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HERSHEY, Pa. Half of all men develop enlarged prostates also called benign prostatic hyperplasia by the time theyre 50 years old. The walnut-sized gland never stops slowly growing. But like the fabled frog in hot water, men often dont realize how disruptive the symptoms of an enlarged prostate have become.

Benign prostatic hyperplasia is, like the name says, not malignant. It is not cancer. Instead, its the enlargement of the prostate caused by testosterone. Because most men produce the hormone throughout their lives, the prostate continues to grow typically inward, compressing the base of the bladder as well as the urethra, said Dr. Jaime Herrera Caceres, a urologic oncologist at Penn State Health Specialty Services.

An enlarged prostate makes the bladder work harder to push the urine out due to the increasingly narrow urethra. Patients start not being able to empty their bladder completely, Herrera Caceres said. So maybe theyre retaining three to five ounces in their bladder, meaning it fills more quickly and they have to go more often.

Not only will those with an enlarged prostate typically have to wake up at night often multiple times to relieve themselves, they may also have a weaker urine stream and have to strain to urinate. Going to the bathroom becomes stressful, Herrera Caceres said. When youre out and about, youre always conscious of where the next toilet is because you know youll need it soon.

Men may just accept the disruptive symptoms of their enlarged prostate and not seek treatment. But Herrera Caceres cautions that as the prostate continues to grow, serious complications can develop. If you ignore the symptoms, you run the risk of bladder failure and kidney failure of having a catheter or needing dialysis.

When patients see Herrera Caceres, he asks about their symptoms and how severe they are. He also measures urine flow to learn how weak or strong it is and examines the prostate to determine its size and shape to help guide him in finding the appropriate treatment.

Prescription medications are the most common treatment for mild to moderate benign prostatic hyperplasia. Some relax the bladder neck muscles and muscle fibers in the prostate, making urination easier, Herrera Caceres explains. Others can shrink the prostate by decreasing the amount of the active form of testosterone, though these might take up to six months to be effective and may also reduce sexual desire.

Having benign prostatic hyperplasia in itself does not cause erectile dysfunction, but some treatments might.

Can you take Viagra if you have an enlarged prostate? Herrera Caceres says he has no concerns. In fact, for some patients hes prescribed a different type of medication for erectile disfunction Cialis to control their enlarged prostate symptoms.

For those with moderate to severe benign prostatic hyperplasia, or those who dont respond to medication, surgery may be advised. The classic option is a transurethral resection of the prostate, Herrera Caceres said, explaining that it involves a surgeon going in with a heated loop into the prostatic urethra the portion of the urethra that goes through the prostate and scraping from the inside. Basically, were digging a hole and opening the prostate so theres a better flow.

Other surgical procedures include using heated water or vapor to burn the prostate from inside to open it and using a laser to enucleate the gland. These treatments require hospitalization for a day and a catheter for up to five days, Herrera Caceres said. They may also cause retrograde ejaculation, in which the seminal vesicles fail to squish the semen into the prostate and instead it goes into the bladder.

One new treatment option that Herrera Caceres calls a game changer is the minimally invasive procedure iTind. It involves placing a temporary stent in the prostatic urethra and having it slowly expand over the course of a week.

Patients are asleep for the 15-minute procedure and dont need a catheter at all, Herrera Caceres said. Theres also no hospital stay. Patients will return a week later to have the stent removed.

The technology is new, with patients only tracked for three years thus far, Herrera Caceres says. Those results show continued relief from the symptoms of an enlarged prostate. Patients have reported mild to moderate discomfort during the week that the iTind device is in place, but once its removed, they dont experience the side effects caused by the medications and other procedures used to treat, the urologist says.

No matter what surgical procedure is used to treat the condition, as long as the body produces testosterone, the prostate will grow. It may take eight or 10 years, but when it happens, patients should discuss their symptoms with their doctor to see if they should be treated with medication or another surgical procedure, Herrera Caceres said.

TheMedical Minuteis a weekly health news feature produced by Penn State Health. Articles feature the expertise of faculty, physicians and staff, and are designed to offer timely, relevant health information of interest to a broad audience.

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The Medical Minute: Dont wait to treat your enlarged prostate - Pennsylvania State University

A 25-Year-Old Trans Activist Injected Testosterone In Front Of The Florida Board Of Medicine To Protest A Ban On Gender-Affirming Care For Minors  BuzzFeed News

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A 25-Year-Old Trans Activist Injected Testosterone In Front Of The Florida Board Of Medicine To Protest A Ban On Gender-Affirming Care For Minors -...

Testosterone is the main male sex hormone that plays a vital role in male and female health, and it is one of the key anabolic hormones.

If you feel you lack energy, have a low libido, or have issues with sexual function, then low testosterone could be an issue. For women, the signs also include symptoms of osteoporosis or hair loss.

In this article, we will show you how to increase your testosterone levels naturally and healthily. With just a few changes to your diet, you can find a quick fix to raise low testosterone and give your hormone levels the kick that you need for that extra spark and energy you may be missing.

>>Boost your testosterone with TestoPrime

Here is a quick overview of the top 15 foods that act as a natural testosterone booster:

We know testosterone is key to our health [1]. Wondering how to increase testosterone? One of the quickest and easiest ways anyone can take personal control over their hormone levels is to adopt healthy habits.

By making a few choices about what you eat, you can raise your testosterone levels naturally. We have compiled a list of foods to help you do just that.

>>Boost your testosterone with TestoPrime

Increasing your vitamin D intake is an excellent way to boost testosterone levels [2]. D vitamins play an important role in the manufacture of testosterone in your body.

