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Testosterone Replacement Therapy on the Natural History of Prostate Disease

  • Benign Prostatic Hyperplasia (K McVary, Section Editor)
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Abstract

The physiology of testosterone production and action are closely related to prostatic disease. An understanding of the natural history of testosterone and prostate growth and development is needed in order to understand this complex relationship. Lower urinary tract symptoms (LUTS), benign prostatic hyperplasia (BPH), prostate cancer, and sexual function are common disorders for which testosterone is thought to play a role. Proposed in this review are some theories as to how testosterone interacts to potentially ameliorate these conditions. Further research is needed, but we feel our proposed points are valid given the review of the literature.

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References

  1. AndroGel 1.62% Product Insert. North Chicago, IL: AbbVie Inc.

  2. Brambilla DJ, Matsumoto AM, Araujo AB, McKinlay JB. The effect of diurnal variation on clinical measurement of serum testosterone and other sex hormone levels in men. J Clin Endocrinol Metab. 2009;94(3):907–13. doi:10.1210/jc.2008-1902.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  3. Welliver Jr RC, Wiser HJ, Brannigan RE, Feia K, Monga M, Kohler TS. Validity of midday total testosterone levels in older men with erectile dysfunction. J Urol. 2014;192(1):165–9. doi:10.1016/j.juro.2014.01.085.

    Article  CAS  PubMed  Google Scholar 

  4. Araujo AB, Esche GR, Kupelian V, O'Donnell AB, Travison TG, Williams RE, et al. Prevalence of symptomatic androgen deficiency in men. J Clin Endocrinol Metab. 2007;92(11):4241–7. doi:10.1210/jc.2007-1245.

    Article  CAS  PubMed  Google Scholar 

  5. Gapstur SM, Gann PH, Kopp P, Colangelo L, Longcope C, Liu K. Serum androgen concentrations in young men: a longitudinal analysis of associations with age, obesity, and race. The CARDIA male hormone study. Cancer Epidemiol Biomark Prev: Publ Am Assoc Cancer Res Cosponsored Am Soc Prev Oncol. 2002;11(10 Pt 1):1041–7.

    CAS  Google Scholar 

  6. Gray A, Feldman HA, McKinlay JB, Longcope C. Age, disease, and changing sex hormone levels in middle-aged men: results of the Massachusetts Male Aging Study. J Clin Endocrinol Metab. 1991;73(5):1016–25. doi:10.1210/jcem-73-5-1016.

    Article  CAS  PubMed  Google Scholar 

  7. Harman SM, Metter EJ, Tobin JD, Pearson J, Blackman MR. Longitudinal effects of aging on serum total and free testosterone levels in healthy men. Baltimore Longitudinal Study of Aging. J Clin Endocrinol Metab. 2001;86(2):724–31. doi:10.1210/jcem.86.2.7219.

    Article  CAS  PubMed  Google Scholar 

  8. Liu PY, Beilin J, Meier C, Nguyen TV, Center JR, Leedman PJ, et al. Age-related changes in serum testosterone and sex hormone binding globulin in Australian men: longitudinal analyses of two geographically separate regional cohorts. J Clin Endocrinol Metab. 2007;92(9):3599–603. doi:10.1210/jc.2007-0862.

    Article  CAS  PubMed  Google Scholar 

  9. Morley JE, Kaiser FE, Perry 3rd HM, Patrick P, Morley PM, Stauber PM, et al. Longitudinal changes in testosterone, luteinizing hormone, and follicle-stimulating hormone in healthy older men. Metab Clin Exp. 1997;46(4):410–3.

    Article  CAS  PubMed  Google Scholar 

  10. Zmuda JM, Cauley JA, Kriska A, Glynn NW, Gutai JP, Kuller LH. Longitudinal relation between endogenous testosterone and cardiovascular disease risk factors in middle-aged men. A 13-year follow-up of former multiple risk factor intervention trial participants. Am J Epidemiol. 1997;146(8):609–17.

