Testosterone and Lower Urinary Tract Symptoms: A Narrative Review

Area of Science:

• Endocrinology
• Urology
• Metabolic Health

Background:

• Lower urinary tract symptoms (LUTS) are common in men.
• The role of testosterone in LUTS is complex, involving endocrine, metabolic, and inflammatory pathways.
• Existing evidence suggests testosterone influences bladder, prostate, and pelvic floor function.

Purpose of the Study:

• To review current evidence on the relationship between testosterone and LUTS in men.
• To explore the endocrine, metabolic, and inflammatory mechanisms involved.
• To discuss implications for clinical practice and patient management.

Main Methods:

• Systematic review of recent experimental and clinical studies.
• Analysis of androgen-receptor pathways and their effects on lower urinary tract tissues.
• Evaluation of the impact of testosterone deficiency and therapy on LUTS and prostate outcomes.

Main Results:

• Testosterone deficiency amplifies inflammation, oxidative stress, and vascular dysfunction, contributing to LUTS.
• Metabolic syndrome, hypogonadism, and sleep disorders exacerbate LUTS severity.
• Physiologic testosterone therapy, when appropriately monitored, does not worsen LUTS or prostate outcomes.
• Testosterone deficiency contributes to LUTS via systemic mechanisms, not solely anatomical ones.

Conclusions:

• Restoring physiologic testosterone balance and addressing metabolic and sleep factors can improve urinary function and quality of life in men with LUTS.
• Future research should focus on phenotype-specific trials and integrated metabolic-endocrine-urological approaches for personalized care.
• Testosterone therapy can be a safe and effective component of LUTS management in hypogonadal men.