Fortified milk has a raised vitamin D content and should be part of your diet. It is a quick and easy dietary change to make, one with certain benefits.

Oysters are rich in zincin fact, they contain more zinc than any other food. Zinc just happens to be an essential nutrient in the manufacture of testosterone [3].

Making sure that you have a diet rich in the minerals needed to produce testosterone is a surefire way to help with testosterone increases.

Shellfish are rich in trace elements such as zinc and magnesium and have been found to significantly boost T levels [4]. An easy and effective way to help your body make all the testosterone it needs is to ensure it is well supplied with all the building blocks it needs.

Fatty fish are rich in omega-3 fatty acids. These long-chain fatty acids have long been known to have many health benefits.

Good sources of fatty acids are:

A medically reviewed study from 2017 showed that serum testosterone levels in healthy young men were raised with fatty acid intake. It also showed better reproductive health and healthier sperm (motility and activity) [5].

>>Boost your testosterone with Testogen

Tuna is rich in vitamin D, protein, trace minerals, and micronutrients. A single serving of tuna can fulfill all your daily dietary needs of vitamin D [6].

We know that this vitamin is key in the production of sex hormones, and as such, is a good addition to any healthy diet [2].

Egg yolks are a great source of D vitamins. They are also key to maintaining healthy cholesterol levels, another building block of many hormones [2].

For normal healthy males, eating one boiled or scrambled egg a day poses no risk. Your health provider can provide medical advice and a cholesterol check if you are concerned.

Olive oil is a key component in the Mediterranean diet, long-established as one of the healthiest diets. As such, it is a good starting point for a good dietary choice.

In addition to the benefits of a healthy diet, small-scale studies have shown that in young healthy men, extra virgin olive oil may help raise testosterone levels [7].

If you have concerns over high cholesterol levels and/or eating beef or eggs, then fortified cereals are a great method of zinc and vitamin D supplementation to your diet [2].

>>Boost your testosterone with TestoPrime

If you have a plant-centered diet, then fortified plant milk is an excellent source of essential vitamins and minerals.

We know that vitamin D plays a role in testosterone production, so a tall, chilled glass of the milk of your choice is a great way to add extra D vitamins to your diet [2].

Onions are a great staple food, the cornerstone of many tasty dishes. They are known to have a range of health benefits, but studies show they may also help raise testosterone production by boosting luteinizing hormone [8].

We all know that leafy greens should be part of a healthy diet. Spinach is a great choice, as is chard, kale, and a number of other green veggies.

All are rich in magnesium (among other minerals). Studies indicate that consuming higher levels of magnesium can lift low testosterone levels [9].

Beans may not be at the top of many peoples lists when it comes to boosting reproductive hormones. They are usually known for their other, more effervescent effects.

Beans (lentils, chickpeas, and legumes in general) are key to a plant-based healthy diet. They are full of protein, carbs, and both zinc and magnesium.

We have already discussed the benefits of boosting the two essential minerals, and eating plenty of beans is a cheap, healthy, and tasty way to up your T levels [3] [4].

>>Boost your testosterone with Testogen

Beef products, such as beef liver and ground beef, are rich in protein, huge amounts of micronutrients, and a wide range of vitamins [6].

The term superfood is used a lot in the media, but for male sex hormone production, this really is not a misnomer.

As part of a balanced diet, lean beef is nutritionally dense, healthy in the right quantities, and provides a huge dietary boost that leads to increased levels of testosterone [10].

Pomegranate is an aromatase inhibitor, which prevents testosterone from converting to estrogen. A medically reviewed study of 60 healthy men and women that drank pure pomegranate juice showed promising results after only 14 days [11].

The participants had, on average, a 24% increase in their testosterone level. In addition, they reported lower stress levels and a feeling of wellbeing, both key to helping to raise testosterone.

Ginger has been used for thousands of years as a tonic for better blood flow and as a medicine for nausea, digestion, and colds and flu. Current research has suggested that it may well have testosterone-boosting properties in addition to the aforementioned benefits.

A study in rats showed an increase in both testosterone levels and antioxidant levels after just 30 days of ginger intake [12].

A medically reviewed study pointed to a 17.7% increase in testosterone levels and a boost to sperm count and quality (motility and viability) after using a daily ginger supplement [13].

Can you hit two birds with one stone? Here is a quick checklist of foods that can do that for you by increasing testosterone and lowering estrogen:

This is an important group of foods, including broccoli, cauliflower, Brussel sprouts, kale, turnips, and cabbage. Not only are they healthy, they also boost testosterone.

This group is high in indole-3 carbinol and diindolylmethane (DIM). These are an essential addition to the male diet as they are aromatase inhibitors. This slows the production of estrogen and makes testosterone regulation easier in men [14].

An added bonus is that eating cruciferous vegetables may lower the risk of prostate cancer, a common problem in older men [15].

Curcumin is a main compound present in turmeric, known for its anti-inflammatory effects. Studies have shown that it can raise testosterone when given in large doses [16].

A separate study from 2013 indicated that it might have an effect on lowering estrogen, although this was only in a laboratory, so more work here is needed [17].

Green tea is a powerful aromatase inhibitor, and studies show that it can lower estrogen levels [18].

As noted above, fortified plant milks (such as soy milk) can be an easy and valuable way to increase vitamin D levels and boost testosterone naturally. Read more on if soy is bad for men here.

>>Boost your testosterone with TestoPrime

There are a number of foods that may have the ability to lower testosterone levels or lower testosterone production, such as:

Processed foods are a problem when it comes to reproductive hormones, as are trans fats. A 2016 study showed that trans fats can adversely affect testosterone levels [19].

