Role of estrogens in human benign prostatic hyperplasia

F Sciarra, Valeria Sciarra, V Toscano
Archives of andrology · 2000 · vol. 44(3) , pp. 213–220 · doi:10.1080/014850100262191 · PMID:10864369 · W2144597464
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This study examines the role of estrogens in benign prostatic hyperplasia, noting elevated intraprostatic estrogens and evaluating the limited clinical efficacy of antiestrogen treatments for obstructive symptoms.

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Abstract

The aging process is associated with a progressive decline of plasma testosterone levels, while estrone and estradiol remain unchanged and sex hormone binding globulin (SHBG) increases, with reduction of bioavailable testosterone in prostatic tissue with benign prostatic hyperplasia (BPH) the most important androgen is dihydrotestosterone: with its receptors it is almost uniformly distributed in the epithelial and stromal compartment and is not supranormal. Intraprostatic estrogens and their receptors are elevated and concentrated in the stroma. Androgens may act on the prostate indirectly through the production of growth factors; in human BPH no clear evidence exists on the modulatory effect of estrogens on bFGF, KGF and TGFbeta formation. A western diet, characterized by high fat consumption, predisposes men to BPH, while a diet rich in flavonoids and lignanes, containing phyto-estrogens, lowers this risk. These data suggest that in the medical treatment of BPH, antiestrogens or aromatase inhibitors may be used: however, up to now the clinical results of this treatment are not promising and the improvement of the obstructive symptoms does not exceed that of placebo. A possible explanation of this unsatisfactory result could be that the estrogen reduction secondary to the use of aromatase inhibitors is counterbalanced by the rise of androgen precursors.

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MeSH descriptors

Estrogens Prostatic Hyperplasia Adult Aged Aged, 80 and over Aging Aging Aromatase Inhibitors Diet Enzyme Inhibitors Enzyme Inhibitors Estrogen Antagonists Estrogen Antagonists Estrogens Humans Male Prostatic Hyperplasia Prostatic Hyperplasia Prostatic Hyperplasia

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