TY - JOUR
T1 - Effects of transdermal testosterone gel or an aromatase inhibitor on prostate volume in older men
AU - Dias, Jenny Pena
AU - Melvin, Denise
AU - Shardell, Michelle
AU - Ferrucci, Luigi
AU - Chia, Chee Wei
AU - Gharib, Mohsen
AU - Egan, Josephine M.
AU - Basaria, Shehzad
N1 - Funding Information:
This study had a clinical trial registration number of NCT00104572. This work was supported by the Intramural Research Program of the National Institute on Aging, National Institutes of Health. S.B. has previously received research grants from AbbVie and consulting fees from Eli Lilly and Takeda. The other authors have nothing to disclose.
Publisher Copyright:
Copyright © 2016 by the Endocrine Society.
PY - 2016/4
Y1 - 2016/4
N2 - Context: T replacement is being increasingly offered to older men with age-related low T; hence, monitoring prostate health is important during T therapy. Data suggest that estrogens have an independent effect on the prostate and some effects of T on the prostate might be mediated via its aromatization to estradiol. Although some studies have assessed the effects of T replacement on prostate volume, the differential effects of T and estradiol have not been delineated. Objective: The objective of the study was to investigate the relative effects of T and estradiol on prostate volume in older men with low T. Participants: Thirty-one men, 65 years old or older with total T less than 350 ng/dL (measured by mass spectrometry) participated in the study. Intervention: The intervention included randomization to 5 g transdermal T gel (TT), 1 mg oral aromatase inhibitor (AI), or placebo daily for 12 months. Main Outcome Measures: The primary outcome was prostate volume measured by transrectal ultrasound at baseline and 12 months. Secondary outcomes included prostate-specific antigen levels and lower urinary tract symptoms score. Results: Serum T levels increased in both intervention groups; estradiol levels increased in the TT group, whereas it decreased in the AI group. At 12 months, prostate volume significantly increased (4.5 ± 1.76 cc, P < .05) only in the TT group. Increase in prostate-specific antigen levels were seen in both intervention groups at 6 months (P < .01 and P < .001). The lower urinary tract symptoms score increased only in the TT group (P < .05). Conclusion: The tropic effects of T 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.
AB - Context: T replacement is being increasingly offered to older men with age-related low T; hence, monitoring prostate health is important during T therapy. Data suggest that estrogens have an independent effect on the prostate and some effects of T on the prostate might be mediated via its aromatization to estradiol. Although some studies have assessed the effects of T replacement on prostate volume, the differential effects of T and estradiol have not been delineated. Objective: The objective of the study was to investigate the relative effects of T and estradiol on prostate volume in older men with low T. Participants: Thirty-one men, 65 years old or older with total T less than 350 ng/dL (measured by mass spectrometry) participated in the study. Intervention: The intervention included randomization to 5 g transdermal T gel (TT), 1 mg oral aromatase inhibitor (AI), or placebo daily for 12 months. Main Outcome Measures: The primary outcome was prostate volume measured by transrectal ultrasound at baseline and 12 months. Secondary outcomes included prostate-specific antigen levels and lower urinary tract symptoms score. Results: Serum T levels increased in both intervention groups; estradiol levels increased in the TT group, whereas it decreased in the AI group. At 12 months, prostate volume significantly increased (4.5 ± 1.76 cc, P < .05) only in the TT group. Increase in prostate-specific antigen levels were seen in both intervention groups at 6 months (P < .01 and P < .001). The lower urinary tract symptoms score increased only in the TT group (P < .05). Conclusion: The tropic effects of T 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.
UR - http://www.scopus.com/inward/record.url?scp=85010295238&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85010295238&partnerID=8YFLogxK
U2 - 10.1210/jc.2016-1111
DO - 10.1210/jc.2016-1111
M3 - Article
C2 - 26950683
AN - SCOPUS:85010295238
SN - 0021-972X
VL - 101
SP - 1865
EP - 1871
JO - Journal of Clinical Endocrinology and Metabolism
JF - Journal of Clinical Endocrinology and Metabolism
IS - 4
ER -