A 2018 study showed that high levels of sugar-sweetened beverages in a diet resulted in a lowering of testosterone levels. Research also showed that having a BMI constantly over 25 was a risk factor too [20].

Human and animal testing has demonstrated a drop of up to 26% in testosterone levels with licorice consumption. This treat may be one to drop if your T levels are too low [21].

A recent study showed that a diet rich in cooking oils (fried foods) was linked to lower testosterone levels. This could be linked to high BMI, but it is worth cutting down if you want to keep your testosterone level in the healthy range [22].

This isnt strictly a food, but if there is one single thing you can cut out of your diet to boost your T levels, it should be alcohol.

Alcohol is the one medically proven substance that has the most dramatic effect on testosterone levels. Regular or heavy drinkers have a range of medical issues, not least of those being shrunken testes, chronic liver issues, and low testosterone [23].

There are a number of non-dietary ways to naturally raise your testosterone levels:

You can cultivate a number of healthy habits, and a few small changes can produce a range of beneficial changes to testosterone levels.

>>Boost your testosterone with TestoPrime

If you are looking to boost testosterone naturally, then a healthy balanced diet is always a good idea. Ensuring that all food groups are represented and in their correct proportions is sure to boost your testosterone.

Choosing your foods with a little care can have a big positive impact on testosterone production.

An excellent way to boost testosterone naturally is to cut down on alcohol. Excessive drinking will have an adverse effect on your testosterone levels leading to issues such as erectile dysfunction [23].

A good way to increase testosterone naturally is with regular exercise. Resistance training has been shown to have a number of health benefits other than as a natural testosterone booster [24].

Medically reviewed papers have shown that an increase in muscle mass can raise blood flow, increase bone health, raise the number of red blood cells, and lower BMI.

Losing weight will also help, as having a high BMI can lead to insulin resistance. This can, in turn, lead to low T levels [25].

Raised cortisol levels are the enemy of the production of key hormones. Many studies have demonstrated that chronic stress leads to lower free testosterone and lower serum testosterone levels [26].

A popular way to raise low testosterone is with supplements and testosterone boosters. They are readily available over the counter in health stores or online.

Testosterone supplements or even testosterone replacement therapy can be used to quickly address erectile dysfunction, improve sexual function, raise sperm count, and improve male fertility.

The supplements contain a mix of essential nutrients, vitamins, and herbal supplements to help boost T production. The most effective are Testogen, Test RX, and TestoPrime.

True or false: Besides increasing testosterone, T boosters can also improve energy

Choose an answer to reveal if it's true or false

True: Many T booster supplements contain creatinine, providing an energy boost

We will run through some of the most common questions about foods that increase testosterone.

Foods that are high in zinc, D vitamins, and omega 3 fatty acids are the best to boost testosterone levels. These include oysters, pomegranates, ginger, egg yolks, and fatty fish.

Exercise that leads to a boost in muscle mass is ideal. High-intensity workouts have been clinically proven to raise free testosterone levels [24].

There is no definitive proof that caffeine can change testosterone levels. A study with around 20 healthy young men was inconclusive [27]. Further research with larger sample sizes is needed for meaningful data.

As men age, testosterone levels naturally fall. From the age of 30 years onwards, there is roughly a 1% drop in overall testosterone levels each year [1].

As this occurs, estrogen levels will naturally rise slightly, but the rise and fall are not clearly linked. There is a hormone called aromatase which can convert testosterone into estradiol, an estrogen precursor.

The conversion from testosterone to estradiol is not thought to be a significant factor in low testosterone levels.

>>Boost your testosterone with TestoPrime

If you have problems with testosterone levels or you just want to give yourself a natural boost, there are many options open to you.

A change in diet, lifestyle, and a new exercise regime can make a huge change. You can make a conscious choice to alter your diet, actively selecting a range of beneficial foods.

Take control of your weight and lose weight if necessary. Having a long-term BMI of over 25 will lead to a lowering of your testosterone levels and a higher risk of associated issues.

A third viable option is to choose one of a range of natural testosterone boosters. We recommend Testogen, Test RX, and TestoPrime as the three market leaders.

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15 Foods That Increase Testosterone Levels Naturally - Farr Institute

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Anahita Mansooriet al. Phytother Res. 2020 Jul.

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Different types of glycosides extract of fenugreek have shown androgenic and anabolic effect in male. The aim of the study was to evaluate the effect of fenugreek extract on total testosterone levels in male. Medline via PubMed, Scopus databases, Cochrane Library, Web of Science, and Google Scholar were searched up to November 2018 for randomized clinical trials comparing intake of fenugreek extract with control group. Data on change in serum total testosterone were pooled using random-effects models. A total of four trials were included. Fenugreek extract has a significant effect on total serum testosterone. Results from clinical trials suggest that fenugreek extract supplement has an effect on serum total testosterone levels in male.

Keywords: fenugreek extract; total testosterone.

2020 John Wiley & Sons, Ltd.

Neelakantan N, Narayanan M, de Souza RJ, van Dam RM. Neelakantan N, et al. Nutr J. 2014 Jan 18;13:7. doi: 10.1186/1475-2891-13-7. Nutr J. 2014. PMID: 24438170 Free PMC article.

Chevassus H, Gaillard JB, Farret A, Costa F, Gabillaud I, Mas E, Dupuy AM, Michel F, Canti C, Renard E, Galtier F, Petit P. Chevassus H, et al. Eur J Clin Pharmacol. 2010 May;66(5):449-55. doi: 10.1007/s00228-009-0770-0. Epub 2009 Dec 18. Eur J Clin Pharmacol. 2010. PMID: 20020282 Clinical Trial.

