age and a swelling prostate

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Ask Dr. H: A puzzling aspect of age and a swelling prostate

By Hecht

Medical Columnist

Question: If a man's testosterone level decreases as he gets older, why doesn't the prostate get smaller with age rather than developing BPH? Answer: That's because testosterone is not the main driving force behind BPH (Benign Prostatic Hyperplasia), the age-related enlargement of the prostate gland. No one knows for sure why a prostate grows with age, but we do know that men whose testicles were removed before puberty do not develop BPH. There are several theories: 1. Both men and women produce testosterone and estrogen. As a man's testosterone level wanes with age, the balance between testosterone and estrogen tips toward the side of relative estrogen excess. This higher amount of estrogen within the prostate gland may stimulate prostate growth; 2. Although a man's testosterone level tends to wane with age, the level of its active breakdown product DHT (dihydrotestosterone) remains relatively constant and high. DHT accumulates in the prostate tissue even as the testosterone level wanes and stimulates prostate growth; and 3. BPH may occur as a result of genetically preprogrammed cells in the prostate that may sensitize the prostate to factors that encourage a prostate to grow later in life.

http://www.philly.com/inquirer/columnists/20080721_Ask_Dr__H__A_puzzling_aspect_of_age_and_a_swelling_prostate.html

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