Low Testosterone and Chronic Prostatitis/Chronic Pelvic Pain Syndrome

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Nelson Vergel

Founder, ExcelMale.com
J Sex Med. 2016 Jul;13(7):1047-55. doi: 10.1016/j.jsxm.2016.04.070. Epub 2016 May 24.
Testosterone and Chronic Prostatitis/Chronic Pelvic Pain Syndrome: A Propensity Score-Matched Analysis.
Lee JH1, Lee SW2.


A recent study investigated the role of testosterone (T) in chronic prostatitis or chronic pelvic pain syndrome (CP/CPPS). However, only a small amount of data is available to date, and the results are inconsistent.

To evaluate the relation between total T (TT) and CP/CPPS.


We conducted a propensity-matched study by identifying men with a TT level lower than 3.5 ng/mL among 8,336 men in their 40s and 50s. A control group of men with a TT level of at least 3.5 ng/mL matched for age, metabolic syndrome, and body mass index at a 5:1 ratio was selected for comparison. Using the same cohort and methods, another case group (TT < 3.0 ng/mL) and control group (TT &#8805; 3.0 ng/mL) were selected. The National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) was administered. A &#967;(2) test, a t-test and logistic regression analyses were used to evaluate the relation between TT and prostatitis-like symptoms.

Association of TT with NIH-CPSI score.

After propensity score matching, 948 cases (TT < 3.5 ng/mL) and 4,740 controls (TT &#8805; 3.5 ng/mL) were included. The ratio of mild and moderate to severe prostatitis-like symptoms was higher in the case group than in the control group (24.0% vs 27.4%, P = .001). The ratio of moderate to severe prostatitis-like symptoms also was higher in the case group than in the control group (6.2% vs 9.2%, P = .028). The pain domain of the NIH-CPSI, quality of life, and total NIH-CPSI scores also were higher in the case group. Ratios of severe lower urinary tract symptoms (12.6% vs 15.1%, P = .044) to maximal flow rate no higher than 10 mL/sec (3.8% vs 5.3%, P = .044) and postvoid residual urine volume of at least 100 mL (4.0% vs 5.6%, P = .035), which suggest high pressure in the prostate urethra, were higher in the case group. After adjusting for voided volume during uroflowmetry and total prostate volume, the relations of a TT level lower than 3.5 ng/mL to a maximal flow rate no higher than 10 mL/sec (odds ratio = 1.402, 95% CI = 1.017-1.934, P = .039) and to a postvoid residual urine volume of at least 100 mL (odds ratio = 1.410, 95% CI = 1.031-1.927, P = .031) were maintained. Using the cutoff TT value of 3.0 ng/mL, 437 cases (TT < 3.0 ng/mL) and 2,185 controls (TT &#8805; 3.0 ng/mL) were included. The result of the 3.0-ng/mL cutoff value for TT showed a higher incidence of prostatitis-like symptoms in the group with a TT level lower than 3.0 ng/mL, but this was not statistically significant.

Low TT level (<3.5 ng/mL) was significantly correlated with prostatitis-like symptoms in this study.

Chronic Pelvic Pain Syndrome; Chronic Prostatitis; Lower Urinary Tract Symptom; Prostate; Testosterone
Defy Medical TRT clinic doctor
Chronic pelvic pain in men is more prevalent than I thought and often misdiagnosed.
One potential cause that is often overlooked is referred pain from lower back injury/disc.
I have seen cases where men have various pain/sensation throughout the pelvic/genitals, where they were convinced something was seriously wrong with their testes/penis, only to test negative for any direct cause. Sometimes these cases can result from a nerve in the back. Prostatitis is another cause of this sometimes vague pain. Of course, stressing about it makes it seem worse.
This is very true! I have been suffering from pelvic pain/ prostatitis for 3 yrs now and it's better but not gone. The pain was so bad I thought I had some kind of cancer either penis or prostate. I did a ton of tests and saw 4 urologist all test came out negative.....even had an MRI done. Stress was the biggest thing that made things way worse. Itchy urethra was part of it.....the itching was so bad. I tried a ton of medication what I think works is daily cialis and doxazosin......i think that relaxing things more with those muscles down there. I also can't have certain pre work outs with vasoristrictors they end up making things to tight on those muscles down there and irritate my bladder. All in all am a bit better but not cured by any means.......i think stress is the biggest part of this! I wish I could stress less but am so prone to anxiety....been like that since I was a kid.
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