Rao A, Steels E, Beccaria G, Inder WJ, Vitetta L. Rao A, et al. Phytother Res. 2015 Aug;29(8):1123-30. doi: 10.1002/ptr.5355. Epub 2015 Apr 24. Phytother Res. 2015. PMID: 25914334 Clinical Trial.

Bae MJ, Shin HS, Choi DW, Shon DH. Bae MJ, et al. J Ethnopharmacol. 2012 Dec 18;144(3):514-22. doi: 10.1016/j.jep.2012.09.030. Epub 2012 Oct 2. J Ethnopharmacol. 2012. PMID: 23036811

Gong J, Fang K, Dong H, Wang D, Hu M, Lu F. Gong J, et al. J Ethnopharmacol. 2016 Dec 24;194:260-268. doi: 10.1016/j.jep.2016.08.003. Epub 2016 Aug 2. J Ethnopharmacol. 2016. PMID: 27496582 Review.

Ghayur MN, Abdalla M, Khalid A, Ahmad S, Gilani AH. Ghayur MN, et al. Biomed Res Int. 2022 Apr 5;2022:4849464. doi: 10.1155/2022/4849464. eCollection 2022. Biomed Res Int. 2022. PMID: 35425837 Free PMC article.

Smith SJ, Lopresti AL, Teo SYM, Fairchild TJ. Smith SJ, et al. Adv Nutr. 2021 Jun 1;12(3):744-765. doi: 10.1093/advances/nmaa134. Adv Nutr. 2021. PMID: 33150931 Free PMC article.

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Low testosterone and age

When you think of declining levels of testosterone, you might think of middle-aged or older men. But men under 30 can also experience low testosterone, or low T.

According to the Mayo Clinic, testosterone levels tend to peak in men during adolescence and early adulthood. Those levels typically decline by about 1 percent each year, starting around age 30. But in some cases, you may experience declining testosterone at a younger age.

Low T is a medical condition where your body doesnt produce enough of the hormone testosterone. Both men and women produce testosterone, but its called the male hormone because men produce a lot more of it. Its critical for many male characteristics, including the maturation of male sex organs, sperm development, muscle mass development, voice deepening, and hair growth. Low T can cause a variety of symptoms, including erectile dysfunction, infertility, muscle mass loss, fat gain, and balding.

If you think you might be experiencing low T, make an appointment with your doctor. In some cases, it is caused by unhealthy lifestyle habits that you can change. In other cases, it is caused by an underlying medical condition that requires treatment. Your doctor can help you identify the cause of your symptoms and learn how to manage them.

Some advertisements for testosterone replacement products may lead you to believe that simply feeling tired or cranky is a sign of low T. In reality, symptoms tend to be more involved than that. Regardless of your age, low T symptoms can include:

Many of these symptoms can also be caused by other medical conditions or lifestyle factors. If youre experiencing them, make an appointment with your doctor. They can help you identify the underlying cause and recommend a treatment plan.

Low T is less common among men under 30, but it can still occur. Contributing factors include:

Some cases of low T may be linked to other medical conditions, such as:

If you suspect that you might have low T, make an appointment with your doctor. They can use a simple blood test to determine your testosterone level.

If your doctor finds that your testosterone level is lower than normal, they may order additional tests or do an exam to investigate why. Your treatment plan will depend on your diagnosis and medical history. Your doctor may recommend lifestyle changes or testosterone replacement therapy.

You should always talk to your doctor before taking new medications, including testosterone replacement therapy and supplements. According to research published in PLOSOne, testosterone therapy may increase your risk of heart attack, particularly if you already have heart disease. Your doctor can help you understand the potential benefits and risks of different treatment options.

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Healthline: Medical information and health advice you can trust.

Introduction

The application of the knowledgeon dihydrotestosterone-related processes spans from the prenatal development of organs to the aging-related complications in males. A clinician can single-handedly tackle the issues that occur out throughout the age spectrum. This hormone finds its utility as an essential hormone in males until puberty, after which it is considered an etiology for certain diseases. Thedualfunction of this hormone places it in the basic science and applied field of medicine. This article aims to outline thebasic biochemistry of the hormone, its physiological functions at different stages of development, and its role in certain pathological conditions.

Androgens are endogenous steroid hormones. They consist of the hormones dehydroepiandrosterone (DHEA), androstenedione, testosterone, and dihydrotestosterone (DHT). DHT is the most potent hormone among the androgens and is considered a pure androgen as it cannot convert into estrogen. It is formed primarily in peripheral tissues of the body, where it exerts its effects. Testosterone converts to DHT by the action of the 5 alpha-reductase enzyme at these target tissues.[1]This isolated synthesis at a specific target tissue makes DHT primarily a paracrine hormone.[2] Asit is produced mainly in the liver, only small amounts are present in the systemic circulation.[3][4]It plays a vital role in the sexual development of males. During embryonic life, it is involved primarily in the sexual differentiation of organs. Through adolescence and adult life, DHT promotes prostate growth, sebaceous gland activity, male pattern baldness, and body, facial and pubic hair growth. This hormone, however, does not seem to play any significant role in normal female physiology. The mutations leading to dramatic losses of DHT in females only have minor effects on their normal physiology. The various functions of DHT are highlighted in the respective pathologies discussed in this article.

Aswith any other disease, a deficiency or an excess of the DHT hormone leads to specific pathologies. These pathologies require identification and treatment for the adequate development and functioning of the genital organs, specifically in males. The hormone deficiency requires special attention as it affects the prenatal sexual differentiation of a fetus, which sets forth a cascade of maldevelopment issues that are unmasked only during puberty.

