An overview of leading pathophysiologic theories in BPH - Androgens and estrogens

[madman]

*26:32-35:10 (androgens/estrogens)

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[madman]

*Androgens are permissive

*Multiple theories exist for BPH, each of which has conflicting evidence

 

[DadOfSonNOVA]

This is over my head so I apologize in advance if I’m way off however does this study suggest castration would shrink prostrate?

 

[LibraTeacher]

This is over my head so I apologize in advance if I’m way off however does this study suggest castration would shrink prostrate?

Castration elicited only a partial reduction in prostate volume, relative to castration-induced regression of the normal prostate gland.

 

[madman]

This is over my head so I apologize in advance if I’m way off however does this study suggest castration would shrink prostrate?

Androgen is required to prevent atrophy of the gland.


*Normal prostate glands undergo atrophy when serum androgens are greatly reduced via castration or administration of LHRH agonists




Testosterone and Prostate Cancer

It is widely recognized that the presence of adequate serum levels of testosterone is necessary for the development of the prostate. Testosterone (T) can act directly on androgen receptors to exert their action or can be converted by 5-alpha-reductase into dihydrotestosterone (DHT) or to estradiol by the aromatase enzyme complex [1].

There are several reasons why it appears logical to believe that testosterone therapy may stimulate prostate cancer. The prostate does not develop properly without androgen stimulation. Normal prostate glands undergo atrophy when serum androgens are greatly reduced via castration or administration of LHRH agonists. Furthermore, most prostate cancers are dependent on androgens in the early stages of progression and demonstrate regression with androgen ablation. Consequently, the presence of excessive androgenic stimulation as an etiologic factor in prostate carcinogenesis appears logical [1–5].

However, a number of studies have suggested that testosterone administration in supraphysiological doses to healthy men did not result in a significant increase in prostate-specific antigen (PSA), nor prostate volume or urinary symptoms [6, 7].PSA also does not seem to be influenced by the circadian rhythm of testosterone levels [8].

A variety of studies in PCa, including experiments in animals, cell lines, and humans, indicate that prostate tissue (benign or malignant) responds quickly and vigorously to the addition of testosterone when it is in an androgen-deprived state. However, at higher concentrations, prostate tissue becomes unresponsive to this hormone [9].