    Article  CAS  PubMed  Google Scholar 

  11. Basaria S. Testosterone therapy in older men with late-onset hypogonadism: a counter-rationale. Endocrine Pract: Off J Am College Endocrinol Am Assoc Clin Endocrinol. 2013;19(5):853–63. doi:10.4158/ep13318.ra.

    Article  Google Scholar 

  12. Mulligan T, Iranmanesh A, Johnson ML, Straume M, Veldhuis JD. Aging alters feed-forward and feedback linkages between LH and testosterone in healthy men. Am J Physiol. 1997;273(4 Pt 2):R1407–13.

    CAS  PubMed  Google Scholar 

  13. Jarvis TR, Chughtai B, Kaplan SA. Testosterone and benign prostatic hyperplasia. Asian J Androl. 2015;17:212–26. doi:10.4103/1008-682x.140966. This is a great review of the effects of testosterone on BPH. With the FDA warning on worseining BPH symptoms with testosteorne supplementation, all patients should be warned about this potential complication. The studies that show no worsening in LUTS/BPH are not high level evidence making clinical decisions difficult.

    Article  CAS  PubMed  Google Scholar 

  14. Kaplan SA, Roehrborn CG, McConnell JD, Meehan AG, Surynawanshi S, Lee JY, et al. Long-term treatment with finasteride results in a clinically significant reduction in total prostate volume compared to placebo over the full range of baseline prostate sizes in men enrolled in the MTOPS trial. J Urol. 2008;180(3):1030–2. doi:10.1016/j.juro.2008.05.004. discussion 2–3.

    Article  CAS  PubMed  Google Scholar 

  15. Fan Y, Hu S, Liu J, Xiao F, Li X, Yu W, et al. Low intraprostatic DHT promotes the infiltration of CD8+ T cells in BPH tissues via modulation of CCL5 secretion. Mediat Inflamm. 2014;2014:397815. doi:10.1155/2014/397815.

    Article  Google Scholar 

  16. Araujo AB, O'Donnell AB, Brambilla DJ, Simpson WB, Longcope C, Matsumoto AM, et al. Prevalence and incidence of androgen deficiency in middle-aged and older men: estimates from the Massachusetts Male Aging Study. J Clin Endocrinol Metab. 2004;89(12):5920–6. doi:10.1210/jc.2003-031719.

    Article  CAS  PubMed  Google Scholar 

  17. Bhasin S, Cunningham GR, Hayes FJ, Matsumoto AM, Snyder PJ, Swerdloff RS, et al. Testosterone therapy in men with androgen deficiency syndromes: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2010;95(6):2536–59. doi:10.1210/jc.2009-2354. These are clinical guidelines for testosterone replacement per the Endocrine Society. This is one accepted way to correctly diagnosis, treat, and follow hypogonadal men.

    Article  CAS  PubMed  Google Scholar 

  18. Wang C, Nieschlag E, Swerdloff R, Behre HM, Hellstrom WJ, Gooren LJ, et al. Investigation, treatment, and monitoring of late-onset hypogonadism in males: ISA, ISSAM, EAU, EAA, and ASA recommendations. Eur Urol. 2009;55(1):121–30. doi:10.1016/j.eururo.2008.08.033.

    Article  PubMed  Google Scholar 

  19. Wu FC, Tajar A, Beynon JM, Pye SR, Silman AJ, Finn JD, et al. Identification of late-onset hypogonadism in middle-aged and elderly men. N Engl J Med. 2010;363(2):123–35. doi:10.1056/NEJMoa0911101. A prospective study of 3,369 men in Europe screened and treated for hypogonadism. The aim was to help identify late-onset hypogondism. Erectile dysfunction, poor morning erections, and few thoughts about sex along with total testosterone levels of <11nmol/l and free testosterone of <200pmol/l can be diagnostic of late-onset hypogonadsim.

    Article  CAS  PubMed  Google Scholar 

  20. Kelleher S, Conway AJ, Handelsman DJ. Blood testosterone threshold for androgen deficiency symptoms. J Clin Endocrinol Metab. 2004;89(8):3813–7. doi:10.1210/jc.2004-0143.

