Testosterone therapy: a friend or a foe for the aging men with benign prostatic hyperplasia?

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madman

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One of the major concerns for the prescription of medications containing testosterone (T) in the aging men with T deficiency (TD) is prostate disorders (such as benign prostatic hyperplasia, BPH) and their related symptoms (lower urinary tract symptoms, LUTS). This is because prostate is an androgen-responsive gland; however, the androgen dependence of prostate growth, well demonstrated in earlier phases of life, has no clear evidence in late adulthood and senescence. In fact, after the age of 40 years, BPH becomes increasingly more prevalent. On the other hand, in men older than 40 year, a progressive decline in T is observed. These epidemiological data are a starting point for questioning a putative detrimental role of T on the prostate health in the ageing man.

According to the available evidence, the concerns on the use of TTh in men with BPH and LUTS have no supportive experimental basis. BPH can be considered part of the constellation of derangements occurring in MetS. TD associated with MetS has the potential to exacerbate prostatic inflammation, thus favoring its progression to BPH. In this view, TTh could represent an obvious solution to improve the prostatic inflammation occurring in MetS. Although specifically designed RCTs are needed, it is likely that, in the next future, we will assist to a transition of TTh from the side of the enemies of the prostate to that of the allies.
 

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