Cholesterol is the precursor molecule for DHT synthesis, which passes through a series of reactions to form testosterone. Testosterone is then reduced by the enzyme 5-alpha-reductase at the target tissues to form DHT. This reduction step involves the use of NADPH to remove a double bond in the testosterone molecule. There are three isoenzymes of 5-alpha-reductase: types 1, 2, and 3. 5-alpha-reductase type 2 is the most prevalent and the most biologically active isoenzyme.[1]This enzyme is present primarily at the target tissues where DHT exerts its actions, allowing the conversion of testosterone to DHT to occur only at these specific sites.[1]

DHT is significantly more potent than the other androgens; this is due to the high affinity of DHT to the androgen receptor, its slow dissociation, and a long half-life. Compared to testosterone, DHT has approximately double the binding affinity to the androgen receptor and a dissociation rate about five times slower.[1]The enzyme 3-alpha-hydroxysteroid dehydrogenase, which is present in the DHT target tissues and the liver, is responsible for the metabolism of DHT. The metabolism yields inactive metabolites, which are excreted in the urine.[3]

DHT plays a critical function in the sexual development of males, beginning early in prenatal life. The role of DHT differs as males progress through the different stages of development. It has various impacts on their physiology during childhood, puberty, and even throughout adult life.

Prenatal

During sexual development, various embryological structures develop under the influence of a variety of genes and hormones. A specific and unique environment of hormones results in male or female differentiation of structures. In males, testosterone, anti-mullerian hormone (AMH), and DHT act in concert to inhibit female differentiation and promote the development of the male phenotype. DHT is essential for the formation of the male external genitalia. The testicular Leydig cells produce testosterone under the influence of placental human chorionic gonadotropin by around day 60 of prenatal development. The luteinizing hormone (LH) from the fetal pituitary takes over testosterone production by roughly week 16. The peripheral 5-alpha-reductase type 2 converts circulating fetal testosterone to DHT, which is responsible for proper male differentiation of the urogenital sinus, the genital tubercle, urogenital fold, and labio-scrotal folds. This activity leads to the formation of the penis, scrotum, and prostate. DHT, along with insulin-like factor 3 (INSL3), helps stimulate gubernacular growth required for testicular descent. The absence of DHT may lead to ambiguous male external genitalia and undescended testis. Sex steroids accumulate from testicular production of testosterone in the male fetus and placental production of estrogen in both sexes, causing negative feedback on fetal pituitary, which helps control gonadotropin levels in the womb.

Childhood

After birth, the loss of placental estrogen removes negative feedback on the hypothalamic-pituitary-gonadal (HPG) axis, which results in a transient increase in its activity in both sexes for the first few months of life. In males, this promotes a rise in testosterone levels and, therefore, DHT. The negative feedback on the HPG axis recovers by six months of age and the levels of sex hormones remain low until adrenarche.

Adrenarche typically occurs around six years of age in both sexes. The adrenal gland develops a new layer, the zona reticularis. This layer of the adrenal gland produces androgens, including testosterone, which increases systemic testosterone, leading to the development of sebaceous and apocrine glands, contributing to the development of minor acne and body odor. Testosterone production continues to increase as the zona reticularis continues to mature. There is enough peripheral conversion of testosterone into DHT by age 10 to result in pubic hair development. These events of adrenarche are distinct from puberty though they often coincide.

Puberty

An increase in the activity of the HPG axis characterizes the onset of puberty. Hypothalamic secretion of gonadotropin-releasing hormone (GnRH) increases, stimulating pituitary LH secretion, which increases testosterone production from the testes. The increase in systemic testosterone is associated with a significant conversion to DHT at its target tissues. This DHT promotes further growth and maturation of the penis and scrotum. DHT is also the primary androgen responsible for facial hair, body hair, pubic hair, and prostate growth. The circulating level of DHT in the blood is only 10% of the circulating level of testosterone. However, the DHT level can be as much as ten times greater than testosterone due to its isolated production in peripheral tissues.[2]

Adult

DHT does not play a significant role in the normal physiology of adults. The most notable effects are prostate enlargement and male pattern hair loss as they age.[5]

The effects of DHT are mediated through the intracellular androgen receptor.It passes through the cell membrane and binds to the androgen receptor in the cytoplasm of the cell. This interaction initiates a cascade leading to the transport of the ligand-androgen receptor complex to the nucleus, where it acts as a transcription factor to alter gene expression.[1]

DHT levels are useful in the diagnosis of 5-alpha-reductase deficiency and male-pattern baldness. The elevated testosterone-to-DHT ratio is a diagnostic of 5-alpha-reductase deficiency. The test is done during early infancy or puberty when the HPG axis is active. The axis becomes stimulated with the administration of hCG in the period between infancy and puberty. The serum DHT level does not directly correlate with the production in peripheral tissues. Its level increases to near-normal following puberty due to the activity of functional 5-alpha-reductase type 1 enzymes. A definitive diagnosis requires genetic testing to identify the aberration. The utility of DHT levels in diagnosing male-pattern alopecia is controversial, with no statistical significance or correlation of DHT levels with the progression of baldness.[6]

The variations in dihydrotestosterone levels are associated with various pathological conditions. These conditions usually affect people in different stages of life.