    Article  CAS  PubMed  Google Scholar 

  21. Zitzmann M, Nieschlag E. The CAG repeat polymorphism within the androgen receptor gene and maleness. Int J Androl. 2003;26(2):76–83.

    Article  CAS  PubMed  Google Scholar 

  22. Wang C, Catlin DH, Demers LM, Starcevic B, Swerdloff RS. Measurement of total serum testosterone in adult men: comparison of current laboratory methods versus liquid chromatography-tandem mass spectrometry. J Clin Endocrinol Metab. 2004;89(2):534–43. doi:10.1210/jc.2003-031287.

    Article  CAS  PubMed  Google Scholar 

  23. Cooper LA, Page ST. Androgens and prostate disease. Asian J Androl. 2014;16(2):248–55. doi:10.4103/1008-682x.122361.

    Article  PubMed Central  PubMed  Google Scholar 

  24. Parsons JK, Carter HB, Platz EA, Wright EJ, Landis P, Metter EJ. Serum testosterone and the risk of prostate cancer: potential implications for testosterone therapy. Cancer Epidemiol Biomark Prev: Publ Am Assoc Cancer Res Cosponsored Am Soc Prev Oncol. 2005;14(9):2257–60. doi:10.1158/1055-9965.epi-04-0715.

    Article  CAS  Google Scholar 

  25. Pierorazio PM, Ferrucci L, Kettermann A, Longo DL, Metter EJ, Carter HB. Serum testosterone is associated with aggressive prostate cancer in older men: results from the Baltimore Longitudinal Study of Aging. BJU Int. 2010;105(6):824–9. doi:10.1111/j.1464-410X.2009.08853.x.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  26. Roddam AW, Allen NE, Appleby P, Key TJ. Endogenous sex hormones and prostate cancer: a collaborative analysis of 18 prospective studies. J Natl Cancer Inst. 2008;100(3):170–83. doi:10.1093/jnci/djm323.

    Article  CAS  PubMed  Google Scholar 

  27. Fernandez-Balsells MM, Murad MH, Lane M, Lampropulos JF, Albuquerque F, Mullan RJ, et al. Clinical review 1: adverse effects of testosterone therapy in adult men: a systematic review and meta-analysis. J Clin Endocrinol Metab. 2010;95(6):2560–75. doi:10.1210/jc.2009-2575.

    Article  CAS  PubMed  Google Scholar 

  28. Berry SJ, Coffey DS, Walsh PC, Ewing LL. The development of human benign prostatic hyperplasia with age. J Urol. 1984;132(3):474–9.

    CAS  PubMed  Google Scholar 

  29. McVary KT, Rademaker A, Lloyd GL, Gann P. Autonomic nervous system overactivity in men with lower urinary tract symptoms secondary to benign prostatic hyperplasia. J Urol. 2005;174(4 Pt 1):1327–433.

    Article  PubMed  Google Scholar 

  30. Gacci M, Corona G, Vignozzi L, Salvi M, Serni S, De Nunzio C, et al. Metabolic syndrome and benign prostatic enlargement: a systematic review and meta-analysis. BJU Int. 2015;115(1):24–31. doi:10.1111/bju.12728.

    Article  PubMed  Google Scholar 

  31. Cattabiani C, Basaria S, Ceda GP, Luci M, Vignali A, Lauretani F, et al. Relationship between testosterone deficiency and cardiovascular risk and mortality in adult men. J Endocrinol Investig. 2012;35(1):104–20. doi:10.3275/8061.

    CAS  Google Scholar 

  32. Bekaert M, Van Nieuwenhove Y, Calders P, Cuvelier CA, Batens AH, Kaufman JM, et al. Determinants of testosterone levels in human male obesity. Endocrine. 2015. doi:10.1007/s12020-015-0563-4.

    PubMed  Google Scholar 

  33. De Nunzio C, Aronson W, Freedland SJ, Giovannucci E, Parsons JK. The correlation between metabolic syndrome and prostatic diseases. Eur Urol. 2012;61(3):560–70. doi:10.1016/j.eururo.2011.11.013.

