Benign prostatic hyperplasia--from bench to bedside

Serum sex steroids, gonadotrophins and sex hormone-binding globulin in prostatic hyperplasia

BACKGROUND

Benign prostatic hyperplasia (BPH) develops in elderly males when serum androgens are relatively lower than in healthy younger males, but it is not well understood whether and how sex steroids are altered in prostatic hyperplasia. It is also uncertain whether there is any change in sex steroid levels in males older than 40 years of age. The use of androgens in elderly males is often discouraged because of the probable worsening effect of androgens on prostatism. This study aimed to determine the relationship between prostatic hyperplasia and sex steroid levels and whether there is any significant change in these hormones after the age of 40 years.

SUBJECTS AND METHODS

We studied healthy males of age >or=40 years with (n=92) or without (n=93) clinical prostatic hyperplasia. Serum testosterone, estradiol, gonadotrophins and sex hormone-binding globulin (SHBG) were compared. The hormones and SHBG were also correlated with age.

RESULTS

No significant difference was found in any hormone in cases with prostatic hyperplasia as compared with the controls. There was no significant age-related change in any hormone except estradiol where as a negative correlation (P<.003) with age was found.

CONCLUSIONS

Serum sex steroids and SHBG remained unchanged in symptomatic prostatic hyperplasia and except for estradiol there was no significant age-related change in serum testosterone, gonadotrophins and SHBG in healthy males after the fourth decade. More studies are needed to confirm the age-related decline of estrogens in males.