5-alpha-reductase Deficiency

The 5-alpha-reductase enzyme is involved in the production of DHT. The enzyme deficiencies are an autosomal recessive condition, typically arising due to loss-of-function mutations in the gene encoding 5-alpha-reductase type 2.[7]Males born with a 5-alpha-reductase deficiency have underdeveloped genitalia, undescended functional testes, and a small or absent prostate. The development of the testes and the internal organs of sexual differentiation are unaltered. The presentation is variable depending on the enzyme level. In severe cases, the infants have external genitalia that appears typical for a female, and hence, are raised as one. They have a small clitoris-like penis, an unfused scrotum appearing as labia, and a short, blind-ending vagina. DHT levels are about 30% of their normal values. However, testosterone and AMH are produced normally, maintaining the mesonephric duct and inhibiting the paramesonephric duct, respectively. The testes continue to develop normally, but they fail to descend due to the lack of DHT. At the onset of puberty, the patients have a rapid increase in testosterone production from the testicles leading to the development of many secondary sexual characteristics. Their voice deepens, testes may descend, muscle mass increases, and the penis enlarges. Although DHT is involved in some of these processes at puberty, testosterone levels are sufficiently elevated to induce these changes without its influence, though they remain undervirilized in other ways. Facial hair growth is greatly diminished, and pubic hair grows in a typical female pattern. The prostate does not develop normally. The patients ultimately develop male gender identity and a sexual preference for females. These individuals can become fertile with surgery to correct the male ductal system. Female development is largely unimpacted by a congenital 5-alpha-reductase deficiency. Normal female development is not dependent on significant DHT activity. The low DHT levels may lead to reduced body hair growth and a mild decrease in pubic hair.

Androgen Deficiency

Testosterone is the primary hormone used in androgen-deficiency states like male hypogonadism, androgen deficiency of severe illness, androgen deficiency of aging, and microphallus in infancy. DHT has also been proposed as a treatment for androgen deficiency as it is a pure androgen and does not convert to estrogen. A potential advantage of DHT over testosterone is the reported and seemingly paradoxically muted effects of DHT on prostate growth. The decreased effect of DHT on the prostate gland of humans may be due to the decrease in intraprostatic estradiol levels.[8]

5-alpha-reductase Inhibitors

5-alpha-reductase inhibitors are useful in the treatment of conditions that have excessive DHT activity. The conditions include benign prostatic hyperplasia (BPH), prostate cancer, androgenic alopecia (male pattern hair loss), and hirsutism. These drugs work by inhibiting the 5-alpha-reductase enzymes, thereby reducing DHT production in tissues.[9]The most common drugs are finasteride and dutasteride. Finasteride inhibits only 5-alpha-reductase type 2, while dutasteride inhibits both type 1 and type 2 isoforms of the enzyme. Generally, the drugs are well tolerated, though they may diminish libido and sexual function.[9]

Benign Prostatic Hyperplasia

The prostate has a significant 5-alpha-reductase type 2 activity, producing large amounts of the potent DHT. This local DHT stimulates normal activity but also commonly induces hypertrophy and hyperplasia of the prostate. More than 50% of men over the age of 50 have some degree of BPH.[10]The increase in prostate growth is likely due to increased local production of DHT or increased activity of its receptor.[10]The patients may experience symptoms such as difficulty urinating and sexual dysfunction due to increased prostate growth.

The treatment of BPH mainly involves the administration of alpha-1 adrenergic antagonists. But in some patients, 5-alpha-reductase inhibitors, such as finasteride and dutasteride, are indicated. These drugs are effective in reducing the size of the prostate and relieving symptoms associated with BPH.[9]

Prostate Cancer

Prostate cancer also characteristically demonstrates an increase in the activity of DHT. There is an upregulation in all three isoforms of the 5-alpha reductase enzyme. The mutations in genes result in uncontrolled proliferation and inhibition of apoptosis, which are related to pathways involving DHT.[11]The mutations in the androgen receptor also have implications in many cases of prostate cancer.

The 5-alpha-reductase inhibitors: finasteride and dutasteride are effective in treating and decreasing the risk of prostate cancer.[11]Though several clinical trials have demonstrated an overall decrease in prostate cancer incidence with these drugs, patients undergoing these therapies have increased rates of higher-grade cancers.[11]

Male Androgenic Alopecia (MAA)

Male androgenic alopecia is commonly known as male pattern hair loss. It is a form of hair loss occurring commonly on the top and frontal region of the scalp that recedes progressively. Increased DHT activity is responsible, amongst other factors, in the pathophysiology of androgenic alopecia.[6]Men with androgenic alopecia are genetically predisposed to higher 5-alpha-reductase enzyme levels and androgen receptor activity at the hair follicles.[12]Similarly, patients with enzyme deficiency are less likely to be prone to male androgenic alopecia.[12]

The oral 5-alpha-reductase inhibitors, such as finasteride, can effectively slow or even reverse this hair loss pattern. In two large randomized controlled trials, approximately 99% of participants showed either a decrease in or reversal of hair loss.[13]The other first-line therapy for treating MAA is topical minoxidil, an arterial vasodilator.