    Article  PubMed  Google Scholar 

  34. Parsons JK, Carter HB, Partin AW, Windham BG, Metter EJ, Ferrucci L, et al. Metabolic factors associated with benign prostatic hyperplasia. J Clin Endocrinol Metab. 2006;91(7):2562–8. doi:10.1210/jc.2005-2799.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  35. Kopp RP, Han M, Partin AW, Humphreys E, Freedland SJ, Parsons JK. Obesity and prostate enlargement in men with localized prostate cancer. BJU Int. 2011;108(11):1750–5. doi:10.1111/j.1464-410X.2011.10227.x.

    Article  PubMed  Google Scholar 

  36. Kupelian V, McVary KT, Kaplan SA, Hall SA, Link CL, Aiyer LP, et al. Association of lower urinary tract symptoms and the metabolic syndrome: results from the Boston Area Community Health Survey. J Urol. 2009;182(2):616–24. doi:10.1016/j.juro.2009.04.025. discussion 24–5.

    Article  PubMed Central  PubMed  Google Scholar 

  37. Rohrmann S, Smit E, Giovannucci E, Platz EA. Association between markers of the metabolic syndrome and lower urinary tract symptoms in the Third National Health and Nutrition Examination Survey (NHANES III). Int J Obes. 2005;29(3):310–6. doi:10.1038/sj.ijo.0802881.

    Article  CAS  Google Scholar 

  38. Rosen R, Altwein J, Boyle P, Kirby RS, Lukacs B, Meuleman E, et al. Lower urinary tract symptoms and male sexual dysfunction: the multinational survey of the aging male (MSAM-7). Eur Urol. 2003;44(6):637–49.

    Article  PubMed  Google Scholar 

  39. Bozkurt O, Bolat D, Demir O, Ucer O, Sahin A, Ozcift B, et al. Erectile function and late-onset hypogonadism symptoms related to lower urinary tract symptom severity in elderly men. Asian J Androl. 2013;15(6):785–9. doi:10.1038/aja.2013.44.

    Article  PubMed Central  PubMed  Google Scholar 

  40. Macfarlane GJ, Botto H, Sagnier PP, Teillac P, Richard F, Boyle P. The relationship between sexual life and urinary condition in the French community. J Clin Epidemiol. 1996;49(10):1171–6.

    Article  CAS  PubMed  Google Scholar 

  41. Chung WS, Nehra A, Jacobson DJ, Roberts RO, Rhodes T, Girman CJ, et al. Lower urinary tract symptoms and sexual dysfunction in community-dwelling men. Mayo Clin Proc. 2004;79(6):745–9. doi:10.4065/79.6.745.

    Article  PubMed  Google Scholar 

  42. Blanker MH, Bohnen AM, Groeneveld FP, Bernsen RM, Prins A, Thomas S, et al. Correlates for erectile and ejaculatory dysfunction in older Dutch men: a community-based study. J Am Geriatr Soc. 2001;49(4):436–42.

    Article  CAS  PubMed  Google Scholar 

  43. McVary KT. Erectile dysfunction and lower urinary tract symptoms secondary to BPH. Eur Urol. 2005;47(6):838–45. doi:10.1016/j.eururo.2005.02.001.

    Article  PubMed  Google Scholar 

  44. Pradidarcheep W. Lower urinary tract symptoms and its potential relation with late-onset hypogonadism. Aging Male: Off J Int Soc Study Aging Male. 2008;11(2):51–5. doi:10.1080/13685530801954026.

    Article  CAS  Google Scholar 

  45. Sommers SC. Endocrine changes with prostatic carcinoma. Cancer. 1957;10(2):345–58.

    Article  CAS  PubMed  Google Scholar 

  46. Chokkalingam AP, Nyren O, Johansson JE, Gridley G, McLaughlin JK, Adami HO, et al. Prostate carcinoma risk subsequent to diagnosis of benign prostatic hyperplasia: a population-based cohort study in Sweden. Cancer. 2003;98(8):1727–34. doi:10.1002/cncr.11710.

