syndrome and type 2 diabetes. Links between these conditions, including therapies targeted to co-occurring complications that have demonstrated benefits for LUTS, suggest compelling avenues of research and also underscore critical gaps in understanding the mechanisms underlying urinary dysfunction. These gaps are prominent in the IH field, where an acknowledged link between OSA and LUTS has gone largely uninvestigated. New tools, models, or reappropriation of existing ones, especially rodent models, is required to parse the associations between IH/OSA, LUTS and obesity/diabetes and to elucidate their underlying, and potentially shared, etiologies.

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“…The growth and development of the prostate gland is strongly influenced by androgens and their metabolites. 1 – 2 Prostatic hyperplasia is the commonest disorder of the prostate in elderly males. Only minor ethnic or racial variation in its prevalence has been found.…”

mentioning

confidence: 99%

“…Age is the only unmodifiable and established factor known so far, although androgens, estrogens and several intraprostatic factors are believed to be responsible for its development. 1 , 7 , 8 …”

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confidence: 99%

Serum sex steroids, gonadotrophins and sex hormone-binding globulin in prostatic hyperplasia

Ansari

¹

,

Begum

²

,

Islam

³

2008

Annals of Saudi Medicine

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BACKGROUNDBenign prostatic hyperplasia (BPH) develops in elderly males when serum androgens are relatively lower than in healthy younger males, but it is not well understood whether and how sex steroids are altered in prostatic hyperplasia. It is also uncertain whether there is any change in sex steroid levels in males older than 40 years of age. The use of androgens in elderly males is often discouraged because of the probable worsening effect of androgens on prostatism. This study aimed to determine the relationship between prostatic hyperplasia and sex steroid levels and whether there is any significant change in these hormones after the age of 40 years.SUBJECTS AND METHODSWe studied healthy males of age ≥40 years with (n=92) or without (n=93) clinical prostatic hyperplasia. Serum testosterone, estradiol, gonadotrophins and sex hormone-binding globulin (SHBG) were compared. The hormones and SHBG were also correlated with age.RESULTSNo significant difference was found in any hormone in cases with prostatic hyperplasia as compared with the controls. There was no significant age-related change in any hormone except estradiol where as a negative correlation (P<.003) with age was found.CONCLUSIONSSerum sex steroids and SHBG remained unchanged in symptomatic prostatic hyperplasia and except for estradiol there was no significant age-related change in serum testosterone, gonadotrophins and SHBG in healthy males after the fourth decade. More studies are needed to confirm the age-related decline of estrogens in males.

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“…Age is the only unmodifi-able and established factor known so far, although an-drogens, estrogens and several intraprostatic factors are believed to be responsible for its development. 1,7,8 Serum androgens in elderly males are significantly lower than in young males. Following a relatively sharp pubertal surge, androgens in males rise steadily fol-lowed by a slow decline in the mid-30s.…”

mentioning

confidence: 95%

Serum sex steroids, gonadotrophins and sex hormone-binding globulin in prostatic hyperplasia

Ansari¹,

Begum²,

Islam³

2008

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BACKGROUNDBenign prostatic hyperplasia (BPH) develops in elderly males when serum androgens are relatively lower than in healthy younger males, but it is not well understood whether and how sex steroids are altered in prostatic hyperplasia. It is also uncertain whether there is any change in sex steroid levels in males older than 40 years of age. The use of androgens in elderly males is often discouraged because of the probable worsening effect of androgens on prostatism. This study aimed to determine the relationship between prostatic hyperplasia and sex steroid levels and whether there is any significant change in these hormones after the age of 40 years.SUBJECTS AND METHODSWe studied healthy males of age ≥40 years with (n=92) or without (n=93) clinical prostatic hyperplasia. Serum testosterone, estradiol, gonadotrophins and sex hormone-binding globulin (SHBG) were compared. The hormones and SHBG were also correlated with age.RESULTSNo significant difference was found in any hormone in cases with prostatic hyperplasia as compared with the controls. There was no significant age-related change in any hormone except estradiol where as a negative correlation (P<.003) with age was found.CONCLUSIONSSerum sex steroids and SHBG remained unchanged in symptomatic prostatic hyperplasia and except for estradiol there was no significant age-related change in serum testosterone, gonadotrophins and SHBG in healthy males after the fourth decade. More studies are needed to confirm the age-related decline of estrogens in males.

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Benign Prostatic Hyperplasia: A Disorder of Androgen Metabolism in the Male

Cited by 23 publications

References 49 publications

Links between lower urinary tract symptoms, intermittent hypoxia and diabetes: Causes or cures?

Links between lower urinary tract symptoms, intermittent hypoxia and diabetes: Causes or cures?

Serum sex steroids, gonadotrophins and sex hormone-binding globulin in prostatic hyperplasia

Serum sex steroids, gonadotrophins and sex hormone-binding globulin in prostatic hyperplasia

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