Dihydrotestosterone and the prostate: The scientific rationale for 5α-reductase inhibitors in the treatment of benign prostatic hyperplasia

Gerald Andriole, Nicholas Bruchovsky, Leland W K Chung, Alvin M. Matsumoto, Roger Rittmaster, Claus Roehrborn, David W Russell, Donald Tindall

Research output: Contribution to journalArticle

184 Citations (Scopus)

Abstract

Purpose: We reviewed the physiological and pathogenic role of dihydrotestosterone (DHT), evidence for the beneficial effects of decreasing DHT through 5α-reductase inhibition and the effects of altering the androgen balance with these agents. Materials and Methods: A review of the relevant literature was done using published studies identified from the MEDLINE database. Results: The androgens DHT and testosterone have complementary roles in male physiology. Each is mediated through the intracellular androgen receptor. It has been hypothesized that DHT may provide an amplification mechanism for testosterone, which could be a beneficial adaptation in men with low circulating testosterone. The recognition of the central role of DHT in benign prostatic hyperplasia (BPH) has changed the way the disease is viewed and has led to the introduction of 5α-reductase inhibitors, which can prevent and retard the progression of BPH by suppressing DHT synthesis. The 5α-reductase inhibitors decrease prostate volume. In doing so they improve symptoms and urinary flow, and decrease the risks of acute urinary retention and the need for BPH related surgery. The predominant drug related adverse events with 5α-reductase inhibitors are reproductive events, that is typically decreased libido, impotence and ejaculatory dysfunction. These events occur in a minority of men and tend to decrease with a longer treatment duration. Conclusions: DHT appears to have an obligatory role in the development of BPH. The role of 5α-reductase inhibitors in the treatment of BPH has been firmly established with an adverse events profile that is suitable for long-term use.

Original languageEnglish (US)
Pages (from-to)1399-1403
Number of pages5
JournalJournal of Urology
Volume172
Issue number4 I
DOIs
StatePublished - Oct 2004

Fingerprint

Dihydrotestosterone
Prostatic Hyperplasia
Prostate
Oxidoreductases
Testosterone
Therapeutics
Androgens
Libido
Urinary Retention
Androgen Receptors
Erectile Dysfunction
Drug-Related Side Effects and Adverse Reactions
MEDLINE
Databases

Keywords

  • Dihydrotestosterone
  • Finasteride
  • GG 745
  • Prostate
  • Prostatic hyperplasia

ASJC Scopus subject areas

  • Urology

Cite this

Dihydrotestosterone and the prostate : The scientific rationale for 5α-reductase inhibitors in the treatment of benign prostatic hyperplasia. / Andriole, Gerald; Bruchovsky, Nicholas; Chung, Leland W K; Matsumoto, Alvin M.; Rittmaster, Roger; Roehrborn, Claus; Russell, David W; Tindall, Donald.

In: Journal of Urology, Vol. 172, No. 4 I, 10.2004, p. 1399-1403.

Research output: Contribution to journalArticle

Andriole, Gerald ; Bruchovsky, Nicholas ; Chung, Leland W K ; Matsumoto, Alvin M. ; Rittmaster, Roger ; Roehrborn, Claus ; Russell, David W ; Tindall, Donald. / Dihydrotestosterone and the prostate : The scientific rationale for 5α-reductase inhibitors in the treatment of benign prostatic hyperplasia. In: Journal of Urology. 2004 ; Vol. 172, No. 4 I. pp. 1399-1403.
@article{cd96c480bf034788bb6fae972329f7ba,
title = "Dihydrotestosterone and the prostate: The scientific rationale for 5α-reductase inhibitors in the treatment of benign prostatic hyperplasia",
abstract = "Purpose: We reviewed the physiological and pathogenic role of dihydrotestosterone (DHT), evidence for the beneficial effects of decreasing DHT through 5α-reductase inhibition and the effects of altering the androgen balance with these agents. Materials and Methods: A review of the relevant literature was done using published studies identified from the MEDLINE database. Results: The androgens DHT and testosterone have complementary roles in male physiology. Each is mediated through the intracellular androgen receptor. It has been hypothesized that DHT may provide an amplification mechanism for testosterone, which could be a beneficial adaptation in men with low circulating testosterone. The recognition of the central role of DHT in benign prostatic hyperplasia (BPH) has changed the way the disease is viewed and has led to the introduction of 5α-reductase inhibitors, which can prevent and retard the progression of BPH by suppressing DHT synthesis. The 5α-reductase inhibitors decrease prostate volume. In doing so they improve symptoms and urinary flow, and decrease the risks of acute urinary retention and the need for BPH related surgery. The predominant drug related adverse events with 5α-reductase inhibitors are reproductive events, that is typically decreased libido, impotence and ejaculatory dysfunction. These events occur in a minority of men and tend to decrease with a longer treatment duration. Conclusions: DHT appears to have an obligatory role in the development of BPH. The role of 5α-reductase inhibitors in the treatment of BPH has been firmly established with an adverse events profile that is suitable for long-term use.",
keywords = "Dihydrotestosterone, Finasteride, GG 745, Prostate, Prostatic hyperplasia",
author = "Gerald Andriole and Nicholas Bruchovsky and Chung, {Leland W K} and Matsumoto, {Alvin M.} and Roger Rittmaster and Claus Roehrborn and Russell, {David W} and Donald Tindall",
year = "2004",
month = "10",
doi = "10.1097/01.ju.0000139539.94828.29",
language = "English (US)",
volume = "172",
pages = "1399--1403",
journal = "Journal of Urology",
issn = "0022-5347",
publisher = "Elsevier Inc.",
number = "4 I",