    Article  PubMed  Google Scholar 

  47. Orsted DD, Bojesen SE, Nielsen SF, Nordestgaard BG. Association of clinical benign prostate hyperplasia with prostate cancer incidence and mortality revisited: a nationwide cohort study of 3,009,258 men. Eur Urol. 2011;60(4):691–8. doi:10.1016/j.eururo.2011.06.016.

    Article  PubMed  Google Scholar 

  48. Guess HA. Benign prostatic hyperplasia and prostate cancer. Epidemiol Rev. 2001;23(1):152–8.

    Article  CAS  PubMed  Google Scholar 

  49. Orsted DD, Bojesen SE. The link between benign prostatic hyperplasia and prostate cancer. Nat Rev Urol. 2013;10(1):49–54. doi:10.1038/nrurol.2012.192.

    Article  CAS  PubMed  Google Scholar 

  50. Morgentaler A, Traish AM. Shifting the paradigm of testosterone and prostate cancer: the saturation model and the limits of androgen-dependent growth. Eur Urol. 2009;55(2):310–20. doi:10.1016/j.eururo.2008.09.024.

    Article  PubMed  Google Scholar 

  51. Page ST, Lin DW, Mostaghel EA, Hess DL, True LD, Amory JK, et al. Persistent intraprostatic androgen concentrations after medical castration in healthy men. J Clin Endocrinol Metab. 2006;91(10):3850–6. doi:10.1210/jc.2006-0968.

    Article  CAS  PubMed  Google Scholar 

  52. Page ST, Lin DW, Mostaghel EA, Marck BT, Wright JL, Wu J, et al. Dihydrotestosterone administration does not increase intraprostatic androgen concentrations or alter prostate androgen action in healthy men: a randomized-controlled trial. J Clin Endocrinol Metab. 2011;96(2):430–7. doi:10.1210/jc.2010-1865.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  53. Gat Y, Joshua S, Gornish MG. Prostate cancer: a newly discovered route for testosterone to reach the prostate: treatment by super-selective intraprostatic androgen deprivation. Andrologia. 2009;41(5):305–15. doi:10.1111/j.1439-0272.2009.00972.x.

    Article  CAS  PubMed  Google Scholar 

  54. van der Sluis TM, Meuleman EJ, van Moorselaar RJ, Bui HN, Blankenstein MA, Heijboer AC, et al. Intraprostatic testosterone and dihydrotestosterone. Part II: concentrations after androgen hormonal manipulation in men with benign prostatic hyperplasia and prostate cancer. BJU Int. 2012;109(2):183–8. doi:10.1111/j.1464-410X.2011.10652.x. This reference in part 1 and part 2 both demonstrate how DHT in the prostate and testosterone in the serum and prostate are related to each other. Homonal manipulation with drugs and the physiology of DHT and testostoerone in the prostate leading to pathology is explored. See Van der Sluis et al. Part I for further details.

    Article  PubMed  Google Scholar 

  55. van der Sluis TM, Vis AN, van Moorselaar RJ, Bui HN, Blankenstein MA, Meuleman EJ, et al. Intraprostatic testosterone and dihydrotestosterone. Part I: concentrations and methods of determination in men with benign prostatic hyperplasia and prostate cancer. BJU Int. 2012;109(2):176–82. doi:10.1111/j.1464-410X.2011.10651.x.

    Article  PubMed  Google Scholar 

  56. Marks LS, Mazer NA, Mostaghel E, Hess DL, Dorey FJ, Epstein JI, et al. Effect of testosterone replacement therapy on prostate tissue in men with late-onset hypogonadism: a randomized controlled trial. JAMA. 2006;296(19):2351–61. doi:10.1001/jama.296.19.2351.

