BPH and TRT

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Question for our resident experts!

Why is it that some men get BPH while on TRT even when the levels are within normal range (TT , FT, E2 etc), when older teenagers have relatively high estrogen and testosterone and never have any prostate related problems?
 
Question for our resident experts!

Why is it that some men get BPH while on TRT even when the levels are within normal range (TT , FT, E2 etc), when older teenagers have relatively high estrogen and testosterone and never have any prostate related problems?

The prostate goes through two main growth periods as a man ages. The first occurs early in puberty, when the prostate doubles in size.

The second phase of growth begins around age 25 and continues during most of a man’s life. Benign prostatic hyperplasia often occurs with the second growth phase.

Benign prostatic hyperplasia affects about 50 percent of men between the ages of 51 and 60 and up to 90 percent of men older than 80.2


Prostate Enlargement (Benign Prostatic Hyperplasia) | NIDDK

Before puberty the prostate if very small, but teenagers' prostates double in size, if that kept up they would have BPH by the time they were 25.

They don't get BPH because they start out very, very small. Kind of like why teenagers aren't as strong as men age 25, your strength does't peak till at least age 25.

BTW, if someone is castrated before puberty they never get BPH.
 
One thought I have read on why older men develop BPH is that their testosterone always declines while often their estrogen climbs. Or at least the ratio favors estrogen more.

Typically PSA levels remain constant until some age.

And that it is this climb in estrogen and decline in testosterone that causes it.

What seems to be true is BPH can be caused from several different avenues, which makes it confusing.
 

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