The effect of testosterone replacement on prostate growth

Nelson Vergel

Founder, ExcelMale.com
The effect of androgen-replacement therapy on prostate growth: a systematic review and meta-analysis.


AuthorsCui Y, et al.

Eur Urol. 2013 Nov;64(5):811-22. doi: 10.1016/j.eururo.2013.03.042. Epub 2013 Apr 3.


Abstract

CONTEXT: Androgen-replacement therapy (ART) is a widely accepted form of treatment worldwide for aging men with late-onset hypogonadism syndrome. Urologists have been concerned about the possibility of ART causing prostate growth.


OBJECTIVE: To assess the relationship between ART and prostate growth.


EVIDENCE ACQUISITION: A literature review was performed to identify all published randomized controlled trials (RCTs) of androgen treatment for hypogonadism. The search included the Medline, Embase, and Cochrane Controlled Trials Register databases. The reference lists of the retrieved studies were also investigated. A systematic review and meta-analysis were conducted.


EVIDENCE SYNTHESIS: Results of 16 RCTs involving a total of 1030 patients were analyzed. Seven RCTs were short-term (<12 mo) and nine were long-term (12-36 mo) comparisons of ART with a placebo; ART was administered transdermally, orally, or by injection. Respective p values for injection, transdermal administration, and oral administration of short-term ART were as follows: PSA level: 0.07, 0.01, and 0.95; prostate volume: 0.70, 0.79, and 0.32; IPSS: 0.78, 0.98, and no oral; Qmax: 0.92, no transdermal, and 0.10. Respective p values for injection, transdermal administration, and oral administration of long-term ART were as follows: PSA level: 0.42, 0.51, and 0.57; prostate volume: 0.35, 0.59, and 0.47; IPSS: 0.34, 0.32, and 0.97; Qmax: 0.11, 0.63, and no oral. Neither short-term nor long-term ART showed significant changes in the four determinants of prostate growth investigated compared with placebo.


CONCLUSIONS: This meta-analysis shows that regardless of the administration method, neither short-term nor long-term ART increases the risk of prostate growth. Further high-quality, prospective studies are required to confirm this observation.
 
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Estradiol (E2)

A form of estrogen produced from testosterone. Important for bone health, mood, and libido. Too high can cause side effects; too low can affect well-being.

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Dihydrotestosterone is a potent androgen derived from testosterone. Affects hair growth, prostate health, and masculinization effects.

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The biologically active form of testosterone not bound to proteins. Directly available for cellular uptake and biological effects.

Scientific Reference

Lakshman KM, Kaplan B, Travison TG, Basaria S, Knapp PE, Singh AB, LaValley MP, Mazer NA, Bhasin S. The effects of injected testosterone dose and age on the conversion of testosterone to estradiol and dihydrotestosterone in young and older men. J Clin Endocrinol Metab. 2010 Aug;95(8):3955-64.

DOI: 10.1210/jc.2010-0102 | PMID: 20534765 | PMCID: PMC2913038

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