    Article  CAS  PubMed  Google Scholar 

  57. St Sauver JL, Jacobson DJ, McGree ME, Girman CJ, Klee GG, Lieber MM, et al. Associations between longitudinal changes in serum estrogen, testosterone, and bioavailable testosterone and changes in benign urologic outcomes. Am J Epidemiol. 2011;173(7):787–96. doi:10.1093/aje/kwq438.

    Article  PubMed Central  PubMed  Google Scholar 

  58. Parsons JK, Palazzi-Churas K, Bergstrom J, Barrett-Connor E. Prospective study of serum dihydrotestosterone and subsequent risk of benign prostatic hyperplasia in community dwelling men: the Rancho Bernardo Study. J Urol. 2010;184(3):1040–4. doi:10.1016/j.juro.2010.05.033.

    Article  CAS  PubMed  Google Scholar 

  59. Trifiro MD, Parsons JK, Palazzi-Churas K, Bergstrom J, Lakin C, Barrett-Connor E. Serum sex hormones and the 20-year risk of lower urinary tract symptoms in community-dwelling older men. BJU Int. 2010;105(11):1554–9. doi:10.1111/j.1464-410X.2009.09090.x.

    Article  CAS  PubMed  Google Scholar 

  60. Kristal AR, Schenk JM, Song Y, Arnold KB, Neuhouser ML, Goodman PJ, et al. Serum steroid and sex hormone-binding globulin concentrations and the risk of incident benign prostatic hyperplasia: results from the prostate cancer prevention trial. Am J Epidemiol. 2008;168(12):1416–24. doi:10.1093/aje/kwn272.

    Article  PubMed Central  PubMed  Google Scholar 

  61. Litman HJ, Bhasin S, O'Leary MP, Link CL, McKinlay JB. An investigation of the relationship between sex-steroid levels and urological symptoms: results from the Boston Area Community Health survey. BJU Int. 2007;100(2):321–6. doi:10.1111/j.1464-410X.2007.06938.x.

    Article  CAS  PubMed  Google Scholar 

  62. Lee JH, Kim Y, Park YW, Lee DG. Relationship between benign prostatic hyperplasia/lower urinary tract symptoms and total serum testosterone level in healthy middle-aged eugonadal men. J Sex Med. 2014;11(5):1309–15. doi:10.1111/jsm.12489.

    Article  CAS  PubMed  Google Scholar 

  63. Liu CC, Huang SP, Li WM, Wang CJ, Chou YH, Li CC, et al. Relationship between serum testosterone and measures of benign prostatic hyperplasia in aging men. Urology. 2007;70(4):677–80. doi:10.1016/j.urology.2007.05.025.

    Article  PubMed  Google Scholar 

  64. Roberts RO, Jacobson DJ, Rhodes T, Klee GG, Leiber MM, Jacobsen SJ. Serum sex hormones and measures of benign prostatic hyperplasia. Prostate. 2004;61(2):124–31. doi:10.1002/pros.20080.

    Article  CAS  PubMed  Google Scholar 

  65. Pearl JA, Berhanu D, Francois N, Masson P, Zargaroff S, Cashy J, et al. Testosterone supplementation does not worsen lower urinary tract symptoms. J Urol. 2013;190(5):1828–33. doi:10.1016/j.juro.2013.05.111. Administration of testosterone in 120 hypogondal men did not cause a worsening in LUTS/BPH per the AUASI validated questionaaire in these patients.

    Article  CAS  PubMed  Google Scholar 

  66. Haider A, Gooren LJ, Padungtod P, Saad F. Concurrent improvement of the metabolic syndrome and lower urinary tract symptoms upon normalisation of plasma testosterone levels in hypogonadal elderly men. Andrologia. 2009;41(1):7–13. doi:10.1111/j.1439-0272.2008.00880.x.

    Article  CAS  PubMed  Google Scholar 

  67. Amano T, Imao T, Takemae K, Iwamoto T, Nakanome M. Testosterone replacement therapy by testosterone ointment relieves lower urinary tract symptoms in late onset hypogonadism patients. Aging Male: Off J Int Soc Study Aging Male. 2010;13(4):242–6. doi:10.3109/13685538.2010.487552.

