Effects of transdermal testosterone gel or an aromatase inhibitor on prostate volume in older men

Jenny Pena Dias, Denise Melvin, Michelle Shardell, Luigi Ferrucci, Chee W. Chia, Mohsen Gharib, Josephine M. Egan, Shehzad Basaria

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1865-1871
Number of pages7
JournalJournal of Clinical Endocrinology and Metabolism
Volume101
Issue number4
DOIs
StatePublished - Apr 1 2016
Externally publishedYes

Fingerprint

Aromatase Inhibitors
Testosterone
Prostate
Estradiol
Gels
Aromatization
Prostate-Specific Antigen
Lower Urinary Tract Symptoms
Tropics
Mass spectrometry
Estrogens
Ultrasonics
Health
Monitoring
Random Allocation
Mass Spectrometry
Placebos
Outcome Assessment (Health Care)

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Biochemistry
  • Endocrinology
  • Clinical Biochemistry
  • Biochemistry, medical

Cite this

Effects of transdermal testosterone gel or an aromatase inhibitor on prostate volume in older men. / Pena Dias, Jenny; Melvin, Denise; Shardell, Michelle; Ferrucci, Luigi; Chia, Chee W.; Gharib, Mohsen; Egan, Josephine M.; Basaria, Shehzad.

In: Journal of Clinical Endocrinology and Metabolism, Vol. 101, No. 4, 01.04.2016, p. 1865-1871.

Research output: Contribution to journalArticle

Pena Dias, Jenny ; Melvin, Denise ; Shardell, Michelle ; Ferrucci, Luigi ; Chia, Chee W. ; Gharib, Mohsen ; Egan, Josephine M. ; Basaria, Shehzad. / Effects of transdermal testosterone gel or an aromatase inhibitor on prostate volume in older men. In: Journal of Clinical Endocrinology and Metabolism. 2016 ; Vol. 101, No. 4. pp. 1865-1871.
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AU - Chia, Chee W.

AU - Gharib, Mohsen

AU - Egan, Josephine M.

AU - Basaria, Shehzad

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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.

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