Polycystic Ovarian Syndrome (PCOS)

DHT has a negligible role in regulating normal female physiology. However, there are implications in the pathophysiology of PCOS. It is known to cause an increase in body weight, body fat, serum cholesterol, and adipocyte hypertrophy in experimental mice.[14]Surprisingly, the administration of prenatal DHT in experimental female mice does not induce penile formation.[15]

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Biochemistry, Dihydrotestosterone - StatPearls - NCBI Bookshelf

Exercise has a profound effect on muscle growth, which can occur only if muscle protein synthesis exceeds muscle protein breakdown; there must be a positive muscle protein balance. Resistance exercise improves muscle protein balance, but, in the absence of food intake, the balance remains negative (i.e., catabolic). The response of muscle protein metabolism to a resistance exercise bout lasts for 24-48 hours; thus, the interaction between protein metabolism and any meals consumed in this period will determine the impact of the diet on muscle hypertrophy. Amino acid availability is an important regulator of muscle protein metabolism. The interaction of postexercise metabolic processes and increased amino acid availability maximizes the stimulation of muscle protein synthesis and results in even greater muscle anabolism than when dietary amino acids are not present. Hormones, especially insulin and testosterone, have important roles as regulators of muscle protein synthesis and muscle hypertrophy. Following exercise, insulin has only a permissive role on muscle protein synthesis, but it appears to inhibit the increase in muscle protein breakdown. Ingestion of only small amounts of amino acids, combined with carbohydrates, can transiently increase muscle protein anabolism, but it has yet to be determined if these transient responses translate into an appreciable increase in muscle mass over a prolonged training period.

Excerpt from:
Exercise, protein metabolism, and muscle growth - PubMed

Early testing can help identify low testosterone.PeopleImages/Getty Images

Low testosterone levels can cause side effects ranging from low libido and mood to muscle loss.

A urologist said more men should get tested so their doctors can see how their hormone levels change over time.

There is some evidence that higher testosterone levels may prevent illness like prostate cancer, not increase the risk.

Testosterone is a crucial hormone for men's health, and a top urologist says more men should know their levels earlier in life.

Low testosterone can causeloss of energy, muscle, and libido, and can contribute to chronic illnesses such as heart disease, diabetes, and obesity, according to research.

But diagnosing low testosterone can be tricky, because natural testosterone levels can vary.

If you don't already know your baseline, and you start experiencing these symptoms, you may not be able to trust the results of a testosterone test, said Dr. Ananias C. Diokno, former chief medical officer and chair of urology at Beaumont Hospital, Royal Oak.

"If you ask men what their testosterone levels are, they'll scratch their heads. They don't know and doctors aren't testing for this.You should know what your level is by the time you hit 30 to 35,"Diokno told Insider.

Testing for low testosterone is simple, using a blood test.

In healthy men, testosterone levels can range between 260 nanograms per deciliter (ng/dL) and more than 900 ng/dL, depending on age.

Low testosterone is typically defined as less than 250-300 ng/dL, according to the Cleveland Clinic.

However, since natural testosterone levels can vary widely,Diokno said many men can be misdiagnosed for hormone deficiencies.

For example, a person with testosterone levels of 400 or 500 ng/dL won't be diagnosed with low testosterone because it's higher than the defined standard, but if his initial levels were 700 or higher, the drop is significant and may warrant treatment.

Story continues

"Many practitioners close their minds. Someone may be having symptoms but according to the guidelines, does not have low testosterone. It's frustrating among men and among doctors who can't help them," Diokno said.

One solution is more routine hormone testing so men can establish what a healthy baseline looks like for them, similar to other markers of health like cholesterol, blood pressure, and blood sugar, Diokno said.

Over time, men's testosterone levels dwindle as a common side effect of aging.However, younger men can also have low testosterone, causing them to experience similar symptoms to much older men.

Telltalesymptoms of low testosterone can be mental, physical, and emotional, including:

"The lower the testosterone, the more symptoms," Diokno said.

For men who have had sudden dips in hormone levels, testosterone therapy can help restore quality of life, energy, and libido, Diokno said.

Previously, testosterone therapy has been carefully regulated, in part because high testosterone has been linked to a higher risk of prostate cancer in some studies.

Diokno said the opposite may be true, according to some observational studies, and healthy testosterone levels may protect prostate health.

Loss of muscle linked to low testosterone can cause other problems, too, including a decreased metabolism that can lead to weight gain and associated health issues.

Available evidence suggests that testosterone therapy, done correctly and with medical supervision, is a safe and effective way to raise hormone levels, and more research is needed to see who could benefit, Diokno said.

"It's a Pandora's Box, I think there are many questions that are still unanswered," he said.

Read the original article on Insider

Read more:
Men should know their testosterone levels by age 30 to prevent health issues like weight gain and muscle loss, says top urologist - Yahoo News

Testosterone is a sex hormone in males and females. The adrenal glands secrete it, along with the testes in males and the ovaries in females.In males, testosterone forms reproductive organs and characteristics such as increased muscle and bone mass and body hair growth. In females, testosterone contributes to the sex drive and plays a role in the menstrual cycle.

This article explores the hormone testosterone, its role in the body, and what happens when testosterone levels are out of balance.

Testosterone is a sex hormone present in greater amounts in males. Hormones are chemicals made by the bodys glands that circulate in the bloodstream and control certain processes.

In males, testosterone plays a key role in developing sex organs such as the prostate and testicles. It also produces other male characteristics, such as:

Although people often think of testosterone as a male hormone, its also essential in the female body. In females, testosterone plays a role in the sex drive or libido.

Other characteristics that testosterone influences in females include:

Testosterone levels typically change during your lifetime and even throughout the day. Levels also differ between males and females. Doctors measure testosterone levels in nanograms (ng) per decilitre (dL).

Below are typical testosterone levels for male children and adults by age range.

Female testosterone levels

Below are typical testosterone levels for female children and adults by age range.

Several conditions may cause testosterone levels to become out of balance, leading to reproductive dysfunction and other symptoms.

Conditions that can cause low levels of testosterone

Hypogonadism refers to low levels of testosterone in males. Primary hypogonadism happens when the testicles do not produce enough testosterone.

This condition may develop due to Klinefelter syndrome, in which a male is born with an extra X chromosome. Other causes of primary hypogonadism include chemotherapy and aging.