    Article  CAS  Google Scholar 

  68. Kalinchenko S, Vishnevskiy EL, Koval AN, Mskhalaya GJ, Saad F. Beneficial effects of testosterone administration on symptoms of the lower urinary tract in men with late-onset hypogonadism: a pilot study. Aging Male: Off J Int Soc Study Aging Male. 2008;11(2):57–61. doi:10.1080/13685530801953994.

    Article  CAS  Google Scholar 

  69. Karazindiyanoglu S, Cayan S. The effect of testosterone therapy on lower urinary tract symptoms/bladder and sexual functions in men with symptomatic late-onset hypogonadism. Aging Male: Off J Int Soc Study Aging Male. 2008;11(3):146–9. doi:10.1080/13685530802290438.

    Article  CAS  Google Scholar 

  70. Pechersky AV, Mazurov VI, Semiglazov VF, Karpischenko AI, Mikhailichenko VV, Udintsev AV. Androgen administration in middle-aged and ageing men: effects of oral testosterone undecanoate on dihydrotestosterone, oestradiol and prostate volume. Int J Androl. 2002;25(2):119–25.

    Article  CAS  PubMed  Google Scholar 

  71. Shigehara K, Sugimoto K, Konaka H, Iijima M, Fukushima M, Maeda Y, et al. Androgen replacement therapy contributes to improving lower urinary tract symptoms in patients with hypogonadism and benign prostate hypertrophy: a randomised controlled study. Aging Male: Off J Int Soc Study Aging Male. 2011;14(1):53–8. doi:10.3109/13685538.2010.518178.

    Article  Google Scholar 

  72. Page ST, Hirano L, Gilchriest J, Dighe M, Amory JK, Marck BT, et al. Dutasteride reduces prostate size and prostate specific antigen in older hypogonadal men with benign prostatic hyperplasia undergoing testosterone replacement therapy. J Urol. 2011;186(1):191–7. doi:10.1016/j.juro.2011.03.026.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  73. Francomano D, Ilacqua A, Bruzziches R, Lenzi A, Aversa A. Effects of 5-year treatment with testosterone undecanoate on lower urinary tract symptoms in obese men with hypogonadism and metabolic syndrome. Urology. 2014;83(1):167–73. doi:10.1016/j.urology.2013.08.019.

    Article  PubMed  Google Scholar 

  74. Yassin DJ, El Douaihy Y, Yassin AA, Kashanian J, Shabsigh R, Hammerer PG. Lower urinary tract symptoms improve with testosterone replacement therapy in men with late-onset hypogonadism: 5-year prospective, observational and longitudinal registry study. World J Urol. 2014;32(4):1049–54. doi:10.1007/s00345-013-1187-z.

    Article  CAS  PubMed  Google Scholar 

  75. Aversa A, Bruzziches R, Francomano D, Rosano G, Isidori AM, Lenzi A, et al. Effects of testosterone undecanoate on cardiovascular risk factors and atherosclerosis in middle-aged men with late-onset hypogonadism and metabolic syndrome: results from a 24-month, randomized, double-blind, placebo-controlled study. J Sex Med. 2010;7(10):3495–503. doi:10.1111/j.1743-6109.2010.01931.x.

    Article  CAS  PubMed  Google Scholar 

  76. Rosner W, Hryb DJ, Khan MS, Nakhla AM, Romas NA. Androgen and estrogen signaling at the cell membrane via G-proteins and cyclic adenosine monophosphate. Steroids. 1999;64(1–2):100–6.

    Article  CAS  PubMed  Google Scholar 

  77. Traish AM. Testosterone and weight loss: the evidence. Curr Opin Endocrinol Diabetes Obes. 2014;21(5):313–22. doi:10.1097/med.0000000000000086.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  78. Cunningham GR. Testosterone and metabolic syndrome. Asian J Androl. 2015;17(2):192–6. doi:10.4103/1008-682x.148068.

