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Androgens and prostate disease.

Lori A Cooper, Stephanie T Page1

  • 1Department of Medicine, Division of Endocrinology and Metabolism, University of Washington; University of Washington and Harborview Medical Center, Seattle, Washington, USA.

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|January 11, 2014
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Summary
This summary is machine-generated.

Testosterone therapy in hypogonadal men offers anabolic benefits. Current data do not support the idea that restoring testosterone levels to normal ranges promotes prostate disease in older men.

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Area of Science:

  • Endocrinology
  • Urology
  • Androgen Biology

Background:

  • Testosterone (T) therapy is recognized for anabolic benefits in hypogonadal men.
  • Concerns exist regarding risks of exogenous androgen use in older men, particularly prostate effects.
  • Prostate disease has historically contra-indicated T therapy due to potential risks.

Purpose of the Study:

  • To investigate the safety and effects of testosterone therapy in older, hypogonadal men.
  • To clarify the relationship between androgens and prostate health, including lower urinary tract symptoms and prostate cancer.
  • To evaluate the impact of androgen manipulation on prostate hormonal environment and disease risk.

Main Methods:

  • Review of existing literature on testosterone therapy and prostate health.
  • Analysis of epidemiological studies on endogenous androgen concentrations and prostate disease risk.
  • Examination of data from studies on 5α-reductase inhibitors and prostate cancer chemoprevention.

Main Results:

  • Epidemiological studies show inconsistent links between serum androgens and prostate disease risk.
  • 5α-reductase inhibitors reduce low-grade prostate cancer risk, but not high-grade disease.
  • Current data challenge assumptions about parallel effects of serum androgens within the prostate.

Conclusions:

  • Available evidence does not support the notion that restoring physiological testosterone levels drives prostate disease.
  • Long-term intervention studies are necessary to definitively ascertain androgen manipulation effects on prostate tissue and disease.
  • Further research is needed to understand the complex interplay between androgens and prostate health in aging men.