Secondary hypogonadism happens when your pituitary gland or hypothalamus does not function correctly. Factors that may cause this include HIV, obesity, and pituitary disorders.

Turner syndrome occurs when a female is born with only one X chromosome rather than two. This results in lower testosterone levels and a wide range of symptoms.

Conditions that can cause high levels of testosterone

Polycystic ovary syndrome (PCOS) is a common condition in which females can have elevated testosterone levels. While the exact cause of PCOS is not known, it tends to run in families.

Misusing steroids and other appearance performance-enhancing drugs (APEDs) can cause an increase in testosterone levels. This can cause hormonal problems and can put you at a higher risk for:

You may notice symptoms of your testosterone level being too high or too low.

Symptoms of low testosterone

Males with low levels of testosterone may experience:

Females with low levels of testosterone may experience:

Symptoms of high testosterone

High levels of testosterone that do not result from synthetic supplementation are rare in males. In many cases, there are few observable symptoms.

Females with high levels of testosterone may experience symptoms such as:

Medical professionals will test for low testosterone only if you have clinical symptoms such as loss of body hair, sexual dysfunction, hot flashes, or increased breast tissue in males.

If your medical professional believes there may be an imbalance in your testosterone level, they can order a total serum testosterone lab test. To complete this test, you will need to have your blood drawn between 810 a.m.

If your lab results are low, you will need to repeat the test another day. During that test, your doctor may measure other hormone levels as well.

In some cases, a brain MRI can show whether there is a problem with your pituitary gland that may be causing low testosterone levels.

In cases where the cause of low testosterone levels is hypogonadism, your medical professional may prescribe testosterone replacement therapy (TRT).

Females sometimes take TRT to treat postmenopausal loss of sexual drive or to produce male characteristics when making a gender transition.

Potential benefits of TRT include:

Potential risks include cardiovascular complications.

Learn more about TRT.

Testosterone is a sex hormone responsible for forming many male sexual characteristics and reproductive organs. In females, testosterone contributes to the menstrual cycle and sex drive.

Low testosterone levels in males, a condition called hypogonadism, may produce many symptoms. These may include reduced sexual desire and hot flashes. Some people may also experience changes in hair volume, testicular size, and bone density.

High levels of testosterone in males typically result from anabolic steroid use. High levels of testosterone in females generally result from an underlying medical condition.

Contact your doctor if you think your testosterone levels may be imbalanced.

Read more:
Testosterone: Function, Levels, Testing, and More - Healthgrades

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06 October 2022

Womens health expert Prof Susan Davis has been awarded a $160,000 Heart Foundation Vanguard Grant, and along with it their prestigious Ross Hohenen Award for Innovation, for a new study to evaluate the efficacy of testosterone supplementation in preventing a specific type of heart disease in post-menopausal women.

Heart failure with preserved ejection fraction (HFpEF) is an emerging global health problem accounting for approximately half of all patients with heart failure.Its three times more common in women than in men, and a large age-associated spike in prevalence approximately 4-fold - is seen in women aged 55-64 years, when their blood testosterone concentrations are at their lowest.

The new study called ETHEL builds on Prof Daviss impressive track record expanding medical knowledge around the roles of sex hormones, including testosterone, on the physical and mental health of menopausal and post-menopausal women.

Shell work with Dr Rakibul Islam from her own team at the Womens Health Research Program at the Monash School of Public Health and Preventive Medicine, and Prof Thomas Marwick and Dr Erin Howden from the Baker Heart and Diabetes Institute, who have specific expertise in HFpEF diagnosis and monitoring.

Prof Davis says, Sex hormone changes during menopause can have debilitating symptoms on some women, and may have serious implications for long-term heart health. Half of earths inhabitants are women this type of research therefore has the scope for massive impact.

There is already evidence from animal models that low testosterone is associated with the development of HFpEF, and research including some of Prof Daviss previous studies provides biological plausibility and preliminary clinical evidence of the role of testosterone insufficiency in progression to HFpER in post-menopausal women.

The Therapeutic Goods Administration has recently approved a testosterone skin cream for post- menopausal women experiencing sexual dysfunction, which has been shown to have no negative impacts on heart health. Prof Davis and the ETHEL team will conduct a randomized controlled pilot trial to measure the impacts of the skin cream on well-established indicators of heart function in women with asymptomatic heart failure.

If the findings are positive, this would justify larger, longer-term studies that could one day lead to changes in medical practice and massive reductions in disease burden and healthcare costs.

The women taking part in the study will be drawn from a pre-existing Baker Heart and Diabetes Institute study, VicELF, in which 52 per cent of participants are known to fit ETHEL inclusion criteria.

Prof Davis says, The ETHEL team is proud to be making this contribution to womens health, and thrilled that the study design and potential impact has been recognized by the Heart Foundation with the Ross Hohenen Award.

Its such important knowledge for us to have, and we thank the Heart Foundations many donors who make this and other heart-related research projects possible.

Click here for more news from theSchool of Public Health and Preventive Medicine.

About Monash University

Monash University is Australias largest university with more than 80,000 students. In the 60 years since its foundation, it has developed a reputation for world-leading high-impact research, quality teaching, and inspiring innovation.

With four campuses in Australia and a presence in Malaysia, China, India, Indonesia and Italy, it is one of the most internationalised Australian universities.

As a leading international medical research university with the largest medical faculty in Australia and integration with leading Australian teaching hospitals, we consistently rank in the top 50 universities worldwide for clinical, pre-clinical and health sciences.

For more news, visitMedicine, Nursing and Health Sciences orMonash University.

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New study to see whether a skin cream can prevent heart failure in women - Monash University

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