Nelson Vergel
Founder, ExcelMale.com
Effects of Transdermal Testosterone Gel or an Aromatase Inhibitor on Prostate Volume in older men
Jenny Pena Dias1, Denise Melvin1, Michelle Shardell2, Luigi Ferrucci2, Chee W. Chia2, Mohsen Gharib3, Josephine M. Egan1, and Shehzad Basaria4
Abstract
Context:
Testosterone replacement is being increasingly offered to older men with age-related low testosterone; hence, monitoring prostate health is important during testosterone therapy. Data suggest that estrogens have an independent effect on the prostate and some effects of testosterone on the prostate might be mediated via its aromatization to estradiol. Although some studies have assessed the effects of testosterone replacement on prostate volume, the differential effects of testosterone and estradiol have not been delineated.
Objective:
To investigate the relative effects of testosterone and estradiol on prostate volume in older men with low testosterone.
Participants:
31 men, ≥ 65 years with total testosterone <350 ng/dL (measured by mass spectrometry).
Intervention:
Randomization to 5 g transdermal testosterone gel (TT), 1 mg oral aromatase inhibitor (AI) or placebo daily for 12 months.
Main outcome measures:
Primary outcome was prostate volume measured by transrectal ultrasound at baseline and 12 months. Secondary outcomes included PSA levels and lower urinary tract symptoms (LUTS) score.
Results:
Serum testosterone levels increased in both intervention groups; estradiol levels increased in the TT-group while it decreased in the AI-group. At 12 months, prostate volume significantly increased (4.5±1.76 cc, p<0.05) only in the TT group. Increase in PSA levels were seen in both intervention groups at 6 months (p<0.01 and p<0.001). LUTS score increased only in the TT group (p<0.05).
Conclusion:
The tropic effects of testosterone on the prostate are mediated via its aromatization to estradiol. Administration of AI for 12 months to older men was not detrimental to the prostate.
Affiliations
1Laboratory of Clinical Investigation and
2Translational Gerontology Branch, National Institute on Aging, Baltimore, MD, United States, 21225
3Imaging Section, Medstar Harbor Hospital, Baltimore, MD, United States, 21225 and
4Section on Men's Health, Aging and Metabolism, Brigham and Women's Hospital Harvard Medical School, Boston, MA, United States, 02115.
- See more at: http://press.endocrine.org/doi/abs/10.1210/jc.2016-1111#sthash.1hXInyrb.dpuf
Jenny Pena Dias1, Denise Melvin1, Michelle Shardell2, Luigi Ferrucci2, Chee W. Chia2, Mohsen Gharib3, Josephine M. Egan1, and Shehzad Basaria4
Abstract
Context:
Testosterone replacement is being increasingly offered to older men with age-related low testosterone; hence, monitoring prostate health is important during testosterone therapy. Data suggest that estrogens have an independent effect on the prostate and some effects of testosterone on the prostate might be mediated via its aromatization to estradiol. Although some studies have assessed the effects of testosterone replacement on prostate volume, the differential effects of testosterone and estradiol have not been delineated.
Objective:
To investigate the relative effects of testosterone and estradiol on prostate volume in older men with low testosterone.
Participants:
31 men, ≥ 65 years with total testosterone <350 ng/dL (measured by mass spectrometry).
Intervention:
Randomization to 5 g transdermal testosterone gel (TT), 1 mg oral aromatase inhibitor (AI) or placebo daily for 12 months.
Main outcome measures:
Primary outcome was prostate volume measured by transrectal ultrasound at baseline and 12 months. Secondary outcomes included PSA levels and lower urinary tract symptoms (LUTS) score.
Results:
Serum testosterone levels increased in both intervention groups; estradiol levels increased in the TT-group while it decreased in the AI-group. At 12 months, prostate volume significantly increased (4.5±1.76 cc, p<0.05) only in the TT group. Increase in PSA levels were seen in both intervention groups at 6 months (p<0.01 and p<0.001). LUTS score increased only in the TT group (p<0.05).
Conclusion:
The tropic effects of testosterone on the prostate are mediated via its aromatization to estradiol. Administration of AI for 12 months to older men was not detrimental to the prostate.
Affiliations
1Laboratory of Clinical Investigation and
2Translational Gerontology Branch, National Institute on Aging, Baltimore, MD, United States, 21225
3Imaging Section, Medstar Harbor Hospital, Baltimore, MD, United States, 21225 and
4Section on Men's Health, Aging and Metabolism, Brigham and Women's Hospital Harvard Medical School, Boston, MA, United States, 02115.
- See more at: http://press.endocrine.org/doi/abs/10.1210/jc.2016-1111#sthash.1hXInyrb.dpuf