    Article  CAS  PubMed  Google Scholar 

  79. Ficarra V, Rossanese M, Zazzara M, Giannarini G, Abbinante M, Bartoletti R, et al. The role of inflammation in lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) and its potential impact on medical therapy. Curr Urol Rep. 2014;15(12):463. doi:10.1007/s11934-014-0463-9.

    Article  PubMed  Google Scholar 

  80. Vignozzi L, Cellai I, Santi R, Lombardelli L, Morelli A, Comeglio P, et al. Antiinflammatory effect of androgen receptor activation in human benign prostatic hyperplasia cells. J Endocrinol. 2012;214(1):31–43. doi:10.1530/joe-12-0142. This article connects hypogonadism and BPH, revealing a 5 fold increase in BPH symptoms and inflammation in vitro due to hypogonadism and low DHT. DHT helps prevent autoimmunity and inflmaation.

    Article  CAS  PubMed  Google Scholar 

  81. Bodie J, Lewis J, Schow D, Monga M. Laboratory evaluations of erectile dysfunction: an evidence based approach. J Urol. 2003;169(6):2262–4. doi:10.1097/01.ju.0000063940.19080.58.

    Article  PubMed  Google Scholar 

  82. Kohler TS, Kim J, Feia K, Bodie J, Johnson N, Makhlouf A, et al. Prevalence of androgen deficiency in men with erectile dysfunction. Urology. 2008;71(4):693–7. doi:10.1016/j.urology.2007.11.073.

    Article  PubMed  Google Scholar 

  83. Nieschlag E. Current topics in testosterone replacement of hypogonadal men. Best Pract Res Clin Endocrinol Metab. 2015;29(1):77–90. doi:10.1016/j.beem.2014.09.008.

    Article  CAS  PubMed  Google Scholar 

  84. Gray PB, Singh AB, Woodhouse LJ, Storer TW, Casaburi R, Dzekov J, et al. Dose-dependent effects of testosterone on sexual function, mood, and visuospatial cognition in older men. J Clin Endocrinol Metab. 2005;90(7):3838–46. doi:10.1210/jc.2005-0247.

    Article  CAS  PubMed  Google Scholar 

  85. Corona G, Isidori AM, Buvat J, Aversa A, Rastrelli G, Hackett G, et al. Testosterone supplementation and sexual function: a meta-analysis study. J Sex Med. 2014;11(6):1577–92. doi:10.1111/jsm.12536.

    Article  CAS  PubMed  Google Scholar 

  86. Isidori AM, Giannetta E, Gianfrilli D, Greco EA, Bonifacio V, Aversa A, et al. Effects of testosterone on sexual function in men: results of a meta-analysis. Clin Endocrinol. 2005;63(4):381–94. doi:10.1111/j.1365-2265.2005.02350.x.

    Article  CAS  Google Scholar 

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Conflict of Interest

Aaron Moore and Michael J. Butcher each declare no potential conflicts of interest.

Tobias S. Köhler reports grants and personal fees from AMS, grants and personal fees from Coloplast, and personal fees from Auxilium.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. School of Medicine, Southern Illinois University, 801 North Rutledge St., Springfield, IL, 62702, USA

    Aaron Moore

  2. The Pavilion at St. John’s Hospital, 301 North Eighth Street, Springfield, IL, 62701, USA

    Michael J. Butcher & Tobias S. Köhler

  3. Division of Urology, Illinois University School of Medicine, Springfield, IL, USA

    Aaron Moore, Michael J. Butcher & Tobias S. Köhler

Authors
  1. Aaron Moore
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  2. Michael J. Butcher
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  3. Tobias S. Köhler
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Correspondence to Michael J. Butcher.

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This article is part of the Topical Collection on Benign Prostatic Hyperplasia

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Moore, A., Butcher, M.J. & Köhler, T.S. Testosterone Replacement Therapy on the Natural History of Prostate Disease. Curr Urol Rep 16, 51 (2015). https://doi.org/10.1007/s11934-015-0526-6

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  • DOI: https://doi.org/10.1007/s11934-015-0526-6

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