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Androgen action blockade does not result in reduction in size but changes histology of the normal human prostate
H J de Voogt1, B R Rao, A A Geldof
1Department of Urology, Academisch Ziekenhuis Vrije Universiteit, Amsterdam, The Netherlands.
Abstract:
The effect of androgen blockade on the normal human prostate was studied in 16 healthy volunteers opting for male-to-female gender reassignment. Their ages ranged from 19 to 27 years. After 8 weeks of treatment with Anandron, serum hormone levels indicated anti-androgenic action and physical signs of feminization appeared. Prostate volumes (measured by ultrasound) before and following Anandron treatment remained the same. After 18 months of treatment with cyproterone-acetate and ethinyl estradiol, prostate volumes again were not changed. However, histology revealed glandular atrophy and an increase in stromal tissue. The significance of these findings is discussed.
Insights
Androgen blockade in healthy males undergoing gender reassignment did not alter prostate volume. However, histological analysis revealed glandular atrophy and stromal tissue increase, suggesting subtle prostate tissue changes despite unchanged size.
Area of Science:
- Endocrinology
- Urology
- Reproductive Medicine
Background:
- Androgen blockade is a key component of feminizing hormone therapy.
- The effects of long-term androgen blockade on the normal human prostate are not fully understood.
Purpose of the Study:
- To investigate the impact of androgen blockade on prostate volume and histology in healthy males undergoing gender reassignment.
Main Methods:
- 16 healthy male volunteers (ages 19-27) received anti-androgen treatment (Anandron, followed by cyproterone-acetate and ethinyl estradiol).
- Prostate volume was measured using ultrasound before and after treatment.
- Prostate histology was examined after 18 months of treatment.
Main Results:
- Prostate volume remained unchanged after 8 weeks of Anandron and 18 months of cyproterone-acetate/ethinyl estradiol treatment.
- Histological examination revealed significant glandular atrophy and an increase in stromal tissue.
Conclusions:
- Androgen blockade does not significantly reduce prostate volume in healthy young males.
- Despite unchanged volume, androgen blockade induces histological alterations in the prostate, including glandular atrophy and stromal hyperplasia.