}

TY - JOUR

T1 - Dihydrotestosterone and the prostate

T2 - The scientific rationale for 5α-reductase inhibitors in the treatment of benign prostatic hyperplasia

AU - Andriole, Gerald

AU - Bruchovsky, Nicholas

AU - Chung, Leland W K

AU - Matsumoto, Alvin M.

AU - Rittmaster, Roger

AU - Roehrborn, Claus

AU - Russell, David W

AU - Tindall, Donald

PY - 2004/10

Y1 - 2004/10

N2 - Purpose: We reviewed the physiological and pathogenic role of dihydrotestosterone (DHT), evidence for the beneficial effects of decreasing DHT through 5α-reductase inhibition and the effects of altering the androgen balance with these agents. Materials and Methods: A review of the relevant literature was done using published studies identified from the MEDLINE database. Results: The androgens DHT and testosterone have complementary roles in male physiology. Each is mediated through the intracellular androgen receptor. It has been hypothesized that DHT may provide an amplification mechanism for testosterone, which could be a beneficial adaptation in men with low circulating testosterone. The recognition of the central role of DHT in benign prostatic hyperplasia (BPH) has changed the way the disease is viewed and has led to the introduction of 5α-reductase inhibitors, which can prevent and retard the progression of BPH by suppressing DHT synthesis. The 5α-reductase inhibitors decrease prostate volume. In doing so they improve symptoms and urinary flow, and decrease the risks of acute urinary retention and the need for BPH related surgery. The predominant drug related adverse events with 5α-reductase inhibitors are reproductive events, that is typically decreased libido, impotence and ejaculatory dysfunction. These events occur in a minority of men and tend to decrease with a longer treatment duration. Conclusions: DHT appears to have an obligatory role in the development of BPH. The role of 5α-reductase inhibitors in the treatment of BPH has been firmly established with an adverse events profile that is suitable for long-term use.

AB - Purpose: We reviewed the physiological and pathogenic role of dihydrotestosterone (DHT), evidence for the beneficial effects of decreasing DHT through 5α-reductase inhibition and the effects of altering the androgen balance with these agents. Materials and Methods: A review of the relevant literature was done using published studies identified from the MEDLINE database. Results: The androgens DHT and testosterone have complementary roles in male physiology. Each is mediated through the intracellular androgen receptor. It has been hypothesized that DHT may provide an amplification mechanism for testosterone, which could be a beneficial adaptation in men with low circulating testosterone. The recognition of the central role of DHT in benign prostatic hyperplasia (BPH) has changed the way the disease is viewed and has led to the introduction of 5α-reductase inhibitors, which can prevent and retard the progression of BPH by suppressing DHT synthesis. The 5α-reductase inhibitors decrease prostate volume. In doing so they improve symptoms and urinary flow, and decrease the risks of acute urinary retention and the need for BPH related surgery. The predominant drug related adverse events with 5α-reductase inhibitors are reproductive events, that is typically decreased libido, impotence and ejaculatory dysfunction. These events occur in a minority of men and tend to decrease with a longer treatment duration. Conclusions: DHT appears to have an obligatory role in the development of BPH. The role of 5α-reductase inhibitors in the treatment of BPH has been firmly established with an adverse events profile that is suitable for long-term use.

KW - Dihydrotestosterone

KW - Finasteride

KW - GG 745

KW - Prostate

KW - Prostatic hyperplasia

UR - http://www.scopus.com/inward/record.url?scp=4544285381&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=4544285381&partnerID=8YFLogxK

U2 - 10.1097/01.ju.0000139539.94828.29

DO - 10.1097/01.ju.0000139539.94828.29

M3 - Article

C2 - 15371854

AN - SCOPUS:4544285381

VL - 172

SP - 1399

EP - 1403

JO - Journal of Urology

JF - Journal of Urology

SN - 0022-5347

IS - 4 I

ER -